Four-year results of a prospective-controlled clinical study evaluating healing of intra-bony defects following treatment with an enamel matrix protein derivative alone or combined with a bioactive glass.
OBJECTIVE
To evaluate the 4-year results following regenerative periodontal surgery at intra-bony defects with either a combination of an enamel matrix protein derivative (EMD) and a bioactive glass (BG) or with EMD alone.


METHODS
Twenty-five patients with one deep intra-bony defect each were randomly treated with either an EMD+BG (test) or with EMD alone (control). Measurements were recorded at baseline, at 1 and at 4 years following therapy. The primary outcome variable was the clinical attachment level (CAL).


RESULTS
The test group demonstrated a mean CAL change from 10.3+/-1.6 to 6.7+/-1.2 mm (p<0.001) and to 6.9+/-1.0 mm (p<0.001) at 1 and 4 years, respectively. No statistically significant differences were found between the 1- and 4-year results. The control group showed a mean CAL change from 10.4+/-1.6 to 6.7+/-1.1 mm (p<0.001) at 1 year and 7.0+/-0.9 mm (p<0.001) at 4 years. The CAL change between 1 and 4 years did not present statistically significant differences. In each of the two groups, four defects have lost 1 mm of the CAL gained at 1 year. A CAL gain of 1 mm compared with the 1-year results was measured in only one defect of the test group. Compared with baseline, a CAL gain of >/=3 mm was found at 4 years in 10 defects in both groups. Between the treatment groups, no statistically significant differences in any of the investigated parameters were observed at 1 and at 4 years.


CONCLUSIONS
Within their limits, the present results indicate that the clinical improvements obtained with both regenerative modalities can be maintained over a period of 4 years.
Sculean
Anton
A
Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands. a.sculean@dent.umcn.nl
Pietruska
Malgorzata
M
Arweiler
Nicole B
NB
Auschill
Thorsten M
TM
Nemcovsky
Carlos
C
D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification / Q000601:surgery*; D001672:Biocompatible Materials / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use*; D002516:Ceramics / Q000627:therapeutic use*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000145:classification / Q000601:surgery; D005889:Gingival Recession / Q000145:classification / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000601:surgery; D010514:Periodontal Pocket / Q000145:classification / Q000601:surgery; D011446:Prospective Studies; D019237:Tooth Cervix / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D001672:Biocompatible Materials; C022107:Bioglass; D018786:Bone Substitutes; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins