Enamel matrix derivative in propylene glycol alginate for treatment of infrabony defects with or without systemic doxycycline: 12- and 24-month results.
BACKGROUND
This aim of this study is to compare regenerative therapy of infrabony defects with and without administration of post-surgical systemic doxycycline (DOXY) 12 and 24 months after therapy.


METHODS
In each of 57 patients, one infrabony defect (depth ≥ 4 mm) was treated regeneratively using enamel matrix derivative at two centers (Frankfurt am Main and Heidelberg). By random assignment, patients received either 200 mg DOXY per day or placebo (PLAC) for 7 days after surgery. Twelve and 24 months after surgery, clinical parameters (probing depths [PDs] and vertical clinical attachment level [CAL-V]) and standardized radiographs were obtained. Missing data were managed according to the last observation carried forward.


RESULTS
Data of 57 patients (DOXY: 28; PLAC: 29) were analyzed (26 males and 31 females; mean age: 52 ± 10.2 years; 13 smokers). In both groups, significant (P <0.01) PD reduction (DOXY: 3.7 ± 2.2 mm; PLAC: 3.4 ± 1.7 mm), CAL-V gain (DOXY: 2.7 ± 1.9 mm; PLAC: 3.0 ± 1.9 mm), and bone fill (DOXY: 1.6 ± 2.7 mm; PLAC: 1.8 ± 3.0 mm) were observed 24 months after surgery. However, the differences between both groups failed to be statistically significant (PD: P = 0.574; CAL-V: P = 0.696; bone fill: P = 0.318).


CONCLUSIONS
Systemic DOXY, 200 mg/day for 7 days, after regenerative therapy of infrabony defects did not result in better PD reduction, CAL-V gain, or radiographic bone fill compared with PLAC 12 and 24 months after surgery, which may be attributable to low power and, thus, random chance.
Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt, Germany.
Peter
P
Eickholz
Lasse
L
Röllke
Beate
B
Schacher
Martin
M
Wohlfeil
Bettina
B
Dannewitz
Jens
J
Kaltschmitt
Jörg K
JK
Krieger
Diana M
DM
Krigar
Peter
P
Reitmeir
Ti-Sun
TS
Kim
D000464:Alginates / Q000737:chemistry*; D016301:Alveolar Bone Loss / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D003746:Dental Enamel Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D003773:Dental Plaque / Q000382:microbiology; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000187:drug effects; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010919:Placebos; D011092:Polyethylene Glycols / Q000737:chemistry; D011859:Radiography; D054457:Tissue Scaffolds / Q000737:chemistry; D016896:Treatment Outcome
D000464:Alginates; D000900:Anti-Bacterial Agents; D003746:Dental Enamel Proteins; D010919:Placebos; C109069:enamel matrix proteins; D011092:Polyethylene Glycols; D004318:Doxycycline