Role of Periodontal Therapy Plus Sodium Doxycycline in the Management of Desquamative Gingivitis: A Pilot Study †
by
Mario Carbone
*, 
Veronica Avolio
,
Marco Cabras
,
Paola Carcieri
,
Paolo Giacomo Arduino
and
Roberto Broccoletti
Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, 10126 Turin, Italy
*
Author to whom correspondence should be addressed.
†
Presented at the XV National and III International Congress of the Italian Society of Oral Pathology and Medicine (SIPMO), Bari, Italy, 17–19 October 2019.
Proceedings 2019, 35(1), 19; https://doi.org/10.3390/proceedings2019035019
Published: 11 December 2019
(This article belongs to the Proceedings of The XV National and III International Congress of the Italian Society of Oral Pathology and Medicine)
1. Aim
Desquamative gingivitis (DG) is a clinical representation of many autoimmune diseases, presenting with erythema, shedding and ulceration of free and attached gingiva. In the last decade, evidence suggested that DG could play a role in increasing the long-term risk for periodontal tissue breakdown, leading to the inclusion of periodontal therapies as additional treatment for DG patients [1]. Topical doxycycline gel has been tested successfully as additional option to scaling and root planing (SRP), triggering the reduction of periodontal pathogens [2]. Aim of the present work was to assess the role of 14% doxycycline gel (Ligosan®, Dental Trey, Turin, Italy) as an additional tool to non-surgical periodontal treatment on patients affected by Oral Lichen Planus (OLP)-related DG, and active periodontitis.
2. Methods
Patients referred to the Department of Oral Medicine, CIR Dental School, Turin, were enrolled. Inclusion criteria were: symptomatic DG, caused by histologically confirmed OLP, and active periodontitis, with at least three periodontal intraosseous defects of 5 mm or more. The eligible patients were randomly assigned either to “cases”, where Ligosan® was administered with SRP, or to “controls”, undergoing SRP alone. Severity of DG and periodontitis were evaluated through the following parameters: visual analogue scale (VAS), full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and desquamative gingivitis clinical score (DGCS) [3]. Statistical analysis was performed through Wilcoxon and signed rank test. Table 1 shows the main characteristics of each therapeutic protocol.
3. Results
Ten patients were recruited: six cases (4 M; 2 F; mean age: 54 years old; range 48–84), and four controls (1 M; 3 F; mean age: 72 years old; range 64–74). Among cases, statistical analysis revealed a significant decrease of FMPS and FMBS (p < 0.05), a quasi-significant decrease of DGCS (p = 0.07), with no significant variations of VAS (p > 0.05), after treatment. Controls experienced no significant fluctuations for either of the aforesaid parameters (p > 0.05). When compared, only FMPS was significantly decreased in cases rather than controls (p < 0.05).
4. Conclusions
To our knowledge, this is the first attempt of experimenting the reliability of topical doxycycline in patients with DG and active periodontitis. The main limitation of this work relies in the very small sample of patients recruited. Ligosan® showed encouraging results in the reduction of DG severity, and improvement of the periodontal status. Further studies on larger samples could be useful to establish the consistency of these preliminary results.
Acknowledgments
The Authors would like to thank Dental Trey for providing free Ligosan® samples.
Conflicts of Interest
The Authors declare no conflict of interest. Dental Trey had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript.
References
- Guiglia, R.; Di Liberto, C.; Pizzo, G.; Picone, L.; Lo Muzio, L.; Gallo, P.D.; Campisi, G.; D’Angelo, M. A combined treatment regimen for desquamative gingivitis in patients with oral lichen planus. J. Oral Pathol. Med. 2007, 36, 110–116. [Google Scholar] [CrossRef] [PubMed]
- Ratka-Krüger, P.; Schacher, B.; Bürklin, T.; Böddinghaus, B.; Holle, R.; Renggli, H.H.; Eickholz, P.; Kim, T.S. Non-surgical periodontal therapy with adjunctive topical doxycycline: A double-masked, randomized, controlled multicenter study. II. Microbiological results. J. Periodontol. 2005, 76, 66–74. [Google Scholar] [CrossRef] [PubMed]
- Arduino, P.G.; Broccoletti, R.; Sciannameo, V.; Scully, C. A practical clinical recording system for cases of desquamative gingivitis. Br. J. Dermatol. 2017, 177, 299–301. [Google Scholar] [CrossRef] [PubMed]
Table 1.
Treatment designed for Cases and Controls.
| Timing | Cases | Controls |
|---|---|---|
| T0 | Anamnesis; oral examination and orthopantomography (OPT); photographic documentation; fulfilment of periodontal chart; evaluation of VAS, FMBS, FMPS, DGCS | Anamnesis; oral examination and orthopantomography (OPT); photographic documentation; fulfilment of periodontal chart; evaluation of VAS, FMBS, FMPS, DGCS |
| T1 (one week after T0) | Ultrasonic scaling; instructions for domiciliary oral hygiene; Chlorexidine 0.20% mouthrinse three times daily for one month | Ultrasonic scaling; instructions for domiciliary oral hygiene; Chlorexidine 0.20% mouthrinse three times daily for one month |
| T2 (one week after T1) | Root planing of maxillary teeth; reinforcement of motivation for oral hygiene | Root planing of maxillary teeth; reinforcement of motivation for oral hygiene |
| T3 (one week after T2) | Root planing of mandibular teeth; application of Ligosan® in the maxillary intraosseous pockets; no flossing and sole occlusal brushing for 7 days; soft diet for 3 days | Root planing of mandibular teeth; reinforcement of motivation for oral hygiene |
| T4 (one week after T3) | Application of Ligosan® in the mandibular intraosseous pockets; no flossing and sole occlusal brushing for 7 days; soft diet for 3 days | Conventional oral and radiographic (OPT) examination; photographic documentation; fulfilment of periodontal chart; re-evaluation of VAS, FMBS, FMPS, DGCS |
| T5 (eight weeks after T4) | conventional oral and radiographic (OPT) examination; photographic documentation; fulfilment of periodontal chart; re-evaluation of VAS, FMBS, FMPS, DGCS | / |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
MDPI and ACS Style
Carbone, M.; Avolio, V.; Cabras, M.; Carcieri, P.; Arduino, P.G.; Broccoletti, R. Role of Periodontal Therapy Plus Sodium Doxycycline in the Management of Desquamative Gingivitis: A Pilot Study. Proceedings 2019, 35, 19. https://doi.org/10.3390/proceedings2019035019
AMA Style
Carbone M, Avolio V, Cabras M, Carcieri P, Arduino PG, Broccoletti R. Role of Periodontal Therapy Plus Sodium Doxycycline in the Management of Desquamative Gingivitis: A Pilot Study. Proceedings. 2019; 35(1):19. https://doi.org/10.3390/proceedings2019035019
Chicago/Turabian StyleCarbone, Mario, Veronica Avolio, Marco Cabras, Paola Carcieri, Paolo Giacomo Arduino, and Roberto Broccoletti. 2019. "Role of Periodontal Therapy Plus Sodium Doxycycline in the Management of Desquamative Gingivitis: A Pilot Study" Proceedings 35, no. 1: 19. https://doi.org/10.3390/proceedings2019035019
