THE USE OF TETRACYCLINE-CONTAINING CONTROLLED-RELEASE FIBERS IN THE TREATMENT OF REFRACTORY PERIODONTITIS

THE PURPOSE OF THIS STUDY was to evaluate the safety and clinical effi cacy of controlled-release tetracycline-containing fibers in patients with refractory periodontitis versus the preceding classical treatment . One hundred twenty-one sites in 20 patients were followed from basel ine to 6 months after fiber insertion. Each selected site was greater than or equal to 5 mm deep and bled on probing. All 20 patients had at least one site greater than or equal to 7 mm which bled on probing. T hose pockets remained after intense and repeated conventional therapy (scaling and root planing and often surgery), often including the use of systemic antibiotics. This treatment period, the so-called control period, preceded the experimental period by at least 3 years, when the fibers were placed. Both treatments (in control and test period) were performed in the Department of Periodontology at the University Hospi tal in Leuven. At the start of the experimental period, all pockets gr eater than or equal to 5 mm were treated by the placement of fibers im pregnated with 25% tetracycline. The fibers were removed after 10 days . Probing depth, clinical attachment level, gingival recession, and bl eeding on probing were recorded at baseline, and at 1, 3, and 6 months following treatment. Analysis of data from all sites indicated that a significant decrease in probing depth and gain in attachment were pre sent at all follow-up visits. The mean probing depth reduction for sit es greater than or equal to 7 mm was 3.2 mm at month 6, with a gain in attachment of 2.7 mm, while this was -1.0 mm and -1.9 mm, respectivel y, during the preceding control period. The fraction of bleeding pocke ts was reduced from 77% to 27% and from 80% to 77% during the experime ntal and control periods, respectively. No significant adverse side-ef fects were observed, except for a transient redness at fiber removal i n 2 sites. Fiber insertion appeared to be time-consuming even when the operator was familiarized with the procedure. The results of this stu dy prove that tetracycline-impregnated fibers can reduce probing depth significantly for a period of 6 months in patients not responding to thorough and repeated classical periodontal treatment.