Eval of decalcified bone allograft with/without doxycycline in defects

| Posted in: Science Health Sciences

Journal name: Journal of Indian Society of Periodontology
Original article title: Comparative evaluation of decalcified freeze dried bone allograft with and without local doxycycline in non-contained human periodontal infrabony defects
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Ashish Agarwal, Hirak S. Bhattacharya, G. Srikanth, Anjali Singh


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Comparative evaluation of decalcified freeze dried bone allograft with and without local doxycycline in non-contained human periodontal infrabony defects

Year: 2013 | Doi: 10.4103/0972-124X.118322

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

The study investigates the effectiveness of combining doxycycline with a bone graft for the regenerative treatment of non-contained infrabony periodontal defects in patients with chronic periodontitis. Doxycycline, a member of the tetracycline antibiotic family, has been recognized not only for its antimicrobial properties but also for its potential to inhibit collagenolysis, inflammation, and osteoclast activity. The researchers aimed to evaluate whether the addition of local doxycycline enhances the outcomes of bone grafting procedures, specifically measuring parameters like pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF), and alveolar height reduction over a six-month period.

Efficacy of Doxycycline in Periodontal Regeneration

Despite the anticipated benefits of doxycycline in improving periodontal regeneration, the study found no significant added advantages when it was used in conjunction with the decalcified freeze dried bone allograft (DFDBA). The results indicated that both the control group, receiving only DFDBA, and the test group, receiving DFDBA with doxycycline, showed similar improvements in clinical parameters such as PPD reduction and CAL gain after six months post-surgery. Although the test group exhibited a slightly higher RBF percentage (20.7% compared to 18.0% for the control), this difference was not statistically significant. Thus, the study suggests that, at least in the context of the patient population analyzed, the addition of doxycycline does not enhance the regenerative potential provided by DFDBA alone.

Conclusion

In conclusion, the study demonstrates that local doxycycline does not provide additional benefits compared to bone grafting alone in regenerating non-contained periodontal infrabony defects. The findings emphasize the importance of assessing treatment protocols in periodontal therapy, particularly considering variations in patient characteristics and defect types. While doxycycline's theoretical advantages in periodontal regeneration are acknowledged, this study highlights the need for further research with larger samples and longer follow-up periods to explore the potential benefits or lack thereof more definitively.

FAQ section (important questions/answers):

What was the purpose of the study on doxycycline and bone grafts?

The study aimed to evaluate if adding local doxycycline enhances the regenerative outcomes of bone grafts in patients with non-contained infrabony periodontal defects compared to using grafts alone.

What types of periodontal defects were included in the study?

The study included one or two wall infrabony periodontal defects in patients suffering from moderate to severe chronic periodontitis, aged 35-60 years.

What were the main findings related to doxycycline use?

The study found no significant benefits of adding local doxycycline to bone grafts regarding clinical and radiological outcomes in periodontal regeneration compared to using bone grafts alone.

How was the surgical procedure carried out in the study?

Patients underwent a standardized surgical procedure involving incision, flap reflection, defect debridement, and placement of either DFDBA alone or DFDBA mixed with doxycycline into the defect.

What is the significance of the study's findings?

The findings suggest that doxycycline does not enhance the regenerative potential of DFDBA in treating infrabony defects, challenging some previous assumptions about the benefits of adding antibiotics to grafting procedures.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Eval of decalcified bone allograft with/without doxycycline in defects”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Study (Studying):
The study pertains to a cohort analysis examining the efficacy of local doxycycline in conjunction with bone grafts for regenerative periodontal therapy. It investigates critical outcomes such as periodontal parameters and compares them to understand the benefits of additional doxycycline treatment in specific dental defects.

2) Wall:
In the context of periodontal defects, 'wall' refers to the number of bony walls surrounding an infrabony defect. The classification into one or two-wall defects influences healing patterns. These walls can significantly impact the regenerative potential and outcomes of treatment involving bone grafting procedures.

3) Line:
In surgical contexts, 'line' may refer to the incision line or the configuration of the surgical flap. This line is crucial to ensure proper access to the provided defect, allowing for optimal graft placement. Accurate incision lines are vital for effective healing and minimizing post-operative complications.

4) Grafting:
Grafting refers to the surgical procedure of placing a biological material, such as decalcified freeze-dried bone allograft (DFDBA), into the periodontal defect to promote regeneration of lost periodontal structures. The success of grafting procedures is assessed through clinical and radiographic outcomes after treatment.

5) Post:
The term 'post' relates to the post-operative phase after periodontal surgery. This phase includes monitoring healing, evaluating clinical parameters, and assessing the success of the treatment at scheduled follow-ups, which are critical for determining the efficacy of the intervention over time.

6) Disease:
The study focuses on chronic periodontitis, which is a prevalent periodontal disease characterized by inflammation and loss of supportive structures around teeth. Understanding the effects of this disease is essential for developing effective treatment protocols aimed at halting disease progression and facilitating tissue regeneration.

7) Hygiene (Hygienic):
Hygiene refers to oral hygiene practices that patients must maintain to promote healing and prevent complications post-surgery. Adhering to proper hygiene protocols is essential in periodontal therapy, influencing the overall success of grafting treatments and minimizing risks of infection or further tissue damage.

8) Antibiotic (Antibacterial):
Antibiotics like doxycycline have roles beyond antimicrobial activity; they can exert anti-collagenolytic and anti-inflammatory effects in periodontal therapy. This study assesses the utility of using doxycycline with a bone graft to enhance regenerative outcomes in periodontal defects through these multifaceted properties.

9) Suffering:
In the study, 'suffering' describes the patients experiencing moderate to severe chronic periodontitis. This condition poses significant challenges to oral health, and effective treatment is crucial to alleviate discomfort and restore periodontal integrity, thereby enhancing patients' quality of life.

10) Dressing:
Dressing refers to the periodontal dressing applied post-surgery to protect the surgical site. This dressing aids in maintaining flap stability, minimizing discomfort, and reducing the likelihood of infection. The dressing's role is fundamental in the post-operative care regimen for optimal healing.

11) Surface:
The term 'surface' can relate to the treatment surfaces within the periodontal defect where grafting materials are applied. Proper handling of these surfaces, including cleaning and preparation, is essential for promoting integration of the graft and facilitating healing within the defect area.

12) Science (Scientific):
The study embodies principles of dental science, focusing on periodontal therapies. It integrates aspects of microbiology, regenerative medicine, and surgical techniques to enhance the understanding and practice of effective treatments for periodontal diseases and defects.

13) Family:
In the context, 'family' refers to the classification of antibiotics, specifically tetracyclines, which include doxycycline. Understanding the family of drugs helps in recognizing the biological actions, pharmacokinetics, and potential synergistic benefits when applied in periodontal treatments.

14) Table:
Tables within the research provide organized summaries of clinical parameters and statistical analyses comparing outcomes between control and test groups. They allow readers to inspect results clearly, offering insights into the effectiveness of treatment interventions across different measurement time points.

15) Drug:
The term 'drug' refers to pharmacological agents used in the study, specifically doxycycline, which has various therapeutic effects in periodontal therapy. Its classification and functions, including antimicrobial and anti-inflammatory properties, are critical to evaluating the overall treatment effectiveness.

16) Repopulation:
Repopulation signifies the process of restoring specific cell types, such as periodontal ligament cells, to healing periodontal tissues. Enhancing repopulation through treatments can facilitate regeneration, making it a critical factor in the healing post-grafting procedures.

17) Transformation (Transform, Transforming):
Transforming refers to the 'transforming growth factor' (TGF), a crucial protein involved in bone formation and healing. Its role in the study relates to the biological processes induced by doxycycline in promoting periodontal regeneration through modulating cellular activities.

18) Surrounding:
In the context of periodontal defects, 'surrounding' refers to the tissues and physiological conditions that influence healing. Factors in the surrounding environment, including bacteria load and tissue integrity, can significantly impact the outcomes of any surgical intervention.

19) Bleeding:
Bleeding refers to the bleeding on probing (BOP) noted during clinical evaluations. BOP is associated with periodontal inflammation and is used as a parameter to gauge disease severity, treatment effectiveness, and overall periodontal health status in patients.

20) Incision:
Incision signifies the surgical cut made to access the periodontal defect. Proper incisional techniques are vital for a successful surgical approach, facilitating optimal flap reflection for adequate visualization and treatment of the affected areas during the bone grafting process.

21) Filling (Filled):
Filling pertains to the placement of graft materials, such as DFDBA, into the periodontal defect. The effectiveness of filling is crucial for promoting regeneration, as it provides scaffolding for new tissue growth and influences clinical outcomes following surgical intervention.

22) Harvesting (Harvest):
Harvest refers to the process of obtaining bone allograft material from a donor source. The quality of harvested materials impacts their effectiveness in grafting procedures, affecting biological properties such as osteoinductivity and regenerative potential within periodontal defects.

23) Reason:
Reason refers to the rationale behind the study, which aimed to evaluate the efficacy of doxycycline in enhancing bone graft outcomes in periodontal regeneration. Understanding the reasons behind treatment evaluations helps advance clinical practices and therapeutic approaches in dentistry.

24) Water:
Water serves as a solvent in preparing graft materials, such as reconstituting DFDBA. Proper management of water as a medium is essential in ensuring the graft material maintains its biological integrity during application within periodontal defects.

25) Silk:
Silk relates to the type of suture material used to close surgical flaps after graft placement. The choice of 3-0 black braided silk sutures maintains flap stability during healing, which is critical for achieving optimal post-operative outcomes and tissue integration.

26) Hand:
Hand refers to the manual techniques employed during the surgical procedures for grafting. The precision and skillful handling of instruments by the surgeon contribute significantly to the success of the periodontal intervention and the overall treatment outcome.

27) Male (Mālē):
Male pertains to the gender of some participants in the study. Recording patient demographics, including gender, allows researchers to consider its potential influence on treatment responses and outcomes, guiding future studies toward more personalized approaches in periodontal therapy.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Eval of decalcified bone allograft with/without doxycycline in defects’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Statistical analysis, Surgical Procedure, Antimicrobial action, Doxycycline, Clinical attachment level, Periodontal therapy, Initial therapy, Pocket probing depth, Bone graft.

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