Treatment of infrabony defects with or without enamel matrix proteins: a 24-month follow-up randomized pilot study.
OBJECTIVE
To evaluate a comparison of open-flap debridement (OFD) with or without the use of enamel matrix proteins (EMP) for the treatment of infrabony defects.


METHODS
Ten volunteers (38 infrabony defects) were randomized to receive OFD+EMP (test site) and OFD (control site). Clinical outcomes included mean changes in Plaque Index, Gingival Index, probing pocket depth (PPD), relative attachment level (RAL), gingival recession, width of keratinized tissue, and dental mobility at baseline and at 24 months.


RESULTS
A significant reduction of 4.21+/-0.97 mm was observed in PPD for the OFD+EMP group (from 6.30+/-0.99 mm to 2.09+/-0.97 mm) and of 3.28+/-1.23 mm for the OFD group (from 6.13+/-0.88 mm to 2.85+/-1.42 mm) (P<.001). The reduction in PPD was statistically significantly greater for OFD+EMP compared to OFD (P=.03). The mean RAL decreased from 13.26+/-1.88 mm to 7.57+/-2.05 mm for the OFD+EMP group (a gain of 5.69+/-1.96 mm) and from 13.37+/-1.71 mm to 8.13+/-1.34 mm (P<.001) for the OFD group (a gain of 5.24+/-1.55 mm). Gingival recession was higher in the OFD+EMP group than in the OFD group. The mean keratinized tissue significantly decreased from 4.41+/-1.39 mm to 3.63+/-1.54 mm for OFD flap group (P<.01).


CONCLUSIONS
Both treatment modalities were efficient in improving RAL and PPD. Within groups, there was a significant reduction in keratinized tissue for OFD and a significant postoperative recession for the OFD + EMP group. Infrabony defects treated with OFD + EMP showed significantly more PPD reduction when compared to OFD.
Chambrone
Daniella
D
Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil. chambrone@usp.br
Pasin
Ivan Munhoz
IM
Chambrone
Leandro
L
Pannuti
Claudio Mendes
CM
Conde
Marina Clemente
MC
Lima
Luiz A
LA
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery / Q000628:therapy*; D001861:Bone Regeneration; D055113:Chronic Periodontitis / Q000601:surgery / Q000628:therapy*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005889:Gingival Recession / Q000209:etiology / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery / Q000628:therapy; D057747:Periodontal Debridement / Q000009:adverse effects; D010514:Periodontal Pocket / Q000601:surgery / Q000628:therapy; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D003746:Dental Enamel Proteins; C109069:enamel matrix proteins