PGCEE MDS 2022: The host modulation therapy that may be used as adjunctive therapy for aggressive periodontitis is

 # The host modulation therapy that may be used as adjunctive therapy for aggressive periodontitis is:

a) Clindamycin

b) Metronidazole

c) Doxycycline

d) Ciprofloxacin

The correct answer is C. Doxycycline.

Host Modulatory Therapy (HMT) is a treatment concept that aims to reduce tissue destruction and stabilize or even regenerate the periodontium. Doxycycline hyclate is available as a 20mg capsule for use by patients twice daily. The mechanism of action is by suppression of the activity of collagenase, particularly that produced by PMNs. NSAIDs inhibit the formation of prostaglandins, including prostaglandin (PGE2). PGE2 is found to upregulate bone resorption by osteoclasts. Flurbiprofen, an NSAID, significantly inhibits radiographic alveolar bone loss compared to a placebo. A recent study suggested that concomitant administration of doxycycline and flurbiprofen may result in

enhancement of the anti collagenase effects of doxycycline. 

Subantimicrobial-dose doxycycline (SDD) may help to prevent the destruction of the periodontal attachment by controlling the activation of matrix metalloproteinases, primarily collagenase and gelatinase, from both infiltrating cells and resident cells of the periodontium, primarily the neutrophils.