{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:31:07Z","timestamp":1787027467158,"version":"build-2736575974"},"reference-count":52,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Company Bredent GmbH (Senden, Germany)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>We evaluated, in this study, the clinical, microbiological and immunological effects of local drug delivery (LDD) or photodynamic therapy (PDT), adjunctive to subgingival instrumentation (SI) in persistent or recurrent periodontal pockets in patients enrolled in supportive periodontal therapy (SPT) after one year. A total of 105 patients enrolled in SPT with persistent\/recurrent pockets were randomly treated with SI +PDT or SI + LDD or SI (control). The number of treated sites with bleeding on probing (n BOP+), probing pocket depths (PPD), clinical attachment level (CAL), full-mouth plaque and bleeding scores (gingival bleeding index, %bleeding on probing-BOP) was evaluated at baseline and after 12 months. Additionally, eight periodontopathogens and the immunomarkers IL-1\u03b2 (interleukin)and MMP-8 (matrix metalloprotease) were quantitatively determined using real-time PCR and ELISA, respectively. All three treatments resulted in statistically significant clinical improvements (p &lt; 0.05) without statistically significant intergroup differences (p &gt; 0.05), which were maintained up to 12 months. The presence of BOP negatively affected the PPD and CAL. Moreover, statistically significantly fewer bleeding sites at 12 months were observed in the test groups (p = 0.049). Several periodontopathogens were reduced after 12 months. In conclusion, the present data indicate that in periodontal patients enrolled in SPT, treatment of persistent\/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical, microbiological and immunological improvements, which are maintained up to 12 months. Secondly, the presence of BOP directly impacts the PPD and CAL.<\/jats:p>","DOI":"10.3390\/antibiotics11060738","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:25:12Z","timestamp":1653956712000},"page":"738","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["One-Year Clinical, Microbiological and Immunological Results of Local Doxycycline or Antimicrobial Photodynamic Therapy for Recurrent\/Persisting Periodontal Pockets: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"11","author":[{"given":"Raluca","family":"Cosgarea","sequence":"first","affiliation":[{"name":"Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany"},{"name":"Clinic for Periodontology and Peri-Implant Diseases, Philipps University Marburg, 35033 Marburg, Germany"},{"name":"Department of Prosthodontics, Iuliu Hatieganu University Cluj-Napoca, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph A.","family":"Ramseier","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Jepsen","sequence":"additional","affiliation":[{"name":"Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1453-0697","authenticated-orcid":false,"given":"Nicole Birgit","family":"Arweiler","sequence":"additional","affiliation":[{"name":"Clinic for Periodontology and Peri-Implant Diseases, Philipps University Marburg, 35033 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-6984","authenticated-orcid":false,"given":"Pia Merete","family":"Jerv\u00f8e-Storm","sequence":"additional","affiliation":[{"name":"Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ionela","family":"Batori-Andronescu","sequence":"additional","affiliation":[{"name":"Department, Periodontal Private Practice Cosmedica, 400185 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"R\u00f6\u00dfler","sequence":"additional","affiliation":[{"name":"University for Digital Technologies in Medicine and Dentistry, 9516 Wiltz, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Conrad","sequence":"additional","affiliation":[{"name":"University for Digital Technologies in Medicine and Dentistry, 9516 Wiltz, Luxembourg"},{"name":"Clinic for Mouth, Jaw and Plastic Facesurgery, University of Frankfurt, 6059 Frankfurt, Germany"},{"name":"Private Practice, 55411 Bingen am Rhein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4619-2461","authenticated-orcid":false,"given":"Sigrun","family":"Eick","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-5477","authenticated-orcid":false,"given":"Anton","family":"Sculean","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jcpe.13290","article-title":"Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline","volume":"47","author":"Sanz","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1902\/jop.2003.74.9.1395","article-title":"Position paper: Periodontal maintenance","volume":"74","author":"Cohen","year":"2003","journal-title":"J. Periodontol."},{"key":"ref_3","first-page":"7","article-title":"Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT)","volume":"1","author":"Lang","year":"2003","journal-title":"Oral Health Prev. Dent."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1111\/j.1600-051X.2008.01245.x","article-title":"Influence of residual pockets on progression of periodontitis and tooth loss: Results after 11 years of maintenance","volume":"35","author":"Matuliene","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/j.1600-051X.2010.01587.x","article-title":"Predictors of tooth loss during long-term periodontal maintenance: A systematic review of observational studies","volume":"37","author":"Chambrone","year":"2010","journal-title":"J. Clin. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1034\/j.1600-051X.29.s3.9.x","article-title":"Supportive periodontal care: The effect of periodic subgingival debridement compared with supragingival prophylaxis with respect to clinical outcomes","volume":"29","author":"Heasman","year":"2002","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S221","DOI":"10.1111\/jcpe.12339","article-title":"Effect of professional mechanical plaque removal performed on a long-term, routine basis in the secondary prevention of periodontitis: A systematic review","volume":"42","author":"Trombelli","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1902\/jop.2008.070515","article-title":"Locally delivered doxycycline during supportive periodontal therapy: A 3-year study","volume":"79","author":"Bogren","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s10103-012-1159-3","article-title":"The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: A randomized controlled clinical trial","volume":"28","author":"Campos","year":"2013","journal-title":"Lasers Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s10103-008-0565-z","article-title":"Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: A randomized controlled clinical trial","volume":"24","author":"Chondros","year":"2009","journal-title":"Lasers Med. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/j.1600-051X.2009.01414.x","article-title":"Supportive periodontal therapy of furcation sites: Non-surgical instrumentation with or without topical doxycycline","volume":"36","author":"Dannewitz","year":"2009","journal-title":"J. Clin. Periodontol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1902\/jop.2014.130559","article-title":"Photodynamic therapy during supportive periodontal care: Clinical, microbiologic, immunoinflammatory, and patient-centered performance in a split-mouth randomized clinical trial","volume":"85","author":"Kolbe","year":"2014","journal-title":"J. Periodontol."},{"key":"ref_13","first-page":"CD009376","article-title":"Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis","volume":"1","author":"Manresa","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s10103-002-0243-5","article-title":"Bactericidal effects of different laser wavelengths on periodontopathic germs in photodynamic therapy","volume":"18","author":"Chan","year":"2003","journal-title":"Lasers Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1093\/jnci\/90.12.889","article-title":"Photodynamic therapy","volume":"90","author":"Dougherty","year":"1998","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1600-0765.1993.tb01070.x","article-title":"Lethal photosensitization of bacteria in subgingival plaque from patients with chronic periodontitis","volume":"28","author":"Sarkar","year":"1993","journal-title":"J. Periodontal. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1600-0757.2010.00346.x","article-title":"Photodynamic therapy in the control of oral biofilms","volume":"55","author":"Soukos","year":"2011","journal-title":"Periodontol. 2000"},{"key":"ref_18","first-page":"427","article-title":"\u00dcber die Wirkung der photodynamischen (fluorescierenden) Stoffe auf Protozoen und Enzyme","volume":"39","year":"1904","journal-title":"Dtsch. Arch. Klin. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/0003-9969(92)90058-G","article-title":"Sensitization of oral bacteria in biofilms to killing by light from a low-power laser","volume":"37","author":"Dobson","year":"1992","journal-title":"Arch. Oral Biol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1902\/jop.2004.75.10.1343","article-title":"Killing of periodontopathogenic bacteria by photodynamic therapy","volume":"75","author":"Pfitzner","year":"2004","journal-title":"J. Periodontol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF01570963","article-title":"Sensitization of oral bacteria to killing by low-power laser radiation","volume":"25","author":"Wilson","year":"1992","journal-title":"Curr. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/jcpe.12121","article-title":"Photodynamic therapy in the treatment of class II furcation: A randomized controlled clinical trial","volume":"40","author":"Luchesi","year":"2013","journal-title":"J. Clin. Periodontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s10103-011-0942-x","article-title":"Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up","volume":"27","author":"Theodoro","year":"2012","journal-title":"Lasers Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1007\/s00784-014-1193-6","article-title":"Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole","volume":"18","author":"Arweiler","year":"2014","journal-title":"Clin. Oral Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s10103-009-0744-6","article-title":"Photodynamic therapy as an adjunctive treatment for chronic periodontitis: A meta-analysis","volume":"25","author":"Atieh","year":"2010","journal-title":"Lasers Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1902\/jop.2009.090285","article-title":"The effect of photodynamic therapy for periodontitis: A systematic review and meta-analysis","volume":"81","author":"Azarpazhooh","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/jcpe.13236","article-title":"Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis: A systematic review and meta-analysis","volume":"47","author":"Salvi","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s10103-012-1181-5","article-title":"Effectiveness of diode laser as adjunctive therapy to scaling root planning in the treatment of chronic periodontitis: A meta-analysis","volume":"28","author":"Sgolastra","year":"2013","journal-title":"Lasers Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1177\/154405910708600803","article-title":"Photodynamic therapy in dentistry","volume":"86","author":"Konopka","year":"2007","journal-title":"J. Dent. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1159\/000510189","article-title":"Effectiveness of Photodynamic Therapy in the Treatment of Periodontal and Peri-Implant Diseases","volume":"29","author":"Sculean","year":"2021","journal-title":"Monogr. Oral Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1902\/jop.2005.76.8.1227","article-title":"Impact of local adjuncts to scaling and root planing in periodontal disease therapy: A systematic review","volume":"76","author":"Bonito","year":"2005","journal-title":"J. Periodontol."},{"key":"ref_32","first-page":"341","article-title":"Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: A single blind randomized controlled two-center study","volume":"18","author":"Eickholz","year":"2005","journal-title":"Am. J. Dent."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1007\/s00784-016-2018-6","article-title":"Antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: A controlled randomized clinical trial","volume":"21","author":"Tabenski","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/clr.12155","article-title":"Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized controlled clinical trial","volume":"25","author":"Bassetti","year":"2014","journal-title":"Clin. Oral Implants Res."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Cosgarea, R., Eick, S., Batori-Andronescu, I., Jepsen, S., Arweiler, N.B., Rossler, R., Conrad, T., Ramseier, C.A., and Sculean, A. (2021). Clinical and Microbiological Evaluation of Local Doxycycline and Antimicrobial Photodynamic Therapy during Supportive Periodontal Therapy: A Randomized Clinical Trial. Antibiotics, 10.","DOI":"10.3390\/antibiotics10030277"},{"key":"ref_36","first-page":"229","article-title":"Problems and proposals for recording gingivitis and plaque","volume":"25","author":"Ainamo","year":"1975","journal-title":"Int. Dent. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1902\/jop.1972.43.1.38","article-title":"The plaque control record","volume":"43","author":"Drake","year":"1972","journal-title":"J. Periodontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/jcpe.13269","article-title":"Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy: A systematic review and meta-analysis","volume":"47","author":"Trombelli","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/jcpe.12393","article-title":"Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: A randomized controlled clinical trial","volume":"42","author":"Carvalho","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/j.1600-051X.2007.01114.x","article-title":"Efficacy of sub-antimicrobial dose doxycycline in post-menopausal women: Clinical outcomes","volume":"34","author":"Reinhardt","year":"2007","journal-title":"J. Clin. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1600-051X.2009.01432.x","article-title":"One-year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: A proof-of-principle randomized-controlled clinical trial","volume":"36","author":"Lulic","year":"2009","journal-title":"J. Clin. Periodontol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1902\/jop.2016.150551","article-title":"Local Minocycline Effect on Inflammation and Clinical Attachment During Periodontal Maintenance: Randomized Clinical Trial","volume":"87","author":"Killeen","year":"2016","journal-title":"J. Periodontol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1902\/jop.2010.100308","article-title":"Locally delivered doxycycline as an adjunct to mechanical debridement at retreatment of periodontal pockets: Outcome at furcation sites","volume":"82","author":"Tomasi","year":"2011","journal-title":"J. Periodontol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/j.1600-051X.2012.01864.x","article-title":"Effects of a single topical doxycycline administration adjunctive to mechanical debridement in patients with persistent\/recurrent periodontitis but acceptable oral hygiene during supportive periodontal therapy","volume":"39","author":"Tonetti","year":"2012","journal-title":"J. Clin. Periodontol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1902\/jop.2000.71.1.22","article-title":"The effect of locally delivered controlled-release doxycycline or scaling and root planing on periodontal maintenance patients over 9 months","volume":"71","author":"Garrett","year":"2000","journal-title":"J. Periodontol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1902\/jop.2007.070189","article-title":"Microbiologic changes following administration of locally delivered doxycycline in smokers: A 15-month follow-up","volume":"78","author":"Shaddox","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10103-013-1337-y","article-title":"Single or repeated antimicrobial photodynamic therapy as adjunct to ultrasonic debridement in residual periodontal pockets: Clinical, microbiological, and local biological effects","volume":"30","author":"Giannopoulou","year":"2015","journal-title":"Lasers Med. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1007\/s00784-009-0347-4","article-title":"Photodynamic therapy of persistent pockets in maintenance patients-a clinical study","volume":"14","author":"Ruhling","year":"2010","journal-title":"Clin. Oral Investig."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Scribante, A., Butera, A., and Alovisi, M. (2022). Customized Minimally Invasive Protocols for the Clinical and Microbiological Management of the Oral Microbiota. Microorganisms, 10.","DOI":"10.3390\/microorganisms10040675"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/j.1600-051X.1995.tb00139.x","article-title":"Effect of cigarette smoking on periodontal healing following GTR in infrabony defects. A preliminary retrospective study","volume":"22","author":"Tonetti","year":"1995","journal-title":"J. Clin. Periodontol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"16322","DOI":"10.1038\/s41598-020-73054-8","article-title":"Microbiological and host-derived biomarker evaluation following non-surgical periodontal therapy with short-term administration of systemic antimicrobials: Secondary outcomes of an RCT","volume":"10","author":"Cosgarea","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/j.1600-0501.2004.01051.x","article-title":"Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: A pilot study","volume":"16","author":"Schwarz","year":"2005","journal-title":"Clin. Oral Implants Res."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/6\/738\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:22:15Z","timestamp":1760138535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/6\/738"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":52,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["antibiotics11060738"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11060738","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]}}}