ATRIDOX® (doxycycline hyclate) 10%

Part #: T10629


The following documents are relevant to Atridox and are available for download in PDF Format.

You will need the Adobe Acrobat Reader to view these Files

For the Treatment of Chronic Adult Periodontitis
ATRIDOX® (doxycycline hyclate) 10% is a major advancement in the treatment of periodontal disease. It is a locally applied antibiotic (LAA) that is placed gently below the gum line into periodontal pockets where bacteria thrive and cause infection.

ATRIDOX® is the only locally applied antibiotic gel that flows deeply into infected pockets.

  • Flows freely and easily to the bottom of the pocket and adapts to root morphology
  • Controlled release of doxycycline for a period of 21 days1
  • Bioabsorbability eliminates need for removal
  • Allows precise placement for targeted therapy
  • Single syringe effectively treats multiple infected pockets/sites

ATRIDOX® is the only LAA that is clinically proven to achieve all three of the following outcomes in treating chronic adult peridontitis.

  • Gain in clinical attachment2
  • Reduction in probing depths2
  • Reduction of bleeding on probing3

Only ATRIDOX® delivers unbeatable economics.

  • One low, fixed treatment cost per patient – no variable costs per site treated
  • Increase patient acceptance – keep patient fees affordable
  • Increase your standard of care – one low-cost syringe treats eight to 14 sites

ATRIDOX® is an easy-to-use gel that is applied with a syringe into the infected tooth pocket. ATRIDOX® flows to the bottom of pockets and fills even the smallest spaces between teeth and gums. After ATRIDOX® is applied, it hardens upon contact with oral fluids (saliva) to a wax-like substance, and the antibiotic is slowly released into the surrounding infected tooth pocket.

ATRIDOX® Product Insert: 
Click here to download the U.S. Version  | Click here to download the Canadian Version

In clinical studies, ATRIDOX® was generally well-tolerated. Side effects were similar to those of placebo. The most common side effects were: headache, common cold, gum discomfort, pain or soreness, toothache and tooth sensitivity. ATRIDOX® should not be used by patients who are hypersensitive to doxycycline or any other drugs in the tetracycline class. The use of drugs in the tetracycline class during tooth development may cause permanent discoloration of the teeth. Tetracycline drugs, therefore, should not be used in pregnant women, unless other drugs are not likely to be effective or are contraindicated.

You are encouraged to report negative side effects of prescription drugs to the FDA. call 1-800-FDA-1088.

Clinical Studies

Promotes Clinical Attachment Gain2

ATRIDOX® is clinically proven to increase clinical attachment when compared to scaling and root planing, oral hygiene or placebo.

The clinical attachment gain after nine months is 0.8 mm.

Reduction in Probing Depth2

When compared to oral hygiene, or placebo, ATRIDOX® reduced probing depth caused by periodontitis. After nine months, ATRIDOX® reduced the probing depth by 1.2 mm.

Reduces Bleeding Upon Probing

ATRIDOX® was more effective than oral hygiene and placebo in reducing gum bleeding upon probing.2, 5

ATRIDOX® maintains sustained reduction of red complex bacteria over six months4

ATRIDOX® significantly reduced two of the most prevalent pathogens associated with periodontal disease, P. gingivalis and T. forsythia.

ATRIDOX® is shown to significantly reduce red complex bacteria in patients who smoke6

At three months, ATRIDOX® plus scaling and root planing substantially reduced P. gingivalis and T. forsythia.

P. gingivalis and T. forsythia combined were reduced by 82 percent compared to 33 percent for scaling and root planing alone.

ATRIDOX® demonstrated a 45 percent reduction in probing depth in smokers with pockets > 7 mm7

Chart compares probing depth reduction at six months after scaling and root planing alone versus ATRIDOX® plus scaling and root planing.


How to Use

Download a PDF of these instructions. U.S. Version  |  Canadian Version

ATRIDOX® Package Contents

  • 1 syringe with liquid polymer
  • 1 syringe with doxycycline hyclate powder
  • 1 sterile blunt cannula


  • When removing caps, hold syringes with the nozzles upright to avoid spilling before coupling.

Preparation: Step 1

  • Twist and lock syringe A containing liquid polymer with syringe B containing doxycycline powder.
  • Inject contents of syringe A into syringe B and then push contents back into syringe A. Mix syringes back and forth 100 times (about 1 ½ minutes). The contents must be in syringe A (indicated by red stripe) when finished.

Preparation: Step 2

  • Hold the coupled syringes vertically with syringe A at bottom. Pull back on syringe A plunger and allow contents to flow down the barrel for several seconds.

  • Uncouple the two syringes and attach blunt cannula to syringe A.

Administration: Step 1

  • Attach blunt cannula as directed.
  • After attaching blunt cannula as directed, bend cannula to resemble a periodontal probe.


Administration: Step 2

  • Keep cannula tip near pocket base.
  • Fill the majority of the pocket with ATRIDOX® while withdrawing the cannula tip from the pocket.
  • Withdraw cannula tip from pocket.
  • To separate ATRIDOX® from cannula, turn tip toward tooth, press tip against tooth surface and pinch string of formulation against tooth to break off.
  • For a clean separation of the cannula from ATRIDOX® in the pocket, consider using a moistened dental hand instrument to ensure proper placement.


Administration: Step 3

  • If necessary, add more ATRIDOX® and pack into pocket until pocket is full.
  • You are now ready to move to the next pocket.
  • It is not necessary to remove ATRIDOX® from the pocket. It will absorb completely.

Instructional Videos

ATRIDOX®  in Soft Tissue Management In Treating Chronic Adult Periodontitis

ATRIDOX® plays an important role for the dental professional in Soft Tissue Management®.

As the DenMat product designed to treat chronic adult periodontitis, ATRIDOX® helps dental professionals tackle the disease and put it in reverse.

By incorporating this clinically proven antimicrobial within an oral-care program in the dental office, patients will appreciate improved comfort while the dental practice experiences improved patient outcomes.

Insurance Information

ATRIDOX® Reimbursement Guide

Example Claim Narrative

Example Claim Rebuttal Narrative

Insurance Claims Submission for Treatment Using ATRIDOX®

  • Indication for treatment: chronic adult periodontitis
  • Procedure code: D4381
  • CDT-2011/2012 description: Localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth, by report.
  • Use: to report treatment with ATRIDOX®
  • When: possibly on same visit as periodontal maintenance D4910

Initial/Definitive Treatment: Guidelines for New Patients

Treatment type: newly diagnosed chronic adult periodontitis patient

Procedure code: D4381

CDT descriptor: Localized delivery of chemotherapeutic agents via a controlled release vehicle into diseased crevicular tissue, per tooth, by report.

When to use D4381:
1) Following evaluation after mechanical and surgical procedures (i.e. scaling and root planing, flap surgery, etc.); pockets > 5mm that demonstrate bleeding on gentle probing; scaling and root planing completed prior to ATRIDOX® administration
2) During routine periodontal maintenance visits
3) Uncommon situations (i.e. pre-existing medical condition) with detailed documentation

How to use:

  • Report each tooth or site separately on the claim form. For each tooth provide the tooth number, procedure code, date of treatment and fee per tooth.
  • Attach a detailed narrative report to support the claim.
  • Additional information that may be helpful in developing your report can be found in the ATRIDOX® package insert.

NOTE: the D4381 procedure code permits the filing of a separate charge for each tooth being treated with ATRIDOX®. The fee for ATRIDOX® therapy should be per tooth.
D4381 is a procedure code that by definition is covered on a “by report” basis. Review of the claim by a dental claims examiner is likely. Therefore, it is important to support the decision to treat the patient in this manner with sufficient and legible clinical information.

Back to Top

Maintenance Recall Treatment: Guidelines for Maintenance Patient

Treatment type: maintenance patient

Procedure codes: D4910 plus D4381

CDT descriptor:

  • D4910: Periodontal maintenance procedures following active therapy.
  • D4381: Localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth, by report.

When to use D4910 plus D4381:
1) During the maintenance appointment following scaling and root planing
2) After the completion of surgical or other definitive periodontal treatment therapies
3) During the same visit as periodontal maintenance

How to use:

  • Complete the periodontal maintenance procedure including: the removal of subgingival and supragingival plaque and calculus using an ultrasonic instrument, a periodontal evaluation, and a review of the patient’s plaque control efficiency. Treat new or recurring periodontal disease (sites > 5mm and BoP) with ATRIDOX®.
  • Report this procedure on the claim form using code D4910. Report each tooth separately on the claim form. For each tooth provide the tooth number, procedure code D4381, date of treatment and fee per tooth.
  • Attach a detailed narrative report (including pre- and post-therapy periodontal charting of the re-treated sites) to support the claim.

Disclaimer: The reimbursement information contained here is provided to help you understand the reimbursement process. It is intended to assist providers in accurately obtaining reimbursement for dental health care services. It is not intended to increase or maximize reimbursement by any payer. We strongly suggest that you consult your payer organization with regard to local reimbursement policies. The information contained here is provided for information purposes only and represents no statement, promise or guarantee by DenMat, Inc., concerning reimbursement, payment or charge. Similarly, all CDT, CPT/HCPCS and ICD-9 codes are supplied for information purposes only and represent no statement, promise or guarantee by DenMat that these codes will be appropriate or that reimbursement will be made.

Scroll to top