Healing of two and three wall intrabony periodontal defects following treatment with an enamel matrix derivative combined with autogenous bone.
BACKGROUND
There are still limited data on the outcomes of regenerative periodontal surgery using a combination of an enamel matrix protein derivative (EMD) and autogenous bone (AB).


OBJECTIVE
To evaluate the healing of deep intrabony defects treated with either a combination EMD+AB or EMD alone.


METHODS
Forty patients with advanced chronic periodontitis, with one deep intrabony defect, were randomly treated with either EMD+AB (test) or EMD (control). Clinical assessments were performed at baseline and at 1 year after treatment. The primary outcome variable was relative attachment level (RAL).


RESULTS
Healing was uneventful in all patients. The test sites showed a reduction in the mean probing pocket depth (PPD) of 5.6 +/- 0.9 mm (p<0.001), a gain in the mean RAL of 4.2 +/- 1.1 mm (p<0.001) and a gain in the mean probing bone level (PBL) of 3.9 +/- 1.0 mm (p<0.001). The control group displayed a mean PPD reduction of 4.6 +/- 0.4 mm (p<0.001), a mean RAL gain of 3.4 +/- 0.8 mm (p<0.001) and a mean PBL gain of 2.8 +/- 0.8 mm (p<0.001). RAL gains of > or =4 mm were measured in 90% of the test defects and in 55% of the controls. PBL gains of > or =4 mm were obtained in 85% of the test defects and in 25% of the control ones. The test treatment resulted in statistically higher PPD reductions, RAL gains and PBL gains compared with the control (p<0.01).


CONCLUSIONS
Within their limits, the present results indicate that: (i) at 1 year after surgery, both therapies resulted in statistically significant clinical improvements compared with baseline and (ii) although the combination of EMD+AB resulted in statistically significant higher soft and hard tissue improvements compared with treatment with EMD, the clinical relevance of this finding is unclear.
Yilmaz
Selcuc
S
Department of Periodontology, Yeditepe University, Istanbul, Turkey.
Cakar
Gokser
G
Yildirim
Burak
B
Sculean
Anton
A
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001861:Bone Regeneration / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods*; D055113:Chronic Periodontitis / Q000601:surgery; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000502:physiology
D003746:Dental Enamel Proteins; C109069:enamel matrix proteins