{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:17:03Z","timestamp":1790731023856,"version":"4.1.0"},"reference-count":0,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,12,1]],"date-time":"2003-12-01T00:00:00Z","timestamp":1070236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Periodontol"],"published-print":{"date-parts":[[2003,12]]},"abstract":"\n Background:<\/jats:bold>\n The use of modulating agents, including inhibition of matrix metalloproteinases (MMPs) with antiproteinases, blocking production of proinflammatory cytokines and prostaglandins with antiinflammatory drugs, and inhibiting activation of osteoclasts with bone\u2010sparing agents, has been postulated to be of therapeutic value as an adjunctive therapy to the management of chronic periodontitis.\n <\/jats:p>\n \n Rationale:<\/jats:bold>\n The objective of this systematic review of the literature was to assess the adjunctive efficacy of antiproteinase, anti\u2010inflammatory, and bone\u2010sparing host\u2010modulating agents in the treatment of gingivitis, aggressive periodontitis, and chronic periodontitis.\n \n Focused Questions<\/jats:title>\n \n In patients with periodontal diseases, what is the effect of host\u2010modulation agents, alone or combined with conventional therapy, compared to conventional therapy alone as assessed by clinical, radiographic, adverse, and patient\u2010centered outcomes?<\/jats:p>\n <\/jats:list-item>\n \n In patients with dental implants, what is the effect of host\u2010modulation agents on implant success assessed by clinical, radiographic, adverse, and patient\u2010centered outcomes?<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n \n Search Protocol:<\/jats:bold>\n MEDLINE, Embase, and the Cochrane Library databases were searched without language restrictions through April 1, 2002 for studies that used tetracycline (TET)\u2010related matrix metalloproteinase (MMP) inhibitors, or non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) and bisphosphonate anti\u2010osteolytic agents. The investigation also included hand searching of journals and contacting authors and industry experts.\n <\/jats:p>\n \n Selection Criteria<\/jats:bold>\n <\/jats:p>\n \n Inclusion criteria:<\/jats:bold>\n Only human studies (randomized controlled clinical trials, cohort studies, case\u2010control studies, cross\u2010sectional studies, and case series) were selected. Studies were on subjects with gingivitis, aggressive or chronic periodontitis, or dental implants. Interventions included TET\u2010related MMP inhibitors, NSAIDs, or bisphosphonate anti\u2010osteolytic agents.\n <\/jats:p>\n \n Exclusion criteria:<\/jats:bold>\n Studies that used MMP tissue inhibitors as diagnostic or prognostic indicators of periodontal disease or that evaluated short\u2010term systemic antibodies or locally delivered levels of drugs with antiproteinase activity were excluded.\n <\/jats:p>\n \n Data Collection and Analysis:<\/jats:bold>\n The primary outcomes for assessment were changes in bone or clinical attachment levels (CAL); secondary outcomes included clinical measures of plaque, gingival inflammation, probing depth (PD), and mobility. Summary data appropriate for meta\u2010analysis were pooled using a weighted average and analyzed using a standardized difference; the results were checked with both fixed\u2010effects and random\u2010effects models.\n \n Main Results<\/jats:title>\n \n A meta\u2010analysis done on the studies reporting changes in CAL and PD following administration of subantimicrobial doses of doxycycline (SDD) in conjunction with scaling and root planing (SRP) in patients with periodontitis showed a statistically significant beneficial adjunctive effect.<\/jats:p>\n <\/jats:list-item>\n \n There were insufficient data to provide meta\u2010analyses on periodontal patients treated with other hostmodulating agents; descriptive tables are included.<\/jats:p>\n <\/jats:list-item>\n \n NSAIDS show promise in their ability to slow periodontal disease.<\/jats:p>\n <\/jats:list-item>\n \n Preliminary data on bisphosphonate agents indicate there is a potential role for these agents in periodontitis management.<\/jats:p>\n <\/jats:list-item>\n \n There are a very limited number of studies on host\u2010modulating agents and dental implants and no analyses were possible.<\/jats:p>\n <\/jats:list-item>\n \n Because the treatment methodologies and clinical variables differed considerably among the studies, it is difficult to summarize the information and identify a reliable total patient population.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n \n Reviewers' Conclusions<\/jats:title>\n \n Large multi\u2010center trials are needed to evaluate the role of host\u2010modulating agents in the treatment of periodontitis.<\/jats:p>\n <\/jats:list-item>\n \n NSAIDS and bisphosphonate drugs may have a potential adjunctive role in periodontal therapy.<\/jats:p>\n <\/jats:list-item>\n \n The adjunctive use of SDD with SRP is statistically more effective than SRP alone in reducing PD and in achieving CAL gain<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n \n Ann Periodontol 2003;74:12\u201037.<\/jats:italic>\n <\/jats:p>","DOI":"10.1902\/annals.2003.8.1.12","type":"journal-article","created":{"date-parts":[[2005,2,2]],"date-time":"2005-02-02T05:54:22Z","timestamp":1107323662000},"page":"12-37","source":"Crossref","is-referenced-by-count":161,"title":["Periodontal Host Modulation with Antiproteinase, Anti\u2010Inflammatory, and Bone\u2010Sparing Agents. A Systematic Review"],"prefix":"10.1002","volume":"8","author":[{"given":"Michael S.","family":"Reddy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico C.","family":"Geurs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Gunsolley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,12]]},"container-title":["Annals of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1902\/annals.2003.8.1.12","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:30:21Z","timestamp":1762363821000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1902\/annals.2003.8.1.12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,12]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2003,12]]}},"alternative-id":["10.1902\/annals.2003.8.1.12"],"URL":"https:\/\/doi.org\/10.1902\/annals.2003.8.1.12","archive":["Portico"],"relation":{},"ISSN":["1553-0841","2162-5131"],"issn-type":[{"value":"1553-0841","type":"print"},{"value":"2162-5131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,12]]}}}