tetracycline and Furcation-Defects

Topics: Amputation, Surgical; Anti-Bacterial Agents; Anti-Infective Agents, Local; Dental Scaling; Furcation Defects; Humans; Metronidazole; Molar; Subgingival Curettage; Tetracycline; Tooth Root; Toothbrushing

The treatment of molar furcation defects remains a considerable challenge in clinical practice. The degree of success in the management of furcation involvement is highly variable and inversely related to initial probing depth (PD) measurements in these lesions. The identification of clinical measurements influential to the treatment outcomes is critical to optimize the results of surgical periodontal therapy. Therefore, the objective of this study was to evaluate the clinical response of mandibular buccal Class II furcation lesions to a combined regenerative treatment modality.. Sixty patients were divided into two (n = 30) treatment groups. An experimental combined regenerative therapy (ET) was compared to open flap debridement (OFD). The ET was a combination of a composite graft consisting of bioabsorbable hydroxyapatite and tetracycline (3:1), a guided tissue regeneration barrier, and a coronally advanced flap. The clinical variables evaluated were plaque, bleeding on probing, gingival recession, PD, vertical attachment level (VAL), horizontal attachment level (HAL), furcation vertical height, furcation horizontal depth, and the amount of tissue under the barrier membrane at uncovering. Reevaluation was performed 12 months after the surgical procedure.. Both treatments resulted in improvements in all clinical variables evaluated. Postoperative measurements revealed a reduction in PD of 3.65 +/- 0.6 mm and 0.60 +/- 1.0 mm; VAL gains of 3.05 +/- 0.6 mm and 0.65 +/- 0.6 mm and HAL gains of 3.45 +/- 1.3 mm and 0.55 +/- 0.7 mm in the ET and OFD groups, respectively. In the ET group, significant positive correlations were found between baseline PD and PD reduction at 12 months, and the initial VAL correlated positively with PD reduction and HAL gain. The horizontal furcation depth and amount of tissue formed under the membrane at uncovering correlated positively with PD reduction and HAL and VAL gains. For the OFD group, the initial PD correlated positively with PD reduction and VAL and HAL gains and correlated negatively with recession. Initial VAL correlated positively with PD reductions and VAL and HAL gains. The initial HAL correlated negatively with recession at 12 months.. ET exhibited significantly better clinical results, with more PD reduction, HAL and VAL gains, and a higher frequency of furcation closure compared to OFD and showed promise as a regenerative treatment technique. The ability to predict a response to treatment based upon pretreatment parameters was not consistent between groups; thus, prediction of treatment outcomes based on pretreatment measurements should be carefully evaluated for each treatment modality.

Topics: Absorbable Implants; Adult; Alveoloplasty; Anti-Bacterial Agents; Bone Regeneration; Bone Substitutes; Debridement; Dental Plaque Index; Durapatite; Female; Follow-Up Studies; Furcation Defects; Gingival Hemorrhage; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Male; Mandibular Diseases; Membranes, Artificial; Middle Aged; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Prospective Studies; Surgical Flaps; Tetracycline; Treatment Outcome

Class II furcations present difficult treatment problems and historically several treatment approaches to obtain furcation fill have been used.. The response of mandibular Class II facial furcations to treatment with either bioactive glass (PG) bone replacement graft material or expanded polytetrafluoroethylene (ePTFE) barrier membrane was evaluated in 27 pairs of mandibular molars in 27 patients with moderate to advanced periodontitis. Following initial preparation, full thickness flaps were raised in the area being treated, the bone and furcation defects debrided of granulomatous tissue, and the involved root surfaces mechanically prepared and chemically conditioned. By random allocation, PG or ePTFE was placed into or fitted over the furcations, packed or secured in place, and the host flap replaced or coronally positioned with sutures. Postsurgical deplaquing was performed every 10 days leading up to ePTFE removal at about 6 weeks. Continuing periodontal maintenance therapy was provided until surgical reentry at 6 months for documentation and any further necessary treatment.. Direct clinical measurements demonstrated essentially similar clinical results with both treatments for bone and soft tissue changes. There were no statistically or clinically significant differences (e.g., mean horizontal furcation fill 1.4 mm PG, 1.3 mm ePTFE; mean percent horizontal furcation fill 31.6% PG, 31.1% ePTFE, both P>0.85). Seventeen of the PG treated and 18 of the ePTFE furcations became Class I clinically and 1 furcation completely closed clinically with each treatment. Intrapatient comparisons showed similar horizontal furcation responses with both treatments.. The findings of this study suggest essentially equal clinical results with PG bone replacement graft material and e-PTFE barriers in mandibular molar Class II furcations. PG use was associated with simpler application and required no additional material removal procedures.

Topics: Adult; Aged; Analysis of Variance; Anti-Bacterial Agents; Bone Substitutes; Ceramics; Debridement; Dental Plaque; Female; Follow-Up Studies; Furcation Defects; Gingival Recession; Humans; Male; Mandible; Membranes, Artificial; Middle Aged; Molar; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Polytetrafluoroethylene; Statistics, Nonparametric; Surgical Flaps; Tetracycline; Tooth Root; Treatment Outcome

This article reports a successful clinical regimen of treatment for the Class II furcation defect. Twenty-eight patients with molar teeth demonstrating Class II furcations were treated with regenerative therapy with the goal of regenerating lost interradicular periodontium. The treatment selected included scaling and root planing, surgical flap design that would enable the flap to completely cover the surgical site, complete enucleation of granulation tissue, tetracycline root conditioning, a particulate autogenous bone graft, and an expanded polytetrafluoroethylene (e-PTFE) membrane. Of the twenty-eight consecutive patients treated, twenty-five demonstrated no postoperative clinical evidence of furcation invasion, for a success rate of 89%. Eleven sites were reopened 8 to 9 months postsurgical and presented complete furcation fill with a hard, bone-like tissue. Three teeth were judged to be failures because clinical assessment revealed persistent furcation invasion. The absence of histologic evidence precludes the presumption that complete periodontal regeneration occurred.

Topics: Anti-Bacterial Agents; Bone Regeneration; Bone Transplantation; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Membranes, Artificial; Polytetrafluoroethylene; Subgingival Curettage; Tetracycline; Tooth Root; Treatment Failure; Treatment Outcome

The purpose of this study was to evaluate and compare the clinical effectiveness of 2 surgical techniques in treating periodontal defects. Both techniques involved tetracycline treatment of a root planed root, grafting the osseous defect with a bone graft, and placement of a bioabsorbable membrane. In group A, the bone graft was a mix of demineralized freeze-dried allograft, tetracycline, and porous hydroxyapatite and in group B, the bone graft was a mix of demineralized freeze-dried allograft and tetracycline. There was a statistically significant increase in recession (group A, 0.7 mm; group B, 0.6 mm), decreases in probing depth (group A, 6.1 mm; group B, 5.6 mm), and gains in attachment levels (group A, 5.4 mm; group B, 5.0 mm). There were no statistically significant differences between the results for either group. The defects associated with furcations and those that were not associated with furcations had similar results, except for the percent attachment gain. Smoking and age (> or =60 years old) could not be associated with results. Defects with > or =10 mm probing depths (PD) had greater PD reductions (group A, 7.7 mm; group B, 7.1) and attachment gains (group A, 6.6 mm; group B, 6.4 mm) than the defects with probing depths less than 10 mm (probing reduction group A, 4.8 mm; group B, 4.5 mm; attachment gain group A, 4.4 mm; group B, 4.0 mm). Both surgical procedures improved the clinical situation. However, neither technique seemed to offer a statistical advantage over the other. The inclusion of porous hydroxyapatite did not improve or diminish the results.

Topics: Adult; Age Factors; Aged; Alveolar Bone Loss; Analysis of Variance; Anti-Bacterial Agents; Biodegradation, Environmental; Bone Regeneration; Bone Transplantation; Decalcification Technique; Durapatite; Female; Freeze Drying; Furcation Defects; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged; Outcome Assessment, Health Care; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Index; Smoking; Tetracycline; Tooth Root; Transplantation, Autologous; Transplantation, Homologous

The aim of this randomized single-blind multicenter controlled clinical trial was to clinically evaluate the effectiveness of adjunctive local controlled drug delivery in the control of bleeding on probing in mandibular class II furcations during maintenance care. 127 patients presenting with a class II mandibular furcation with bleeding on probing were included in the study. They had been previously treated for periodontitis and were participating in supportive care programs in periodontal specialty practices. Treatments consisted of scaling and root planing with oral hygiene instructions (control) and scaling and root planing and oral hygiene combined with local controlled drug delivery with tetracycline fibers (test). The following outcomes were evaluated at baseline and 3 and 6 months after therapy at the furcation site: bleeding on controlled force probing (BOP), probing pocket depth (PD) and clinical attachment levels (CAL). Levels of oral hygiene and smoking status were also assessed. Both test and controls resulted in significant improvements of BOP and PD at 3 and 6 months. The test treatment, however, resulted in significantly better improvements: BOP decreased by 52% in the control group and by 70% in the test group at 3 months; at 6 months, however, the difference was no longer significant. The test treatment resulted in a 0.5 mm greater reduction of PD than the control at 3 months, the improvement was highly significant but its duration did not extend until the 6 months evaluation. No differences were observed in terms of changes in CAL. These data indicate that addition of tetracycline fibers to mechanical therapy alone resulted in improved control of periodontal parameters during periodontal maintenance of class II mandibular furcations. Short duration of the effect, however, requires further investigations to optimize conservative treatment of these challenging defects.

Topics: Adult; Anti-Bacterial Agents; Combined Modality Therapy; Dental Scaling; Drug Implants; Female; Follow-Up Studies; Furcation Defects; Gingival Hemorrhage; Humans; Male; Mandible; Middle Aged; Oral Hygiene; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Root Planing; Single-Blind Method; Smoking; Tetracycline; Treatment Outcome

A biocompatible microporous composite of PMMA (poly-methyl-methacrylate), PHEMA (poly-hydroxy-ethyl-methacrylate) and calcium hydroxide bone replacement graft material (Bioplant HTR Synthetic Bone) was evaluated in 16 maxillary molar and 10 mandibular molar Grade II furcations in 13 patients. Following initial preparation, full thickness flaps were raised to gain access to the furcations; mechanical hand and ultrasonic root and defect debridement and chemical tetracycline root preparation were performed; furcation and adjacent osseous defects in each patient were grafted with HTR Synthetic Bone; and the host flaps replaced or slightly coronally positioned. Weekly, then monthly deplaquing was performed until surgical re-entry at 6-12 months. Patients were then followed on approximate 3-month recalls for > or = 6 yr. Evaluation of the primary clinical outcome of furcation grade change showed that in the maxilla 5/16 furcations were clinically closed, 9/16 were Grade I, and 2/16 remained Grade II; while in the mandible 3/10 were clinically closed, 5/10 were Grade I, and 2/10 remained Grade II. Other significant clinical changes included decrease in mean horizontal furcation probing attachment level from 4.4 mm at surgery to 2.2 mm at re-entry to 2.0 mm at 6 yr, decrease in probing pocket depth from 5.4 mm at surgery to 3.0 mm at re-entry to 3.2 mm at 6 yr, and improvement in vertical clinical probing attachment level from 5.4 mm at surgery to 4.2 mm at re-entry to 4.1 mm at 6 yr (all p < 0.05 from surgery to re-entry and surgery to 6 yr, n.s. from re-entry to 6 yr via ANOVA). These favorable results with HTR polymer are similar to several reports with other graft materials and with GTR barriers, and suggest that HTR polymer may have a beneficial effect in the clinical management of Grade II molar furcations.

Topics: Adult; Alveoloplasty; Analysis of Variance; Anti-Bacterial Agents; Biocompatible Materials; Bone Substitutes; Composite Resins; Debridement; Dental Plaque; Evaluation Studies as Topic; Female; Follow-Up Studies; Furcation Defects; Humans; Male; Mandible; Maxilla; Methylmethacrylates; Middle Aged; Molar; Periodontal Attachment Loss; Periodontal Pocket; Polyhydroxyethyl Methacrylate; Reoperation; Root Planing; Surgical Flaps; Tetracycline; Treatment Outcome; Ultrasonic Therapy

Individuals with Down syndrome (DS) are susceptible to severe periodontal disease, due to immune alterations related to functional defects of polymorphonuclear leukocytes and monocytes. The adjunctive use of locally delivered antimicrobials has been proven to be beneficial, especially in areas where mechanical therapy might fail. This article describes the management of a patient with DS who had aggressive periodontitis. The treatment used a local drug delivery system with tetracycline fibers as an adjunct to scaling and root planing.

Topics: Adult; Aggressive Periodontitis; Alveolar Bone Loss; Anti-Bacterial Agents; Collagen; Combined Modality Therapy; Dental Plaque Index; Dental Scaling; Down Syndrome; Drug Carriers; Drug Delivery Systems; Female; Follow-Up Studies; Furcation Defects; Humans; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Root Planing; Tetracycline; Tooth Mobility

Topics: Alveolar Bone Loss; Anti-Bacterial Agents; Becaplermin; Bone Substitutes; Bone Transplantation; Calcium Phosphates; Connective Tissue; Dental Enamel Proteins; Esthetics, Dental; Female; Follow-Up Studies; Furcation Defects; Gingiva; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Platelet-Derived Growth Factor; Proto-Oncogene Proteins c-sis; Recombinant Proteins; Root Planing; Tetracycline; Tissue Engineering

The aim of this study was that to determine the clinical and histologic results of a new hydroxyapatite, with innovative properties compared with the other alloplastic materials used in the regenerative treatment of grade 3 bony defects of the mandibular furcations in the human. The hydroxyapatite used in our research is characterized by a scarce density and crystallinity, while from a microstructural point of view, the granules have nanometric dimensions (0.05-0.1 microm). The patient reported here by the authors had a grade 3 infrabony defect into a mandibular furcation. The surgical procedure used consists of the creation of a flap, roots planing, the conditioning of the roots with tetracycline HC, the accurate positioning of the granules of the hydroxyapatite in the furcation area, the crown replacing of the flap, and finally the suture of the same. Six months after the insertion of hydroxyapatite, the clinical effect was studied, comparing the variations found in probing the insertion of depth. At the end of the treatment, a block section of the molar was performed, with part of the surrounding soft tissues, whose histologic analysis underlined the moderate and initial formation of bony tissue, periodontal ligament, and radicular cement in the middle and lower portion of the furcation. In light of these results, the authors conclude that the use of this new hydroxyapatite is promising in the treatment of the mandibular furcations in the human, even if it will be necessary to continue to test its effectiveness through more studies.

Topics: Adult; Alveolar Bone Loss; Anti-Bacterial Agents; Bone Regeneration; Bone Substitutes; Durapatite; Female; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Mandibular Diseases; Molar; Root Planing; Surgical Flaps; Suture Techniques; Tetracycline

Root resorption and ankylosis have been reported rarely as sequelae to guided tissue regeneration (GTR). The authors describe a clinical case of root resorption following GTR that involved the use of a bioabsorbable membrane.. Two years after GTR was performed on a Class II furcation defect, the clinical examination revealed root resorption reaching the pulp chamber. The furcation defect was filled with epithelium and connective tissue, which contained inflammatory infiltrate and fragments of the membrane. The authors also observed areas of the tooth that exhibited points of ankylosis and root resorption.. Clinical trials have reported favorable clinical and histologic results with GTR. However, this case report, along with other case reports and studies in animals, suggests a high risk of root resorption and ankylosis after GTR, which could limit the indications for this technique.

Topics: Absorbable Implants; Adult; Anti-Bacterial Agents; Citrates; Female; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Membranes, Artificial; Polyesters; Root Resorption; Tetracycline; Tooth Ankylosis

The purpose of this study was to histologically evaluate furcation defects in humans treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for guided tissue regeneration (GTR). Three teeth with Class II furcation involvement on the buccal aspects were included in this study. A notch was placed in calculus during the procedure to serve as a reference point for histologic evaluation. The defects were then treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for GTR. At 6 months postoperative, the teeth were extracted with conservative block sections and processed for histologic evaluation. Regeneration (new bone, cementum, and connective tissue attachment) coronal to a notch could be seen in one of the three defects treated. In the other two defects, a new connective tissue attachment was demonstrated (new connective tissue attachment into new cementum) in the notch placed in calculus. In this study, regeneration of a furcation defect in a human was documented with histology.

Topics: Absorbable Implants; Alveolar Process; Anti-Bacterial Agents; Biocompatible Materials; Bone Regeneration; Bone Substitutes; Bone Transplantation; Connective Tissue; Dental Cementum; Durapatite; Female; Follow-Up Studies; Furcation Defects; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Membranes, Artificial; Middle Aged; Periodontal Attachment Loss; Periodontal Ligament; Periodontal Pocket; Regeneration; Tetracycline; Transplantation, Homologous

This report describes the clinical application of an in situ formed barrier of poly(DL-lactide) used in combination with a composite graft of demineralized freeze-dried bone allograft (DFDBA) mixed with calcium sulfate and tetracycline in a ratio of 7:2:1 and citric acid root conditioning for the treatment of intrabony and furcation defects. The clinical outcome was assessed by changes in clinical attachment level (CAL) and probing depth (PD) in 18 consecutively treated patients with 17 intrabony and 5 furcation lesions. After patients demonstrated acceptable oral hygiene, the lesions were surgically treated with combination therapy using an in situ formed barrier over a DFDBA composite graft. Patients followed a stringent postoperative protocol and were evaluated at 6 months postsurgery. CAL improved for all sites from a presurgical average of 8.8+/-2.3 mm to 4.4+/-1.6 mm at 6 months postsurgery (4.4+/-1.5 mm gain), while PD was reduced from an average of 8.3+/-2.1 mm presurgery to 3.3+/-1.1 mm at 6 months postsurgery (5.0+/-1.8 mm reduction). Five furcations were treated, of which 4 were Class II and 1 was Class III. Of these furcation lesions, 3 had complete clinical closure, while 1 improved by 1 grade. The Class III furcation remained the same. Results suggest that DFDBA composite graft covered by an in situ formed barrier on root surfaces treated with citric acid can enhance the prognoses of teeth with periodontal lesions as measured by CAL gains and PD reductions. Further studies are warranted to compare this treatment to other more traditional forms of regenerative therapy to determine its comparative efficacy.

Topics: Adult; Aged; Alveolar Bone Loss; Anti-Bacterial Agents; Biocompatible Materials; Bone Substitutes; Bone Transplantation; Calcium Sulfate; Chelating Agents; Citric Acid; Female; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged; Periodontal Attachment Loss; Periodontal Pocket; Polyesters; Prognosis; Tetracycline; Tooth Root; Transplantation, Homologous; Treatment Outcome

THE PURPOSE OF THIS STUDY was to evaluate the clinical effectiveness of a surgical technique in treating periodontal defects. The technique combined tetracycline treatment of a root planed root, grafting of the osseous defect with a demineralized freeze-dried bone allograft combined with tetracycline and the placement of a bioabsorbable matrix membrane, made of polylactic acid softened with citric acid ester. Thirty defects were treated in 27 patients. Statistically significant changes, as a result of the surgical procedure, were observed in marginal recession (mean: 0.5 mm), probing depth reductions (mean: 5.7 mm), and attachment level gain (mean: 5.2 mm). No statistically significant difference existed between the results in the furcation and non-furcation groups. The defects with probing depths > or = 10 mm had a greater mean probing depth reduction (7.4 mm) and mean attachment level improvement (7.2 mm) than the defects with < 10 mm probing depths (probing depth reduction 4.5 mm and attachment level gain 3.9 mm). The proposed surgical procedure seemed to be an effective method to treat periodontal defects.

Topics: Adult; Aged; Alveolar Bone Loss; Anti-Bacterial Agents; Biodegradation, Environmental; Bone Demineralization Technique; Bone Transplantation; Citric Acid; Female; Furcation Defects; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Lactic Acid; Male; Membranes, Artificial; Middle Aged; Outcome and Process Assessment, Health Care; Periodontal Attachment Loss; Periodontal Index; Polyesters; Polymers; Root Planing; Surface Properties; Tetracycline; Tooth Root

Two separate investigations were undertaken to assess the clinical characteristics and the safety, and to determine whether an absorbable type 1 bovine collagen barrier membrane would result in the improvement of clinical parameters during guided tissue regeneration in humans. The collagen membrane barrier was placed over a total of 21 interdental intrabony periodontal defects in 18 patients. The surgical procedures and postsurgical regimen were similar in both components of the investigation. Sulcular incisions were used and the sites were surgically exposed by reflection of full thickness mucoperiosteal flaps. The intrabony defects were debrided and the root surfaces prepared with automatic scalers and curets. Four 1-minute applications of tetracycline HCl 50 mg/ml were applied to the root surface. The collagen membrane barrier was hydrated in sterile saline until pliable, then trimmed so it covered the osseous defect and extended 2 to 3 mm beyond the defect. In both investigations, the collagen barrier membrane was not sutured, but retained by "pouching" or undermining the flap. Healing occurred without complications. There were no untoward or adverse reactions to the material in either phase of the study. In the initial investigation, 13 intrabony defects with probing depths of > or = 5 mm were treated in 9 patients having a mean age of 50.6 years. No controls defects were treated. Soft and hard tissue measurements were taken at the time of initial surgery and at 2, 4, and 6 months. In the second phase, 9 patients were enrolled with a mean age of 49.7 years. They had similar bilateral interdental intrabony defects with probing depths > or = 6 mm. One defect received the collagen membrane barrier, while the other was treated by flap debridement alone. The collagen membrane had undergone modification since the initial investigation, and was more highly cross-linked to retard absorption. After initial therapy, and prior to the surgical procedure, a series of 3 dermal patch tests were used to determine whether the patient would elicit a reaction to the collagen. Venous blood was drawn at baseline, 7 to 10 days, 18 to 21 days and at 8 weeks for analysis by ELISA for comparison of test and control sites relative to baseline. There were no allergic response to the dermal tests, and the ELISA tests indicated no significant differences between test and control sites. An automated probe was used to record soft and hard tissue measurements. These included the pr

Topics: Adult; Aged; Allergens; Animals; Cattle; Collagen; Dental Scaling; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged; Periodontal Pocket; Pilot Projects; Protein Synthesis Inhibitors; Skin Tests; Surgical Flaps; Tetracycline; Tooth Root; Wound Healing

Controlled drug delivery of antibiotics in the periodontal pocket is a scientifically tested clinical reality. Application of pharmacokinetic principles allows effective suppression of the pathogenic microflora, which, in turn, results in resolution of inflammatory signs. In the cases presented, tetracycline fibers were employed as a supplement to mechanical therapy and oral hygiene in a variety of clinical situations. Outcomes included depression of periodontal pathogens, reduction of bleeding on probing, decrease in probing pocket depths, and increase in probing attachment levels. A novel therapeutic approach based on root planing for debridement, local drug delivery for control of the pathogens, and oral hygiene for preventing recolonization is discussed.

Topics: Adult; Delayed-Action Preparations; Drug Delivery Systems; Female; Furcation Defects; Humans; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Tetracycline

The purpose of the present study was to evaluate the effect of anti-infective therapy on the success of periodontal regeneration in mandibular Class II furcation defects. Eighteen patients with mandibular bilateral Class II furcation defects were enrolled. Following an initial hygienic phase, guided tissue regeneration (GTR) was performed using an expanded polytetrafluoroethylene (e-PTFE) membrane barrier. The area was surgically exposed, thoroughly root planed, and irrigated with either tetracycline (100 mg/ml) or 0.9% saline. Post-operative care included systemic tetracycline (250 mg q.i.d.) and chlorhexidine 0.12% mouthwash twice daily. Patients were maintained on a prophylaxis schedule of every 2 weeks for the first 3 months, and monthly thereafter. Clinical parameters of probing depth (PD), probing attachment level - vertical (PAL-v), probing attachment level - horizontal (PAL-h), and target periodontal pathogens were monitored at baseline and quarterly for one year. An overall improvement in all clinical parameters was observed in both groups: probing reduction (3.1 mm), PAL-h gain (2.3 mm), and PAL-v gain (1.2 mm) were all statistically significant compared to baseline measurements. Vertical measurements were performed parallel to the long axis of the tooth with no attempt to angulate the probe into the furcation. There was no significant difference in sites receiving tetracycline. A strong positive correlation was noted between initial PD and pocket reduction (r = 0.77, P < 0.0001) and between initial PD and PAL-h gain (r = 0.54) and PAL-v gain (r = 0.45) suggesting that initial probing depth might be used to assess the regenerative potential of a given site.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Case-Control Studies; Chlorhexidine; Female; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Mandible; Middle Aged; Periodontal Index; Periodontal Pocket; Polytetrafluoroethylene; Tetracycline