title: Enamel matrix derivative, alone or associated with a synthetic bone substitute, in the treatment of 1- to 2-wall periodontal defects.
abstract: BACKGROUND
  In this study, we compare the effects of enamel matrix derivative (EMD) associated with a hydroxyapatite and β-tricalcium phosphate (HA/β-TCP) implant to EMD alone and to open-flap debridement (OFD) when surgically treating 1- to 2-wall intrabony defects.
  
  
  METHODS
  Thirty-four patients, exhibiting ≥3 intraosseous defects in different quadrants, were each treated by OFD, EMD, or EMD + HA/β-TCP in each defect. At baseline and 12 and 24 months, a complete clinical and radiographic examination was done. Pre-therapy and post-therapy clinical (probing depth [PD], clinical attachment level [CAL], and gingival recession [GR]) and radiographic (defect bone level [DBL] and radiographic bone gain [RBG]) parameters for the different treatments were compared.
  
  
  RESULTS
  After 12 and 24 months, almost all the clinical and radiographic parameters showed significant changes from baseline within each group (P <0.001). Differences in PD, CAL, and DBL scores were also seen among the three groups at the 12- and 24-month visits (P <0.001). At 12 and 24 months after treatment, the EMD + HA/β-TCP group showed significantly greater PD reduction (4.00 ± 0.42 mm; 4.25 ± 0.63 mm), CAL gain (3.47 ± 0.65 mm; 3.63 ± 0.91 mm), and RBG (3.17 ± 0.69 mm; 3.35 ± 0.80 mm) and less GR increase (0.56 ± 0.37 mm; 0.63 ± 0.42 mm) compared with the OFD and EMD groups (P <0.05).
  
  
  CONCLUSIONS
  Our data support the hypothesis that the adjunct of an HA/β-TCP composite implant with EMD may improve the clinical and radiographic outcomes of the surgical treatment of unfavorable intrabony defects.
authors.affiliation: Department of Periodontology, G. d'Annunzio University, School of Dentistry, Chieti, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: De Leonardis
authors.forename: Michele
authors.initials: M
authors.lastname: Paolantonio
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000704:Analysis of Variance; D001861:Bone Regeneration; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use; D005260:Female; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins; D017886:Durapatite; C018392:tricalcium phosphate