title: Doxycycline-tricalcium phosphate composite graft facilitates osseous healing in advanced periodontal furcation defects.
abstract: The purpose of this study was to compare the effectiveness of a tricalcium phosphate, plaster of paris, and doxycycline composite graft to surgical debridement alone in the treatment of Class II and Class III furcation defects. Fifteen patients with adult periodontitis and at least two mandibular molars with Class II or III furcation defects were selected. A total of 40 sites were treated: 26 were Class II defects and 14 were Class III. Following initial therapy one site was randomly selected to receive the composite graft while the remaining site served as the surgically debrided control. Osseous healing was evaluated by direct measurements from an acrylic stent at the time of graft surgery and at the 6-month reentry. Following surgery each patient was placed on doxycycline 100mg/day for 10 days. The absence of clinical inflammation and infection during the healing process provided additional substantiation of the biocompatibility of the grafting materials. Results after 6 months indicated that sites treated with the composite graft had improved defect fill, defect resolution, probing depths, and clinical attachment levels when compared to the surgically debrided controls. Defect fill was 3.7 times greater in grafted sites and these sites were 4.0 times more likely to have 50% or greater defect fill. The effect of grafting was more pronounced in Class III defects where horizontal defect fill and gain of clinical attachment was achieved only in grafted sites. The plaster of paris functioned well as a binder, preventing particle scatter and facilitating graft retention. Additionally the plaster served as a vehicle to carry and retain the doxycycline at the treated site. These short-term results point to the potential of a composite graft containing tricalcium phosphate, plaster of paris, and doxycycline in promoting healing of furcation lesions.
authors.affiliation: Department of Periodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH.
authors.forename: E M
authors.initials: EM
authors.lastname: Pepelassi
authors.forename: N F
authors.initials: NF
authors.lastname: Bissada
authors.forename: H
authors.initials: H
authors.lastname: Greenwell
authors.forename: C F
authors.initials: CF
authors.lastname: Farah
mesh_terms: D000328:Adult; D000539:Alveolar Process / Q000473:pathology / Q000503:physiopathology*; D000543:Alveoloplasty / Q000379:methods*; D002130:Calcium Phosphates / Q000008:administration & dosage / Q000627:therapeutic use*; D002133:Calcium Sulfate; D015921:Dental Implants; D003774:Dental Plaque Index; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005881:Gingiva / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000473:pathology / Q000601:surgery*; D010512:Periodontal Index; D013524:Surgical Flaps; D014086:Tooth Mobility / Q000473:pathology / Q000503:physiopathology; D014092:Tooth Root / Q000473:pathology / Q000601:surgery; D014945:Wound Healing
chemical_list: D002130:Calcium Phosphates; D015921:Dental Implants; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous; D004318:Doxycycline; D002133:Calcium Sulfate