Mineralized versus Demineralized Freeze-Dried Bone/ Doxycycline Allografts in Human Periodontal Osseous Defects

Objectives: The addition of tetracycline to bone allografts has become an increasingly common empiric clinical and research methodology in periodontal regenerative surgery. The advantage of adding tetracycline to the graft, however, has not yet been clearly demonstrated. The purpose of this investigation was to compare bone fill and defect resolution in periodontal osseous defects following 3 different bone graft preparations: demineralized freeze-dried bone (DFDBA) alone; DFDBA plus doxycycline; and mineralized freeze-dried bone (FDBA) plus doxycycline. Methods: Eleven patients with 63 sites were treated and surgically re-entered an average of 11.3 months following surgery. Results: Combined clinical results indicated a mean of 0.76 mm gingival recession, 2.71 mm pocket reduction, and 1.94 mm attachment gain following bone grafting surgery. Surgical measurements indicated 0.29 mm crestal loss, 1.59 mm defect fill (68%), and 69% defect resolution. Seventy percent of all defects had 50% or greater fill. Significantly more attachment gain, pocket reduction, and defect fill were observed in 3-wall defects compared to 2- or 1- wall defects, but no significant differences in treatment results were seen between the three bone graft preparation groups. Conclusions: The benefit of bone grafting surgery seen in these patients is similar to that observed in other clinical studies. Though in a small cohort of subjects, the results of this study do not suggest any particular benefit to DFDBA over FDBA, or to adding doxycycline to bone allografts for periodontal regenerative procedures.