Prospective assessment of the use of enamel matrix proteins with minimally invasive surgery.
BACKGROUND
Minimally invasive surgery (MIS) is a surgical technique using very small incisions, indicated for performing regenerative therapy in periodontal defects. Enamel matrix proteins (EMP) have been shown to enhance periodontal regeneration. This study was undertaken to determine the effect of using EMP in combination with an MIS approach.


METHODS
Patients from two private periodontal practices with chronic periodontitis who, following non-surgical therapy, had one or more sites with probing depths (PD) of > or =6 mm were included in the study. An MIS approach was utilized for surgical access. Following surgical debridement, EMP was placed into the bony defect. The surgical sites were reevaluated after at least 11 months.


RESULTS
Surgical treatment was performed at 160 sites in 16 patients. No significant differences were noted in the results between the two offices and the data were combined. Mean PD reduction (P = 0.002) and attachment level improvements (P = 0.012) were significantly greater than 3 mm with mean post-surgical PD of 3.17 mm and attachment levels of 4.05 mm, based on subject means. Mean change in recession following surgery was negligible (0.01 mm). All sites were considered to be clinically successful.


CONCLUSIONS
The combination of MIS and EMP yields significant reductions in probing depths and improvements in attachment levels while producing little or no increase in recession.
Harrel
Stephen K
SK
Private practice and Baylor College of Dentistry, Dallas, TX 75229, USA. skh1@airmail.net
Wilson
Thomas G
TG
Nunn
Martha E
ME
D000134:Acid Etching, Dental; D018786:Bone Substitutes / Q000627:therapeutic use*; D002908:Chronic Disease; D003646:Debridement; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D012534:Dental Scaling; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000601:surgery; D005889:Gingival Recession / Q000517:prevention & control; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010518:Periodontitis / Q000601:surgery; D011446:Prospective Studies; D016745:Root Planing; D016896:Treatment Outcome
D018786:Bone Substitutes; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins