title: Enamel matrix derivative in the treatment of human intrabony osseous defects.
abstract: BACKGROUND
  There is limited information available from clinical trials regarding the performance of enamel matrix derivative (EMD) in the treatment of periodontal intrabony defects. This randomized, double-blind, placebo-controlled, split-mouth study was designed to compare the clinical and radiographical effects of EMD treatment to that of placebo-controlled treatment for intrabony defects.
  
  
  METHODS
  Sixteen patients were included, each of whom had 1 or 2 pairs of intrabony defects located contralaterally in the same arch. Thirty-six intrabony defects were randomly assigned treatment with flap surgery plus EMD or flap surgery plus placebo. At baseline and at the 12-month follow-up evaluation visit, clinical and radiographic measurements were determined. Data were statistically analyzed using the Wilcoxon-signed rank test (alpha = 0.05).
  
  
  RESULTS
  At the 12-month visit, bleeding on probing for the EMD group was 0.11 +/- 0.32 compared to the placebo group, 0.61 +/- 0.50 (P <0.05). Probing depth reduction was greater in the EMD group (3.00 +/- 0.97 mm) compared to the placebo group (2.22 +/- 0.81 mm) (P <0.05). Mean values for clinical attachment gain in the EMD and the placebo groups were 1.72 +/- 1.07 mm and 0.83 +/- 0.86 mm, respectively (P <0.05). Vertical relative attachment gain was 38.5 +/- 22.6% in the EMD group and 21.4 +/- 25.2% in the placebo group (P<0.05). Radiographic bone density gain was greater in the EMD (20.2 +/- 16.6%) compared to the placebo group (-3.94 +/- 23.3%) (P<0.01).
  
  
  CONCLUSIONS
  Treatment with flap surgery and EMD, compared to flap surgery with placebo, produced a significantly more favorable clinical improvement in intrabony periodontal defects.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Niigata University, Japan. okuda@dent.niigata-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Okuda
authors.forename: M
authors.initials: M
authors.lastname: Momose
authors.forename: A
authors.initials: A
authors.lastname: Miyazaki
authors.forename: M
authors.initials: M
authors.lastname: Murata
authors.forename: S
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Y
authors.initials: Y
authors.lastname: Yonezawa
authors.forename: L F
authors.initials: LF
authors.lastname: Wolff
authors.forename: H
authors.initials: H
authors.lastname: Yoshie
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D015519:Bone Density; D018786:Bone Substitutes / Q000627:therapeutic use*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000601:surgery; D010919:Placebos; D011859:Radiography; D018709:Statistics, Nonparametric; D013524:Surgical Flaps
chemical_list: D018786:Bone Substitutes; D003746:Dental Enamel Proteins; D010919:Placebos; C109069:enamel matrix proteins