title: The effect of postsurgical antibiotics and a bioabsorbable membrane on regenerative healing in Class II furcation defects.
abstract: BACKGROUND
  The purpose of this randomized, controlled, blinded, clinical investigation was to determine the effect of postsurgical antibiotics on osseous healing in Class II furcation defects.
  
  
  METHODS
  Twenty-four Class II furcation defects in 24 patients were treated with either a polylactide bioabsorbable membrane, demineralized freeze-dried bone allograft (DFDBA) plus antibiotics (GBA or test group) or with a polylactide membrane and DFDBA alone (GB or control group). Twelve patients were included in each group. The antibiotic regimen consisted of ciprofloxacin 250 mg twice daily and metronidazole 250 mg tid for 1 week followed by a 7-week regimen of doxycycline hyclate 50 mg daily. Treatment was performed on either mandibular buccal or lingual, or maxillary buccal Class II furcation defects. Defects were randomly selected by a coin toss for treatment and all open and closed measurements were performed by a blinded examiner. Final open and closed measures from a stent were repeated at the 9-month second stage surgery. Power analysis to determine superiority of antibiotic treatment showed that a 12 per group sample size would yield 93% power to detect a 1.5 mm difference and 64% power to detect a 1 mm difference.
  
  
  RESULTS
  Mean open horizontal probing depth reductions at 9 months were greater for the GBA group than for the GB group (2.92+/-1.78 versus 2.50+/-1.62 mm); however, these differences were not statistically significant. Seven of 12 furcations (58%) in the GBA group demonstrated >50% vertical defect fill at 9 months compared to 8 of 12 furcations (67%) in the GB group. There were no significant differences in mean open horizontal probing depth reduction between smokers and non-smokers in either the GBA or GB groups. Membrane exposure did not appear to affect regenerative healing in either the GBA or GB groups.
  
  
  CONCLUSIONS
  The administration of postsurgical antibiotics did not produce statistically superior osseous healing of Class II furcation defects. This result may be attributable to membrane design which facilitates connective tissue ingrowth, thereby preventing bacterial downgrowth and contamination of the newly regenerated tissues.
authors.affiliation: Department of Periodontics, Endodontics and Dental Hygiene, School of Dentistry, University of Louisville, KY 40292, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Vest
authors.forename: H
authors.initials: H
authors.lastname: Greenwell
authors.forename: C
authors.initials: C
authors.lastname: Drisko
authors.forename: J W
authors.initials: JW
authors.lastname: Wittwer
authors.forename: J
authors.initials: J
authors.lastname: Bichara
authors.forename: J
authors.initials: J
authors.lastname: Yancey
authors.forename: J
authors.initials: J
authors.lastname: Goldsmith
authors.forename: G
authors.initials: G
authors.lastname: Rebitski
mesh_terms: D020341:Absorbable Implants; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology*; D001672:Biocompatible Materials; D001861:Bone Regeneration / Q000187:drug effects*; D016025:Bone Transplantation / Q000379:methods; D002939:Ciprofloxacin / Q000494:pharmacology; D003774:Dental Plaque Index; D004311:Double-Blind Method; D004318:Doxycycline / Q000031:analogs & derivatives / Q000494:pharmacology; D004359:Drug Therapy, Combination; D017823:Furcation Defects / Q000188:drug therapy / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008567:Membranes, Artificial; D008795:Metronidazole / Q000494:pharmacology; D017063:Outcome Assessment, Health Care; D010512:Periodontal Index; D011091:Polyesters
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D008795:Metronidazole; C033616:poly(lactide); D002939:Ciprofloxacin; D004318:Doxycycline