title: Microsurgical access flap in conjunction with enamel matrix derivative for the treatment of intra-bony defects: a controlled clinical trial.
abstract: OBJECTIVE
  The aims of this controlled study were to clinically and radiographically evaluate the effect of a microsurgical approach for the treatment of intra-bony defects with and without an enamel matrix derivative (EMD). Parts of this study population were already published by Wachtel and colleagues in 2003.
  
  
  METHODS
  Seventy intra-bony defects were randomly assigned to a microsurgical access flap with application of EMD (test group) and on the contra-lateral side to a microsurgical access flap alone (control group). Clinical and radiographic parameters were assessed at baseline and after 6 and 12 months.
  
  
  RESULTS
  Both test and control treatments resulted in a statistically significant mean clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and radiographic bone fill. The test group yielded statistically significantly more CAL gain, PPD reduction and radiographic bone fill than the control group. Gingival recession increase after 12 months averaged 0.5 and 0.7 mm for the test and control groups, and did not reach statistical significance. Two weeks after surgery, primary wound closure was maintained in 91% of the test sites and 97% of the control sites.
  
  
  CONCLUSIONS
  The combination of a microsurgical access flap with EMD seems to be superior to open flap debridement in terms of PPD reduction, CAL gain and radiographic bone fill. In the test as well as the control group, primary wound closure was successfully achieved.
authors.affiliation: Private Institute for Periodontology and Implantology, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fickl
authors.forename: Tobias
authors.initials: T
authors.lastname: Thalmair
authors.forename: Moritz
authors.initials: M
authors.lastname: Kebschull
authors.forename: Sonja
authors.initials: S
authors.lastname: Böhm
authors.forename: Hannes
authors.initials: H
authors.lastname: Wachtel
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D001861:Bone Regeneration / Q000187:drug effects*; D003646:Debridement; D003746:Dental Enamel Proteins / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D011859:Radiography; D016037:Single-Blind Method; D013524:Surgical Flaps
chemical_list: D003746:Dental Enamel Proteins; C109069:enamel matrix proteins