Five-year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration.
BACKGROUND
Treatment with enamel matrix proteins (EMD) or guided tissue regeneration (GTR) has been shown to enhance periodontal regeneration. However, until now there are limited data on the long-term results following these treatment modalities.


OBJECTIVE
The aim of the present clinical study was to present the 5-year results following treatment of intrabony defects with EMD, GTR, combination of EMD and GTR, and open flap debridement (OFD).


METHODS
Forty-two patients, each of whom displayed one intrabony defect of a probing depth of at least 6 mm, were randomly treated with one of the four treatment modalities. The following parameters were evaluated prior to surgery, at 1 year and at 5 years after: plaque index, gingival index, bleeding on probing, probing pocket depth (PPD), gingival recession, and clinical attachment level (CAL). No statistically significant differences in any of the parameters were observed at baseline between the four groups.


RESULTS
The sites treated with EMD demonstrated a mean CAL gain of 3.4+/-1.1 mm (p<0.001) and of 2.9+/-1.6 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with GTR showed a mean CAL gain of 3.2+/-0.8 (p<0.001) at 1 year and of 2.7+/-0.9 mm (p<0.001) at 5 years. The mean CAL gain at sites treated with EMD+GTR was 3.0+/-1.0 mm (p<0.001) and 2.6+/-0.7 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with OFD demonstrated a mean CAL gain of 1.6+/-1.0 mm (p<0.001) at 1 year and 1.3+/-1.2 mm (p<0.001) at 5 years. At 1 year, the only statistically significant difference between the four different treatments was found in terms of PPD reduction and CAL gain between EMD and OFD (p<0.05). However, at 5 years there were no statistically significant differences in any of the investigated parameters between the four different treatments.


CONCLUSIONS
Within the limits of the present study, it may be concluded that the short-term clinical results following treatment with EMD, GTR, EMD+GTR, and OFD can be maintained over a period of 5 years.
Sculean
Anton
A
Department of Conservative Dentistry and Periodontology, Section of Periodontology, Johannes Gutenberg-University, Mainz, Germany. anton.sculean@gmx.de
Donos
Nicolaos
N
Schwarz
Frank
F
Becker
Jürgen
J
Brecx
Michel
M
Arweiler
Nicole B
NB
D016301:Alveolar Bone Loss / Q000601:surgery*; D000704:Analysis of Variance; D001861:Bone Regeneration / Q000187:drug effects*; D003746:Dental Enamel Proteins / Q000494:pharmacology*; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D008875:Middle Aged; D010512:Periodontal Index; D016745:Root Planing; D018709:Statistics, Nonparametric
D003746:Dental Enamel Proteins; C109069:enamel matrix proteins