Clinical outcomes after treatment of non-contained intrabony defects with enamel matrix derivative or guided tissue regeneration: a 12-month randomized controlled clinical trial.
BACKGROUND
The purpose of this study is to compare the healing of deep, non-contained intrabony defects (i.e., with a ≥80% 1-wall component and a residual 2- to 3-wall component in the most apical part) treated with either an enamel matrix derivative (EMD) or guided tissue regeneration (GTR) after 12 months.


METHODS
In this randomized, controlled clinical trial, 40 subjects with 40 defects affecting single-rooted teeth were treated. The defects were treated with EMD alone or with a non-resorbable titanium-reinforced membrane. No grafting materials were used. At baseline and after 12 months, clinical parameters including probing depths (PDs) and clinical attachment levels (CAL) were recorded. The difference in CAL gain was the primary outcome.


RESULTS
At baseline, the intrabony component of the defects amounted to 8.5 ± 2.2 mm at EMD-treated sites and 8.6 ± 1.7 mm at GTR-treated sites (P = 0.47). The mean CAL gain at sites treated with GTR was significantly greater (P <0.001) than that at sites treated with EMD (4.1 ± 1.4 mm versus 2.4 ± 2.2 mm, respectively). GTR therapy, compared to EMD application alone, significantly (P = 0.01) increased the probability of CAL gain ≥4 mm (79.2% versus 11.3%, respectively) and significantly (P = 0.01) decreased the probability of residual PDs ≥6 mm (3% versus 79.3%, respectively).


CONCLUSIONS
Although the outcomes of open-flap debridement alone were not investigated, the application of EMD alone appeared to yield less PD reduction and CAL gain compared to GTR therapy in the treatment of deep, non-contained intrabony defects.
Siciliano
Vincenzo Iorio
VI
Department of Dental and Maxillofacial Sciences, University of Naples Federico II, Naples, Italy.
Andreuccetti
Gianmaria
G
Siciliano
Alessandro Iorio
AI
Blasi
Andrea
A
Sculean
Anton
A
Salvi
Giovanni E
GE
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001672:Biocompatible Materials; D001861:Bone Regeneration / Q000502:physiology; D055113:Chronic Periodontitis / Q000601:surgery; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery; D005889:Gingival Recession / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010516:Periodontal Splints; D011138:Polytetrafluoroethylene; D014025:Titanium; D014086:Tooth Mobility / Q000628:therapy; D016896:Treatment Outcome
D001672:Biocompatible Materials; D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C109069:enamel matrix proteins; D011138:Polytetrafluoroethylene; D014025:Titanium