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046_doxirobe_KL.qxd 4/2/02 4:44 PM Page 1 V E T E R I N A R Y M E D I C A L S E R V I C E S E X P L O R A T I O N S
i n V e t e r i n a r y M e d i c i n e
Treating Canine Periodontal Disease
with DOXIROBE™ Gel
Source Material: Zetner K, Rothmüller G. The treatment of periodontalpockets with the new perioceutic DOXIROBE. Praktischer Tierarzt. 2002;3:214-225.
T H E B I G P I C T U R E .
T H E P R O C E S S O F D I S C O V E R Y .
Since 1997, doxycycline polymer has been tested and applied in dogs to determine its efficacy and therapeutic value in treating and controlling • At both Week 6 and Week 12 after treatment, significantly less anaerobic This study is the most recent evaluation of the use of DOXIROBE and aerobic bacteria were harvested in treating dogs with periodontal disease. It demonstrated thatDOXIROBE, in combination with traditional subgingival curettage, from teeth treated with DOXIROBE™ was highly effective in reducing aerobic and anaerobic bacteria involved Gel (doxycycline) (P<0.01). in periodontal disease. The result is improvement in gingival health.
H O W T H E S T U D Y W A S C O N D U C T E D .
• Throughout the entire study period, Six beagle patients averaging 3.1 years of age and 13.75 kg or 30.25 lb were question
enrolled in the study. After pretreatment administration of ANTIROBE significantly different between treated (clindamycin hydrochloride), the patients received a professional tooth and control groups (P=0.001 to P=0.009). cleaning that included the removal of plaque and tooth scale, polishing of tooth surfaces, and curettage of the periodontal pockets.
• Application of DOXIROBE after The primary periodontal parameters — gingival crevicular fluid, gingival curettage provided better reduction of index, pocket depth, tooth attachment, and amount of subgingival plaque(colony forming units or CFU) — were measured and established as periodontal disease than curettage alone. baseline values. The periodontal pockets of 4 teeth (maxillary andmandibular left canines and 4th premolars) were filled with DOXIROBE(Figures 1 and 2 on the next page), while the curetted periodontal pocketsof 4 other teeth (maxillary and mandibular right canines and 4th premolars)served as the untreated control group. All periodontal parameters wereassessed again at 6 and 12 weeks after treatment.
046_doxirobe_KL.qxd 4/2/02 4:44 PM Page 2 W H A T W A S L E A R N E D .
The difference between groups was significant with regard to allparameters after 6 weeks as well as after 12 weeks.
• Amount of gingival crevicular fluid after 6 weeks: P=0.001, • Gingivitis index after 6 weeks: P=0.002, after 12 weeks: P=0.007 • Pocket depth after 6 weeks: P=0.001, after 12 weeks: P=0.005 Figure 1. After a professional tooth cleaning, DOXIROBE
is applied to the periodontal pockets of teeth in the treatment
• Attachment gain after 6 weeks: P=0.001, after 12 weeks: P=0.007 group. The product formulation is applied to the pockets When comparing the treatments of curettage only vs. curettage and filling with a blunt cannula and is allowed to solidify after a waiting of the periodontal pockets with DOXIROBE™ Gel, significantly less anaerobic and aerobic bacteria were harvested from the DOXIROBE- Photo courtesy of Prof. K. Zetner, Univ. Vet Med-Vienna.9 treated teeth at both Week 6 and Week 12 (P<0.01). See Tables 1 and 2.
T A L K I T O U T .
The results of the study are consistent with label indications forDOXIROBE. Several characteristics of doxycycline, the active ingredientin DOXIROBE, may help explain its efficacy.
• Doxycycline is a tetracycline derivative that has a wide range of antimicrobial activity against microorganisms.
Figure 2. After solidifying to a partially hardened, rubberized
• Doxycycline has been shown to maintain a long-lasting antibacterial form, DOXIROBE is pressed back into the periodontal effect in vitro after local contact with the cement or dentine surface.7 pocket with an appropriate packing instrument, such as a This is important, because recurrence of periodontopathic bacteria Teflon™-coated spatula, until the polymer no longer is visibleat the tooth surface.
is a considerable obstacle to successful periodontal therapy.
Photo courtesy of Prof. K. Zetner, Univ. Vet Med-Vienna.9 • Compared with tetracycline and minocycline, doxycycline was shown to have the highest anti-collagenase activity.8 This is importantbecause collagenases, which are produced by inflammatory cells,have been shown to damage periodontal tissue.
• The results of this paper are consistent with results of several other studies supporting the efficacy of doxycycline in treating periodontaldisease in dogs.1-6 During the weeks following treatment until the end of the study,none of the patients showed any adverse effect regarding feed intake,confirming the safety of DOXIROBE for canine use.
DOXIROBE should not be used in dogs less than 1 year of age,because the use of tetracycline during tooth development has beenassociated with permanent discoloring of teeth. It also should not beused in pregnant bitches, because use of the product in breeding dogshas not been evaluated.
046_doxirobe_KL.qxd 4/2/02 4:44 PM Page 3 Table 1. Impact of treatment with DOXIROBE™ Gel (doxycycline) on periodontal parameters.
The difference between the two groups was significant at both Weeks 6 and 12.
P value
P value
Gingivitis Index
With DOXIROBE
Gingival Fluid (penotron units)
With DOXIROBE
Pocket Depth (mm)
With DOXIROBE
Attachment Gain (mm)
With DOXIROBE
* The relative increase of the gingivitis index within the last 6 weeks despite a further reduction of gingival crevicular fluid may be due to statistical variations.
Table 2. Impact of treatment with DOXIROBE on subgingival plaque
Subgingival Plaque (CFU*)
P value
P value
With DOXIROBE
Anaerobes
With DOXIROBE
T H E F I N A L W O R D .
Application of DOXIROBE after curettage provides better reduction of periodontal disease than curettage alone.
046_doxirobe_KL.qxd 4/2/02 4:44 PM Page 4 R E F E R E N C E S .
1. Godowski KC, Emily PP, Levin J, Botz MI, Longhofer SL. Microbiological effects of subgingival administration of a sustained-release formulation of,doxycycline on naturally occurring periodontal disease in beagle dogs,in Proceedings. 11th Annual Veterinary Dental Forum, Denver, Colorado.
1997:153-155.
2. Emily PP, Levin J, Longhofer SL. Effects of subgingival administration of a sustained-release formulation of doxycycline on naturally occuringperiodontal disease in beagle dogs, in Proceedings. 5th World VeterinaryDental Congress, Birmingham, UK. 1997:48-53.
3. Longhofer SL, White JV, Godowski KC, Botz MT, Thornsberry C.
Antimicrobial sensitivity of microorganisms cultured from canine subgingival plaque, in Proceedings. 11th Veterinary Dental Forum,Denver, Colorado. 1997:150-152.
4. Cleland WP, Longhofer SL, White JV, Godowski KC, Emily PP.
Doxycycline for periodontal disease, in Proceedings. 10th Annual ScientificMeeting of the British Veterinary Dental Association, Birmingham, UK.
1998:16-20.
5. Haseler P, Johnston N, Robinson J, Sauvage J, Stroud, R. Efficacy of a doxycycline perioceutic in naturally occurring periodontal disease in dogs,in Proceedings. 10th Annual Scientific Meeting of the British VeterinaryDental Association, Birmingham, UK. 1998:47-53.
6. Polson AM, Southard GL, Dunn RL, Yewey GL, Godowski KC, Polson AP, et al. Periodontal pocket treatment in beagle dogs using subgingival doxycycline from a biodegradable system. J Periodont.
1996;67:1176-1184.
7. Demirel K, Baer PN, McNamara TF. Topical application of doxycycline on periodontally involved root surfaces in vitro: comparative analysis ofsubstantivity on cementum and dentin. J Periodont. 1991;62(5):312-316.
references8.Burns PR,Stack MS,Gray RD,Paterson CA.Inhibition ofpurified
collagenase from alkaline-burned rabbit corneas. Investigations intoOphthalmology and Visual Sciences. 1989;30:1569.
9. Zetner K. The treatment of periodontal pockets with the new perioceutic Doxirobe. Der praktische Tierarzt. 2002; 3:214-225.
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