Clinical evaluation of demineralized freeze-dried bone allograft with and without enamel matrix derivative for the treatment of periodontal osseous defects in humans.
BACKGROUND
Beneficial clinical effects have been demonstrated with the addition of enamel matrix derivative (EMD) to demineralized freeze-dried bone allograft (DFDBA) compared to EMD alone. The purpose of this study was to evaluate the effectiveness of DFDBA combined with EMD compared to DFDBA alone in the treatment of intraosseous defects of chronic periodontitis.


METHODS
Thirty-two patients with 41 intrabony defects > or = 3 mm were randomly assigned to one of two treatment groups. Intrabony defects were treated with DFDBA alone or in combination with EMD. Soft tissue measurements included probing depth (PD), gingival recession, and clinical attachment level (CAL). Hard tissue measurements included height of the alveolar crest, defect depth, and defect morphology. Following 6 months of healing, all measurements were repeated with the use of a surgical reentry procedure on 29 patients. Data were analyzed to determine PD reduction, CAL gain, change in recession, crestal resorption, defect fill, defect resolution, percentage of defect fill, and percentage of defect resolution.


RESULTS
Analysis of soft and hard tissue measurements demonstrated a statistically significant difference from baseline within each group (P <0.001); however, there was no statistically significant difference between the groups.


CONCLUSIONS
Both treatments were shown to be safe and effective therapy for periodontal defects; however, the addition of EMD to DFDBA provided no statistically significant improvement to the soft and hard tissue parameters measured.
Hoidal
Matt J
MJ
Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Grimard
Brently A
BA
Mills
Michael P
MP
Schoolfield
John D
JD
Mellonig
James T
JT
Mealey
Brian L
BL
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000539:Alveolar Process / Q000473:pathology; D016025:Bone Transplantation / Q000379:methods*; D055113:Chronic Periodontitis / Q000601:surgery; D003648:Decalcification Technique; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing; D016037:Single-Blind Method; D014021:Tissue Preservation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014945:Wound Healing
D003746:Dental Enamel Proteins; C109069:enamel matrix proteins