title: Four-year results following treatment of intrabony periodontal defects with an enamel matrix derivative alone or combined with a biphasic calcium phosphate.
abstract: The aim of this study was to evaluate the 4-year clinical outcomes following regenerative surgery in intrabony defects with either EMD + BCP or EMD. Twenty-four patients with advanced chronic periodontitis, displaying one-, two-, or three-walled intrabony defect with a probing depth of at least 6 mm, were randomly treated with either EMD + BCP (test) or EMD alone (control). The following clinical parameters were evaluated at baseline, at 1 year and at 4 years after regenerative surgery: plaque index, gingival index, bleeding on probing, probing depth, gingival recession, and clinical attachment level (CAL). The primary outcome variable was CAL. No differences in any of the investigated parameters were observed at baseline between the two groups. The test group demonstrated a mean CAL change from from 10.8 ± 1.6 mm to 7.4 ± 1.6 mm (p < 0.001) and to 7.6 ± 1.7 mm (p < 0.001) at 1 and 4 years, respectively. In the control group, mean CAL changed from 10.4 ± 1.3 at baseline to 6.9 ± 1.0 mm (p < 0.001) at 1 year and 7.2 ± 1.2 mm (p < 0.001) at 4 years. At 4 years, two defects in the test group and three defects in the control group have lost 1 mm of the CAL gained at 1 year. Compared to baseline, at 4 years, a CAL gain of ≥3 mm was measured in 67% of the defects (i.e., in 8 out of 12) in the test group and in 75% of the defects (i.e., in 9 out of 12) in the control group. There were no statistically significant differences in any of the investigated parameters at 1 and at 4 years between the two groups. Within their limits, the present results indicate that: (a) the clinical improvements obtained with both treatments can be maintained over a period of 4 years, and (b) in two- and three-walled intrabony defects, the addition of BCP did not additionally improve the outcomes obtained with EMD alone. In two- and three-walled intrabony defects, the combination of EMD + BCP did not show any advantage over the use of EMD alone.
authors: Department of Periodontal and Oral Mucosa Diseases, Medical Academy Bialystok, Bialystok, Poland.
authors: Malgorzata
authors: M
authors: Pietruska
authors: Jan
authors: J
authors: Pietruski
authors: Katalin
authors: K
authors: Nagy
authors: Michel
authors: M
authors: Brecx
authors: Nicole Birgit
authors: NB
authors: Arweiler
authors: Anton
authors: A
authors: Sculean
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000601:surgery; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000379:methods; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000601:surgery; D006097:Granulation Tissue / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D011446:Prospective Studies; D016745:Root Planing / Q000379:methods; D013524:Surgical Flaps; D019237:Tooth Cervix / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D002614:Chelating Agents; D003746:Dental Enamel Proteins; D006882:Hydroxyapatites; C109069:enamel matrix proteins; C074950:hydroxyapatite-beta tricalcium phosphate; D004492:Edetic Acid