673 Comparative Effectiveness of Various Regenerative Modalities for the Treatment of Localized Juvenile Periodontitis* Peter DiBattista, Nabil F. Bissada, and Paul A. Ricchetti The objective of this study was to assess the effectiveness of surgical debridement versus various guided tissue regeneration techniques for the treatment of localized juvenile Periodontitis (LJP). Seven patients, 14 to 18 years old, were selected on the basis of having: 1) vertical bone loss on at least 3 first molars; 2) probing attachment loss ^ 5 mm; 3) presence of Actinobacillus actinomycetecomitans (Aa) as determined by the DNA probe test; 4) no systemic diseases; and 5) not taken antibiotics for 6 months prior to treatment. Each patient was randomly assigned by first molar involve- ment to one of four treatment modalities: 1) surgical debridement alone (DEBR); 2) ePTFE membrane alone (G); 3) ePTFE membrane plus root conditioning (G+D); or 4) ePTFE membrane plus root conditioning plus composite graft (G+D+B). Stan- dardized clinical attachment level measurements (CAL) were taken at baseline, 6, 12, and 18 months. Hard tissue measurements were evaluated radiographically (RAD) at baseline, 6, 12, and 18 months, and volumetrically at baseline and 12 months post- surgery. At 12 months re-entry, all residual defects were re-treated with a composite graft consisting of calcium sulfate + DFDBA + doxycycline. Results were evaluated 6 months post-retreatment using CAL and RAD measurements. Statistical analysis of the data showed: 1) a significant gain in clinical attachment as well as increased volumetric bone fill of the defects 12 and 18 months following the various treatment modalities when compared to baseline (P < 0.05); and 2) no statistically significant differences among the tested treatment modalities and surgical debridement alone for all parameters (P > 0.05). It may be concluded that surgical debridement in conjunc- tion with systemic administration of doxycycline is as effective as regenerative tech- niques in treating patients with LJP. J Periodontol 1995;66:673-678. Key Words: Guided tissue regeneration; Periodontitis, juvenile/surgery; comparative study. After the etiologic importance of Actinobacillus actino- mycetemcomitans (Aa) was recognized, periodontal treat- ment of localized juvenile Periodontitis was directed to- wards the elimination of Aa in subgingival sites and cor- rection of the soft tissue and osseous lesions produced by the disease.1 Accordingly, a number of different modali- ties have been used in the treatment of LJP, most of which result in at least initial clinical improvement. Lesions caused by LJP have a tendency to recur, so that successful treatment is highly dependent on long-term follow-up.2 Much controversy has existed regarding the most ap- * Department of Periodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH. propriate treatment of intrabony defects associated with LJP. Rapid advances in periodontics made it possible to treat patients with LJP using autogenous bone grafts,3 5 allografts,6-7 and alloplasts.8-9 Encouraging results have been reported by Yukna and Sepe who used freeze-dried bone allograft (FDBA) combined with tetracycline (TTC). They reported complete fill in 35% of the graft sites and >50% fill in 98%.7 Until recently, no study had evaluated the use of oc- clusive membranes for the treatment of LJP. The rationale for this investigation stemmed from a recent study by Fritz et al.10 which showed that intrabony defects in LJP patients, treated with occlusive membranes alone, had greater attachment gain compared to sites treated with