Scaling & Root Planing (Deep Cleaning)
When bacterial accumulations cause bone loss around the teeth, a diagnosis of periodontal disease is made. The bone loss creates periodontal pockets that are too deep to clean by routine oral hygiene methods and the usual supra-gingival cleaning does not allow enough time to get the deep pockets cleaned out. Scaling and root planing uses several appointments in conjunction with a local anesthetic to give the hygienist time to get deep below the gum line and clean the pockets while still insuring that the patient is comfortable.
Chemotherapeutic substances can be used either through local delivery directly in the periodontal pocket or systemically through oral use of antibiotics. In either case, we know that there must be a "lock-and-key" situation where the chemical has a potential action over the microorganism present in the periodontal pocket.
According to the American Academy of Periodontology, Periostat® is a systemically delivered collagenase inhibitor consisting of a 20-mg capsule of doxycycline hyclate for oral administration. This is the first FDA approved systemic drug for host modulation as an adjunct to scaling and root planing in the treatment of periodontitis. Periostat®, administered BID, reduced the elevated collagenase activity in the gingival fluid of patients with adult periodontitis.