title: Healing of human intrabony defects following treatment with enamel matrix proteins or guided tissue regeneration.
abstract: The aim of the present study was to evaluate histologically in humans the healing of advanced intrabony defects following treatment with enamel matrix proteins (EMD) or guided tissue regeneration (GTR). Fourteen patients, each of them displaying 1 advanced intrabony defect around teeth scheduled for extraction were included in the study. The defects were treated randomly either with an enamel matrix protein derivative (Emdogain, BIORA AB, Malmö, Sweden) or with a bioabsorbable membrane (Resolut, Regenerative Material, W.L. Gore & Assoc., Flagstaff, Arizona, USA). At baseline the mean probing pocket depth (PPD) in the EMD group was 11.3 +/- 1.8 mm and the mean clinical attachment level (CAL) 12.1 +/- 2.0 mm, whereas in the GTR group the mean PPD was 11.4 +/- 2.2 mm and the mean CAL 13.3 +/- 2.3 mm. Healing was uneventful in all cases. Neither allergic reactions against EMD or the bioabsorbable membrane, nor suppuration or abscesses were observed. The clinical results revealed at 6 months in the EMD group a mean PPD of 5.6 +/- 1.3 mm and a mean CAL of 9.1 +/- 1.5 mm. In the GTR group the mean PPD was 5.6 +/- 1.3 mm and the mean CAL 10.1 +/- 1.5 mm. The histological analysis showed in the EMD group a mean 2.6 +/- 1.0 mm of new attachment (i.e. new cementum with inserting collagen fibers) and a mean 0.9 +/- 1.0 mm of new bone. In this group, the formation of new attachment was not always followed by bone regeneration. In the GTR group, the mean new attachment was 2.4 +/- 1.0 mm and the mean new bone 2.1 +/- 1.0 mm. In every case treated with GTR, the formation of new attachment was followed by a varying amount of new bone. After both types of regenerative treatment the newly formed cementum displayed a predominantly cellular character. The findings of the present study indicate that the treatment of intrabony defects with enamel matrix proteins or with bioabsorbable membranes enhances the formation of a new connective tissue attachment in humans.
authors.affiliation: Department of Periodontology and Conservative Dentistry, University of Saarland, Homburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Sculean
authors.forename: N
authors.initials: N
authors.lastname: Donos
authors.forename: P
authors.initials: P
authors.lastname: Windisch
authors.forename: M
authors.initials: M
authors.lastname: Brecx
authors.forename: I
authors.initials: I
authors.lastname: Gera
authors.forename: E
authors.initials: E
authors.lastname: Reich
authors.forename: T
authors.initials: T
authors.lastname: Karring
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D001706:Biopsy; D001842:Bone and Bones / Q000187:drug effects* / Q000473:pathology; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008567:Membranes, Artificial; D010518:Periodontitis / Q000473:pathology / Q000628:therapy; D011098:Polyglactin 910 / Q000627:therapeutic use; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D001672:Biocompatible Materials; D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C094810:Resolut; C109069:enamel matrix proteins; D011098:Polyglactin 910