Bna. Vandekerckhove et al., THE USE OF TETRACYCLINE-CONTAINING CONTROLLED-RELEASE FIBERS IN THE TREATMENT OF REFRACTORY PERIODONTITIS, Journal of periodontology, 68(4), 1997, pp. 353-361
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.