Mixing Tetracycline bone graft materials?

~100 mg of tetracycline to 100ml of sterile saline hydrate bone in sol... You can use excess for sterile gauze etc to isolate .... Technique from a Dr Donald Callan lecture. Does it help..... ? Dunno cuz I always use it for all bone grafting

Honestly, I don't use it and almost never see any infections develop post-op. Even in acutely infected sites, I just irrigate with NSS and then peridex. Any post-op bone graft infections I see are usually related to partial exposure (ie: tissue covering a non-resorbable membrane or healing abutment). I don't see that it is necessary.

Why , in 19 years of sinus augmentation I am yet to have an infection . But yes mixing tetracycine in graft materials is the only way to deal effectively with intrabony infections as seen in Orthopeadic cases where they use Stimulan ( A CaSo4 product ) to deliver abs to the site. We have had great success in treating oral intrabony infections ( Necrosis ) using CaSo4/Btcp product mixed with tetracycline ..... But I do hear that when using Bovine products this is advocated by lecturers, but I never use them , so do not have a perceived fear of infective issues. Peter

In my many years of experience in doing bone grafts, we have always added a sprinkling of Metronidazol powder to the particulate as a prevention in the possibility of infection. Dr. Joseph Choukroun has demonstrated very nicely by way of time lapse photography, that anaerobic bacteria in the sinus can actually be seen producing gas bubbles....and Metronidazol is excellent to get rid of that type of bacteria.

I have used 0.3 cc of metronidazole (Flagyl) mixed with every bone graft procedure I have performed in the last 10 years with mineralized Freeze dried bone allograft and have never had a post op infection. However, you have to make sure the patient is not allergic to Flagyl. I have had a few reactions to Flagyl and used a Medrol dose pack and have had immediate resolution from the reaction.

Give us a link of metronidazole or teracicline used with bone... Many thanks

Where do you purchase the tetracycline? I was under the impression it is no longer available in the US.

What is the objective, prospective, controlled evidence that antibiotics are necessary? After 40 years of nearly daily bone grafting, I have yet to have an infection. But if I did, I would harvest a specimen for gram stain, culture and sensitivity testing, then treat with the antibiotic indicated. This is the time for evidence based dentistry. Anecdotal treatment should be evaluated with interest but not followed as the gospel.

If I can't fine tetracycline, I use doxycycline. I use it to decrease the release of collagenase during the healing process, it does make a difference, the healing is faster and there seems to be less discomfort during the healing. We use the on a routine basis at Arkansas Children's Hospital on the cleft palate cases. Don Callan

I hydrate my graft material with IV clindamycin. Just curious what the scientists have to say about that.

I use to mix tetracycline in my perio Packs following Perio surgery and it worked well, but then the Tetracycline got hard to find in capsule form. They use to teach opening tetracycline capsules and sprinkling granules into extracted 3rd molar sites; I also was taught that one could Prescribe Tetracycline Syrup to use for ANUG cases...Worked great with Peridex but its also hard to find now.

I am not aware of any evidence showing the addition of antibiotics to bone mixes is beneficial. Haven't done it since I started grafting in 2000.