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Published on: May 9, 2022
A BiO-Optimizing Site Targeted (BOOST) Approach to Periodontal Regeneration Through Local Doxycycline Prior to
Mario Aimetti1, Giacomo Baima1, Virginia Lorenzetti1
1Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
Aim:
To test a BiO-Optimizing Site Targeted (BOOST) approach to periodontal regeneration by the adjunctive use of locally delivered doxycycline (DOX) 2 weeks prior to minimally invasive surgery in terms of clinical and radiographic outcomes at 1 year.
Methods:
For this randomized clinical trial, stage III/IV periodontitis patients presenting sites with intrabony defects and bleeding on probing (BoP+) after steps 1-2 of periodontal treatment were included. Sites were treated via subgingival instrumentation with or without a BOOST approach by local DOX. After 2 weeks, defects were accessed by minimally invasive surgical technique with xenograft and amelogenins. Primary (clinical attachment level [CAL] gain) and secondary (probing pocket depth [PPD] reduction, composite outcomes, radiographic bone defect fill) outcomes were assessed at 12 months.
Results:
Sixty patients completed the study (30 on each group). BOOST led to lower preoperative BoP (p < 0.001) and better wound healing after surgery (p = 0.027). Both groups showed clinical and radiographic improvements at 1 year, with significant differences in mean CAL gain (4.1 ± 1.9 vs. 3.2 ± 2.0 mm; p = 0.019) and PPD reduction (4.4 ± 1.8 vs. 3.6 ± 1.9 mm; p = 0.040) favoring the test group. BOOST group also achieved higher composite outcome measure (PPD ≤ 4 mm and CAL gain ≥ 3; 83.3% vs. 46.7%; p = 0.006), pocket closure (PPD ≤ 3 mm or 4 mm BoP-; 83.3% vs. 60.0%; p = 0.045), and defect fill (3.5 ± 1.2 vs. 2.7 ± 1.3 mm; p < 0.001) compared to the control group.
Conclusion:
A BOOST approach by local doxycycline 2 weeks before surgery enhanced the local inflammatory control prior to periodontal regeneration and post-operative early wound healing, yielding to improved clinical and radiographic outcomes at 1 year.
Trial Registration:
ClinicalTrials.gov identifier: NCT05878353.
