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A clinical evaluation of demineralized freeze-dried bone allograft in combination with tetracycline in the treatment of periodontal osseous defects.

The purpose was to evaluate the use of demineralized freeze-dried bone allograft reconstituted with 50 mg/ml tetracycline hydrochloride in the treatment of intrabony periodontal defects. Fifteen systemically healthy patients (12 females, 3 males; aged 35 to 61) with moderate-advanced periodontitis were treated. Patients had 3 osseous defects with probing depths (PD) > 5 mm after initial therapy. Each site in each subject was randomly assigned to one of the following groups: 1) demineralized freeze-dried bone allograft reconstituted with 50 mg/ml tetracycline (DFDBA + TCN); 2) demineralized freeze-dried bone allograft alone (DFDBA); or 3) debridement only (D). Clinical measurements were taken the day of surgery, 6 months, and 1 year. Standardized radiographs were taken at baseline and 1 year and were evaluated by computer assisted densitometric image analysis (CADIA). Clinical measurements included gingival recession, PD, clinical attachment level, and mobility. Osseous defect measurements were taken at baseline and at the 1 year reentry. No adverse healing responses occurred. The results showed that all patients had a statistically significant improvement in probing depth and attachment level at 1 year. Osseous measurements showed bone fill of 2.27 mm (51.6%) for the DFDBA + TCN group, 2.20 mm (52.4%) for the DFDBA group, and 1.27 mm (32.8%) for the D group. Defect resolution was 77.3% for the DFDBA + TCN group, 77.9% for the DFDBA group, and 63.8% for the D group. The mean CADIA values were 5.04 for the DFDBA + TCN group, 6.79 for the DFDBA group and 2.78 for the D group. The CADIA values did not correlate with the clinical parameters. Although the grafted groups showed greater bone fill and defect resolution, there was no statistically significant difference in any of the clinical parameters between the treatment groups. This study suggests that there is no significant benefit from reconstituting the allograft with 50 mg/ml of tetracycline hydrochloride.