The effect of 2% minocycline gel as an adjunct to scaling and root planing at the furcation area in supportive periodontal therapy

Main Article Content

Thipphayaphan Sathitthammaphon
Yosvimol Kuphasuk
Pirasut Rodanant


Objective: The aim of this study was to evaluate the clinical outcomes of 2% minocycline gel as an adjunct to scaling and root planing and compare them with scaling and root planing alone at the furcation area in treated periodontal patients during supportive periodontal therapy.

Materials and Methods: Patients entering supportive periodontal therapy who had 2 residual pockets equal to or greater than 5 mm at the contralateral side in the furcation area were recruited in a randomized, controlled, single-blinded study. A full-mouth examination comprising probing depth (PD), relative attachment level (RAL), bleeding on probing (BOP), gingival Index (GI), full mouth plaque index (PI), full mouth bleeding index (BI), and furcation involvement (FI) was performed at baseline, day 30 and day 90. The experiment protocol for the control sites was scaling and root planing (SRP) alone while that of the test sites was SRP and the administration of Periocline® at baseline and day 14.

Results: The full mouth PI and BI, RAL, PD, BOP-positive sites, and GI at the 1-month follow-up were improved in both treatment groups. At the 3-month follow-up, adding minocycline as an adjunctive treatment significantly improved RAL and PD. Furthermore, most teeth showed no progression in the degree of FI. In contrast, the SRP alone group demonstrated a relapse in the degree of furcation involvement more frequently than in the SRP along with minocycline group (18.52% vs 3.70%, respectively). However, the degree of furcation involvement was not significantly different among time points within each group and between groups.

Conclusion: Within the limitations of this study, local application of minocycline HCl 2% gel (Periocline®) as an adjunct to scaling and root planing in the furcation area demonstrated significant improvement in clinical parameters (RAL and PD) and reduced inflammation (BOP-positive sites) than scaling and root planing alone at the 3-month follow-up.


Download data is not yet available.

Article Details

How to Cite
Sathitthammaphon T, Kuphasuk Y, Rodanant P. The effect of 2% minocycline gel as an adjunct to scaling and root planing at the furcation area in supportive periodontal therapy. M Dent J [Internet]. 2023 Aug. 24 [cited 2023 Dec. 12];43(2):49-62. Available from:
Original articles


Kwon T, Lamster IB, Levin, L. Current concepts in the management of periodontitis. Int Dent J 2021.Dec;71(6):462-476. doi:10.1111/idj.12630.

Marsh PD, Zaura, E. Dental biofilm: ecological interactions in health and disease. J Clin Periodontol 2017; 44 (Suppl. 18): S12– S22. doi: 10.1111/jcpe.12679.

Socransky SS, Haffajee AD, Teles R, Wennstrom JL, Lindhe J, Bogren A, et al. Effect of periodontal therapy on the subgingival microbiota over a 2-year monitoring period. I. Overall effect and kinetics of change. J Clin Periodontol. 2013 Aug;40(8):771-780. doi: 10.1111/jcpe.12117.

Manresa C, Sanz-Miralles EC, Twigg J, Bravo M. Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis. Cochrane Database Syst Rev. 2018 Jan 1;1(1):CD009376. doi: 10.1002/14651858.CD009376.pub2.

Axelsson P, Lindhe J. The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol. 1981 Aug;8(4):281-294. doi: 10.1111/j.1600-051x.1981.tb02039.x.

Loos B, Claffey N, Egelberg J. Clinical and microbiological effects of root debridement in periodontal furcation pockets. J Clin Periodontol. 1988 Aug;15(7):453-463. doi: 10.1111/j.1600-051x.1988.tb01600.x.

Gher MW Jr, Dunlap RW. Linear variation of the root surface area of the maxillary first molar. J Periodontol. 1985 Jan;56(1):39-43. doi: 10.1902/jop.1985.56.1.39.

Bower RC. Furcation morphology relative to periodontal treatment. Furcation entrance architecture. J Periodontol. 1979 Jan;50(1):23-27. doi: 10.1902/jop.1979.50.1.23.

Nordland P, Garrett S, Kiger R, Vanooteghem R, Hutchens LH, Egelberg J. The effect of plaque control and root debridement in molar teeth. J Clin Periodontol. 1987 Apr;14(4):231-236. doi: 10.1111/j.1600-051x.1987.


Al-Shammari KF, Kazor CE, Wang HL. Molar root anatomy and management of furcation defects. J Clin Periodontol 2001:28(8);730-740.

Greenstein G, Tonetti M. The role of controlled drug delivery for periodontitis. The Research, Science and Therapy Committee of the American Academy of Periodontology. J Periodontol. 2000 Jan;71(1):125-140. doi: 10.1902/jop.2000.71.1.125.

Garcia Canas P, Khouly I, Sanz J, Loomer PM. Effectiveness of systemic antimicrobial therapy in combination with scaling and root planing in the treatment of periodontitis: a systematic review. J Am Dent Assoc. 2015 Mar;146(3):150-163. doi: 10.1016/j.adaj.2014.12.015.

Etienne D. Locally delivered antimicrobials for the treatment of chronic periodontitis. Oral Dis. 2003;9 Suppl 1:45-50. doi: 10.1034/j.1601-0825.9.s1.8.x.

Chatzopoulos GS, Koidou VP, Tsalikis L. Local drug delivery in the treatment of furcation defects in periodontitis: a systematic review. Clin Oral Invest 2023 Mar;27(3):955–970. doi:10.1007/s00784-023-04871-0

HR R, Dhamecha D, Jagwani S, Rao M, Jadhav K, Shaikh S, et al. Local drug delivery systems in the management of periodontitis: A scientific review. J Control Release. 2019 Aug;307:393-409. doi: 10.1016/j.jconrel.2019.06.038

Grossman TH. Tetracycline Antibiotics and Resistance. Cold Spring Harb Perspect Med. 2016 Apr;6(4):a025387. doi: 10.1101/cshperspect.a025387.

Garrido-Mesa N, Zarzuelo A, Gálvez J. Minocycline: far beyond an antibiotic. Br J Pharmacol. 2013 May;169(2):337-352. doi: 10.1111/bph.12139.

Bonito AJ, Lux L, Lohr KN. Impact of local adjuncts to scaling and root planing in periodontal disease therapy: a systematic review. J Periodontol. 2005 Aug;76(8):1227-1236. doi: 10.1902/jop.2005.76.8.1227.

Nakagawa T, Yamada S, Oosuka Y, Saito A, Hosaka Y, Ishikawa T, et al. Clinical and microbiological study of local minocycline delivery (Periocline) following scaling and root planing in recurrent periodontal pockets. Bull Tokyo Dent Coll. 1991 May;32(2):63-70.

Choi E, Um HS, Chang BS, Lee SY, Lee JK. Clinical and microbiological effects of adjunctive local delivery of minocycline (Periocline®) in patients receiving supportive periodontal therapy: a pilot study. J Periodontal Implant Sci. 2021 Feb;51(1):53-62. doi: 10.5051/jpis.2002720136.

Chackartchi T, Hamzani Y, Shapira L, Polak D. Effect of Subgingival Mechanical Debridement and Local Delivery of Chlorhexidine Gluconate Chip or Minocycline Hydrochloride Microspheres in Patients Enrolled in Supportive Periodontal Therapy: a Retrospective Analysis. Oral Health Prev Dent. 2019;17(2):167-171. doi: 10.3290/j.ohpd.a42375.

McColl E, Patel K, Dahlen G, Tonetti M, Graziani F, Suvan J, et al. Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12 month randomized, controlled, single masked pilot study. J Clin Periodontol. 2006 Feb;33(2):141-150. doi: 10.1111/j.1600-051X.2005.00879.x.

Stelzel M, Florès-de-Jacoby L. Topical metronidazole application compared with subgingival scaling. A clinical and microbiological study on recall patients. J Clin Periodontol. 1996 Jan;23(1):24-9. doi: 10.1111/j.1600-051x.1996.tb00500.x.

Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol. 2018 Jun;45Suppl20:S149-S161. doi: 10.1111/jcpe.12945.

Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975 Dec;25(4):229-235.

Löe H, Silness J. Periodontal disease in pregnancy I.prevalence and severity. Acta Odontol Scand. 1963 Dec;21:533-551. doi: 10.3109/00016356309011240.

O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972 Jan;43(1):38. doi: 10.1902/jop.1972.43.1.38.

Hamp SE, Nyman S, Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol. 1975 Aug;2(3):126-135. doi: 10.1111/j.1600-051x.1975.tb01734.x.

Villedieu A, Diaz-Torres ML, Hunt N, McNab R, Spratt DA, Wilson M, et al. Prevalence of tetracycline resistance genes in oral bacteria. Antimicrob Agents Chemother. 2003 Mar;47(3):878-882. doi:10.1128/aac.47.3.878-882.2003

Kang Y, Sun B, Chen Y, Lou Y, Zheng M, Li Z. Dental plaque microbial resistomes of periodontal health and disease and their changes after scaling and root planing therapy. mSphere. 2021 Aug 25;6(4):e0016221. doi: 10.1128/mSphere.00162-21.

Almeida VSM, Azevedo J, Leal HF, Queiroz ATL, da Silva Filho HP, Reis JN. Bacterial diversity and prevalence of antibiotic resistance genes in the oral microbiome. PLoS One. 2020 Sep;15(9):e0239664. doi: 10.1371/journal.pone.0239664.

Loos B, Claffey N, Crigger M. Effects of oral hygiene measures on clinical and microbiological parameters of periodontal disease. J Clin Periodontol. 1988 Apr;15(4):211-216. doi: 10.1111/j.1600-051x.1988.tb01572.x.

Sreenivasan PK, Prasad KVV, Javali SB. Oral health practices and prevalence of dental plaque and gingivitis among Indian adults. Clin Exp Dent Res. 2016 Jan 28;2(1):6-17. doi: 10.1002/cre2.15.

Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Periodontol. 1990 Nov;17(10):714-721. doi: 10.1111/j.1600-051x.1990.tb01059.x.

Pang T, Wang J, Benicky J, Saavedra JM. Minocycline ameliorates LPS-induced inflammation in human monocytes by novel mechanisms including LOX-1, Nur77 and LITAF inhibition. Biochim Biophys Acta. 2012 Apr;1820(4):503-510. doi: 10.1016/j.bbagen.2012.01.011.

Bahrami F, Morris DL, Pourgholami MH. Tetracyclines: drugs with huge therapeutic potential. Mini Rev Med Chem. 2012 Jan;12(1):44-52. doi: 10.2174/138955712798868977.

Holmes SG, Still K, Buttle DJ, Bishop NJ, Grabowski PS. Chemically modified tetracyclines act through multiple mechanisms directly on osteoclast precursors. Bone. 2004 Aug;35(2):471-478. doi:10.1016/j.bone.2004.02.028.

Tomasi C, Wennström JL. Locally delivered doxycycline as an adjunct to mechanical debridement at retreatment of periodontal pockets: outcome at furcation sites. J Periodontol. 2011 Feb;82(2):210-218. doi: 10.1902/jop.2010.100308.

Dannewitz B, Lippert K, Lang NP, Tonetti MS, Eickholz P. Supportive periodontal therapy of furcation sites: non-surgical instrumentation with or without topical doxycycline. J Clin Periodontol. 2009 Jun;36(6):514-522. doi: 10.1111/j.1600-051X.2009.01414.x.