Comparative evaluation of demineralized freeze-dried bone allograft with and without doxycycline hyclate loaded proniosomal gel in the treatment of class II furcation defects: a randomized controlled trial.

BACKGROUND

Periodontitis is a chronic inflammatory disease that progressively damages the periodontium. Furcation involvement in multirooted teeth presents a significant clinical challenge due to anatomical complexity, limited accessibility, and poor response to conventional therapy. The study aimed to assess and compare the clinical and radiographic outcomes of using demineralized freeze-dried bone allograft (DFDBA) alone versus its combination with doxycycline hyclate loaded proniosomal gel in the management of Class II Furcation defects.

METHODS

A split-mouth, double-blinded randomized controlled trial was conducted in 28 patients with Stage III periodontitis and bilateral Class II furcation defects. Fifty-six sites were treated with either DFDBA alone (Group I) or DFDBA combined with doxycycline hyclate-loaded proniosomal gel (Group II). Clinical parameters to be measured are Plaque index, Gingival Index, Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), and Horizontal Probing Depth (HPD) were recorded at baseline, three months and six months. Cone-beam computed tomography (CBCT) was used to evaluate radiographic parameters at baseline and six months.

RESULTS

Both groups demonstrated significant improvements in Probing Pocket Depth (PPD), Horizontal Probing Depth (HPD), and Clinical Attachment Level (CAL) gain at 3 and 6 months (p < 0.0001). Although intergroup differences in PPD and CAL were not statistically significant, Group II showed significantly greater CAL gain between 3 and 6 months (p = 0.039). Radiographic analysis revealed a significant decrease in defect volume in both groups, with more pronounced changes in the test group.

CONCLUSION

The adjunctive use of doxycycline hyclate-loaded proniosomal gel with DFDBA improved periodontal regeneration outcomes compared to DFDBA alone, suggesting enhanced efficacy through sustained antimicrobial and regenerative effects.

CLINICAL RELEVANCE

DFDBA combined with doxycycline-loaded proniosomal gel enhances regeneration in Class II furcation defects more effectively than DFDBA alone.