COMPARATIVE EFFECTIVENESS OF VARIOUS REGENERATIVE MODALITIES FOR THE TREATMENT OF LOCALIZED JUVENILE PERIODONTITIS

THE OBJECTIVE OF THIS STUDY was to assess the effectiveness of surgica l debridement versus various guided tissue regeneration techniques for the treatment of localized juvenile periodontitis (LJP). Seven patien ts, 14 to 18 years old, were selected on the basis of having: 1) verti cal bone loss on at least 3 first molars; 2) probing attachment loss g reater than or equal to 5 mm; 3) presence of Actinobacillus actinomyce tecomitans (A alpha) as determined by the DNA probe test; 4) no system ic diseases; and 5) not taken antibiotics for 6 months prior to treatm ent. Each patient was randomly assigned by first molar involvement to one of four treatment modalities: 1) surgical debridement alone (DEBR) ; 2) ePTFE membrane alone (G); 3) ePTFE membrane plus root conditionin g (G+D); or 4) ePTFE membrane plus root conditioning plus composite gr aft (G+D+B). Standardized clinical attachment level measurements (GAL) were taken at baseline, 6, 12, and 18 months. Hard tissue measurement s were evaluated radiographically (RAD) at baseline, 6, 12, and 18 mon ths, and volumetrically at baseline and 12 months postsurgery. At 12 m onths re-entry, all residual defects were re-treated with a composite graft consisting of calcium sulfate + DFDBA + doxycycline. Results wer e evaluated 6 months post-retreatment using CAL and RAD measurements. Statistical analysis of the data showed: 1) a significant gain in clin ical attachment as well as Increased volumetric bone fill of the defec ts 12 and 18 months following the various treatment modalities when co mpared to baseline (P < 0.05); and 2) no statistically significant dif ferences among the tested treatment modalities and surgical debridemen t alone for all parameters (P > 0.05). It may be concluded that surgic al debridement in conjunction with systemic administration of doxycycl ine is as effective as regenerative techniques in treating patients wi th LJP.