Combination use of bovine porous bone mineral, enamel matrix proteins, and a bioabsorbable membrane in intrabony periodontal defects in humans.
BACKGROUND
The purpose of this study was to evaluate the effectiveness of a combination of enamel matrix proteins (EMP), bovine porous bone mineral (BPBM), and a bioabsorbable membrane for guided tissue regeneration (GTR) as regenerative therapy for intrabony defects in humans and compare it to an open flap debridement (OFD) technique.


METHODS
Using a split-mouth design, 18 pairs of intrabony defects were treated and surgically reentered 6 months after the initial surgery. Experimental sites were treated with EMP, grafted with BPBM, and received a collagen/polylactic acid membrane for GTR. Control sites were treated with OFD. The primary outcomes evaluated in the study included probing depth resolution, clinical attachment gain, and bony defect fill.


RESULTS
Preoperative probing depths, attachment levels, and intraoperative bone measurements were similar for the experimental and control groups. Postsurgical measurements taken at 6 months revealed a significantly greater reduction in probing depth in the experimental group (4.95+/-1.52 mm on buccal sites and 4.74+/-1.47 mm on lingual sites) when compared to the control group (2.83+/-0.83 mm on buccal sites and 2.90+/-0.91 mm on lingual sites). The experimental sites also presented with significantly more attachment gain (3.89+/-1.16 mm on buccal sites and 3.78+/-1.14 mm on lingual sites) than the control sites (1.52+/-0.83 mm on buccal sites and 1.48+/-0.78 mm on lingual sites). Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of the experimental group (4.76+/-1.36 mm on buccal sites and 4.81+/-1.37 mm on lingual sites) as compared to the control group (1.78+/-0.92 mm on buccal sites and 1.67+/-0.90 mm on lingual sites).


CONCLUSIONS
The results of this study indicate that a combination technique including BPBM, EMP, and GTR results in better clinical resolution of intrabony defects than treatment with OFD. Differences observed were both statistically and clinically significant. The exact role of each of the 3 technique components in achieving the clinical improvement observed in this study remains to be determined.
Lekovic
V
V
University of California, Los Angeles, School of Dentistry, 90095, USA.
Camargo
P M
PM
Weinlaender
M
M
Kenney
E B
EB
Vasilic
N
N
D020341:Absorbable Implants; D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001857:Bone Matrix / Q000637:transplantation*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002138:Calibration; D016022:Case-Control Studies; D003094:Collagen / Q000737:chemistry; D003646:Debridement; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D008567:Membranes, Artificial; D008903:Minerals / Q000627:therapeutic use*; D015588:Observer Variation; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D011091:Polyesters; D011108:Polymers / Q000737:chemistry; D013223:Statistics as Topic; D016896:Treatment Outcome; D014945:Wound Healing
C077540:Bio-Oss; D018786:Bone Substitutes; D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; D008903:Minerals; D011091:Polyesters; D011108:Polymers; C109069:enamel matrix proteins; D019344:Lactic Acid; C033616:poly(lactide); D003094:Collagen