Regeneration of Degree II Furcation Defects With a 4% Doxycycline Hyclate Bioabsorbable Barrier

Abstract

Bacterial contamination of a healing regenerative site has been shown to affect the response to therapy adversely. Doxycycline possesses antibacterial properties as well as other biologic actions that may result in an increased production and maintenance of collagen and bone. The purpose of this study was to assess if the sustained release of 4% doxycycline through a bioabsorbable barrier would enhance the regenerative outcomes of healing furcation sites. Individuals with a single degree II furcation defect in a mandibular molar participated. They were assigned randomly to one of three treatment groups: poly(DL-lactide) polylactic acid (PLA) barrier containing 4% doxycycline hyclate + demineralized freeze-dried bone allograft (DFDBA) (BG+PDox); poly(DL-lactide) PLA barrier without doxycycline + DFDBA (BG+P); or DFDBA alone (BG). Clinical parameters included vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival recession, and horizontal probing depth (HPD). Intrasurgical measurements to calculate vertical and horizontal furcation fill were obtained at the time of surgery (baseline) and during a reentry procedure 9 months later. Statistical tests were used to assess changes in the clinical and surgical parameters before and after treatment among groups and within each group. Mean changes at 9 months for all groups yielded VPD reductions and VCAL gains. However, no significant difference was noted for the group that was treated with 4% doxycycline barrier compared to the other two groups. Vertical bone fill was 0.89, 1.44, and 1.18 mm for the BG+PDox, BG+P, and BG groups, respectively. Furcation horizontal bone was 2.33, 2.11, and 1.18 mm for the BG+PDox, BG+P, and BG groups, respectively. Addition of doxycycline to the guided tissue regeneration barrier did not enhance treatment outcomes compared to the non-antibiotic-loaded barrier or bone graft alone. All treatment modalities provided similar improvement in clinical and intrasurgical parameters.