Ten-year results following treatment of intra-bony defects with enamel matrix proteins and guided tissue regeneration.
BACKGROUND
Surgery utilizing an enamel matrix protein derivative (EMD) or guided tissue regeneration (GTR) has been shown to promote periodontal regeneration.


OBJECTIVE
To evaluate the 10-year results following treatment with EMD, GTR, EMD+GTR, and open flap debridement (OFD).


METHODS
Thirty-eight patients out of an initial group of 56 participants were treated with one of the four modalities. Results were evaluated before surgery, at 1 year, and at 10 years. Primary outcome variable was CAL change.


RESULTS
Treatment with EMD yielded a mean CAL gain of 3.4+/-1.0 mm (p<0.001) and 2.9+/-1.4 mm (p<0.001) at 1 and 10 years, respectively. GTR resulted in a mean CAL gain of 3.2+/-1.4 (p<0.001) at 1 year and 2.8+/-1.2 mm (p<0.001) at 10 years. Mean CAL gain in the EMD+GTR group was of 3.3+/-1.1 mm (p<0.001) and 2.9+/-1.2 mm (p<0.001) at 1 and 10 years, respectively. Treatment with OFD demonstrated a mean CAL gain of 2.0+/-1.2 mm (p<0.01) at 1 year and 1.8+/-1.1 mm (p<0.01) at 10 years. Compared with OFD, the three regenerative treatments resulted in statistically significant (p<0.05) higher CAL gain, at both 1 and 10 years. The CAL change between 1 and 10 years did not present statistically significant differences in any of the four groups.


CONCLUSIONS
The present results indicate that the clinical outcomes obtained with all four approaches can be maintained over a period of 10 years.
Sculean
Anton
A
Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands. anton.sculean@gmx.de
Kiss
Alice
A
Miliauskaite
Asta
A
Schwarz
Frank
F
Arweiler
Nicole B
NB
Hannig
Matthias
M
D020341:Absorbable Implants; D016301:Alveolar Bone Loss / Q000601:surgery*; D000539:Alveolar Process / Q000473:pathology; D003646:Debridement; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery; D005889:Gingival Recession / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D016037:Single-Blind Method; D013524:Surgical Flaps; D013536:Suture Techniques; D019237:Tooth Cervix / Q000473:pathology; D016896:Treatment Outcome
D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C109069:enamel matrix proteins