Comparison of treatments of infrabony defects with enamel matrix derivative, guided tissue regeneration with a nonresorbable membrane and Widman modified flap. A pilot study.
OBJECTIVE
The purpose of the present study was to compare the efficacy of 3 different surgical procedures in the treatment of infrabony defects: guided tissue regeneration (GTR) with non-resorbable membranes, Widman modified flap (WMF) and enamel matrix derivative (EMD).


METHODS
30 patients with an infrabony component > or = 4 mm were selected. 10 were treated with expanded polytetrafluorethylene (ePTFE (Gore - Tex W. L. Gore and Associates, Flagstaff, AZ, USA)) membranes, 10 with WMF and 10 with enamel matrix derivatives (Emdogain (U Biora AB Malm, Sweden)). The efficacy of each treatment modality was investigated through regression analysis. Probing attachment level (PAL) gain, probing depth (PD) reduction and gingival recession (REC) variation were analyzed.


RESULTS
Both Emdogain (enamel matrix derivative) and ePTFE treatment show significant better results as compared to the WMF procedure in which there were no significant changes in PAL gain and PD reduction at baseline and 1 year after surgery.


CONCLUSIONS
Results from our analysis suggest that there is no statistically significant difference in PAL gain between GTR and EMD. The clinical outcomes of this pilot study may be of little significance, considering the small number of patients, but it has provided an important base for a controlled clinical trial (with a larger number of patients) which is currently in progress.
Silvestri
M
M
Cattedra di Parodontologia, University of Pavia, San Matteo Hospital, IRCCS Pavia, Italy. silvestr@telnetwork.it
Ricci
G
G
Rasperini
G
G
Sartori
S
S
Cattaneo
V
V
D016301:Alveolar Bone Loss / Q000188:drug therapy / Q000601:surgery*; D001861:Bone Regeneration / Q000187:drug effects; D003746:Dental Enamel Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy / Q000601:surgery*; D010865:Pilot Projects; D011138:Polytetrafluoroethylene; D012044:Regression Analysis; D013524:Surgical Flaps; D016896:Treatment Outcome
D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C109069:enamel matrix proteins; D011138:Polytetrafluoroethylene