Semester

Spring

Date of Graduation

2025

Document Type

Thesis (Campus Access)

Degree Type

MS

College

School of Dentistry

Department

Periodontics

Committee Chair

Arif Salman

Committee Co-Chair

Manali Vora

Committee Member

Manali Vora

Committee Member

Jennifer Franko

Abstract

Background: Scaling and root planing (SRP) is widely recognized as the gold standard non-surgical treatment for periodontitis. Minocycline, a semi-synthetic tetracycline derivative, is commercially marketed as Arestin®, offering substantivity. It remains active in periodontal pockets for 7–10 days and continues to release the drug for up to 14 days. With its dual mechanism of action—antibacterial effects and the ability to reduce tissue destruction—minocycline shows clinical promise as an adjunct to SRP. However, the supporting evidence remains varied and somewhat inconsistent.

Aim: The primary objective of this study was to assess the change in the proportion of sites with residual periodontal pocket depth (PD) of ≥5 mm in patients with periodontitis treated with scaling and root planing (SRP) alone versus SRP in combination with locally administered minocycline microspheres (MM, Arestin®).

Materials and Methods: This randomized clinical trial included patients diagnosed with periodontitis. The study involved four visits. At Visit 1, patients underwent enrollment, a comprehensive periodontal examination, and radiographic assessment. Visit 2, scheduled two weeks later, involved the removal of supragingival plaque and the collection of subgingival plaque samples from shallow (1-4 mm), moderately deep (5-6mm), and deep periodontal pocket sites (≥7 mm). At Visit 3, participants received treatment with either SRP alone or SRP in combination with minocycline microspheres (MM, Arestin®), based on random group allocation. Visit 4 occurred two months post-treatment and included subgingival plaque sampling from the same sites as Visit 2, followed by a periodontal examination.

Results: Thirty patient completed the study. Both groups showed significant improvements from baseline to 2-month follow-up. At the 2-month follow-up, the SRP + MM group demonstrated a 4.22% lower proportion of sites with residual PD ≥5 mm than the SRP group; however, this difference was not statistically significant (p = 0.09). Bleeding on probing (BOP) decreased by 20.13% in the SRP + MM group and 19.71% in the SRP group, with no significant difference between groups (p = 0.87). Notably, the SRP + MM group demonstrated a greater reduction in the proportion of sites with residual PD ≥5 mm and BOP compared to the SRP-only group.

Conclusion: Within the limitations of this study, the use of minocycline microspheres as an adjunct to scaling and root planing (SRP) demonstrated a potential added clinical benefit in the management of periodontitis. Further studies with larger sample sizes and longer follow-up periods are warranted to confirm these observations.

Available for download on Saturday, May 02, 2026

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