title: Healing of two and three wall intrabony periodontal defects following treatment with an enamel matrix derivative combined with autogenous bone.
abstract: 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.
authors.affiliation: Department of Periodontology, Yeditepe University, Istanbul, Turkey.
authors.forename: Selcuc
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Gokser
authors.initials: G
authors.lastname: Cakar
authors.forename: Burak
authors.initials: B
authors.lastname: Yildirim
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: 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
chemical_list: D003746:Dental Enamel Proteins; C109069:enamel matrix proteins