Perio Protect Advanced
Dye-free Doxycycline CALCIUM compound
50mg/5ml doxycycline calcium is administered via Perio Tray delivery to help suppress the inflammatory response and stabilize bone. Vibramycin® from Pfizer has been unavailable for years. A dye-free version that is compounded has a 120-day shelf life.
Short-Term Use (2-3 weeks)
for antioxidant/anti-inflammatory properties
Prescribe 15-30ml for initial weeks of tray delivery
Long-Term Use
(12+ months) for bone stabilization
Prescribe 60ml
Doxycycline calcium helps
Do not substitute the 50mg/5ml doxycycline calcium. Doxycycline monohydrate oral suspensions, once reconstituted, are only stable for 14 days, and they may contain sugar which can cause tooth or root decay. The dye-free doxycycline calcium compound is sweetened with sorbitol which is not absorbed within the gastrointestinal tract. The dye-free doxycycline calcium has a shelf life of 120 days.
Doxycycline calcium is used in a subclinical dose with Perio Gel® via Perio Tray delivery. It is not recommended to use doxycycline calcium alone in the Perio Tray. In controlled clinical trials, doxycycline calcium in the Perio Tray with 1.7% hydrogen peroxide gel (Perio Gel®, QNT Anderson LLC, Bismarck, ND) helped reduce inflammation.(4) The antibiotic did not help reduce probing depths more than the peroxide gel alone.
Administration: Place gel in a thin line or ribbon on the occlusal surface of the tray and evenly distribute up to 3 drops of doxycycline calcium throughout the tray.[i] (30ml averages 600 drops, providing 100 daily treatments.)
Contraindications: Avoid usage for patients considering orthodontics in the future.
Three drops of doxycycline calcium in a prescription tray is a sub-therapeutic dosage. Systemic antibiotics have not been tested in combination with prescription tray usage and it is important to know that systemic doses have adverse reactions for patients who are on anticoagulant therapy and may require downward adjustments of their anticoagulant dosage.
The dye-free doxycycline calcium compound contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people. Please check Periostat in your PDR for additional information.
Doxycycline should not be prescribed for pregnant or nursing patients or for patients allergic to tetracyclines. A 500mg daily oral dose of Vitamin C is an alternative antioxidant to help manage oxidative stress. Vitamin C does not effectively control matrix metalloproteinases or osteogenic activity.
1. Keller DC, Carano A. Tetracycline effect on osteoclastic and osteoblastic activity. Gen Dent. 1995 Jan-Feb;43(1):60-3. PMID: 7758924.
2. Keller DC. How to Manage Oral Biofilm a case presentation. DPR. 2010 July.
3. Harasty L. Case study report DPS May-June 2022.
4. Putt M, Mallatt M, Messmann L, and Proskin H. A 6-month clinical investigation of custom tray application of peroxide gel with or without doxycycline as adjuncts to scaling and root planning for treatment of periodontitis. American Journal of Dentistry. 2014;27:273-284.
Other Advanced Protocols
Lichen Planus Protocol
Perio Tray™ sequential administration of
At this frequency:
Patients may need to continue longer with the topical steroid or change to another steroid. Lidex does not uniformly work for all patients. See White Paper A Novel Approach for the Treatment of Desquamative Gingivitis by Dr. Robin Henderson
Fluoride Protocol
CariFree 1100 (.24% sodium fluoride)
Prevident Gel (1.1% sodium fluoride)
MI Paste (.20% sodium fluoride)
Caries:
Chronic Sensitivity:
Pharmacies and Rx Forms for Dye-Free Doxycycline Calcium Syrup (by state)
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