title: Ten-year results following treatment of intrabony defects with an enamel matrix protein derivative combined with either a natural bone mineral or a β-tricalcium phosphate.
abstract: BACKGROUND
  The purpose of the present study is to evaluate the 10-year results following treatment of intrabony defects treated with an enamel matrix protein derivative (EMD) combined with either a natural bone mineral (NBM) or β-tricalcium phosphate (β-TCP).
  
  
  METHODS
  Twenty-two patients with advanced chronic periodontitis and displaying one deep intrabony defect were randomly treated with a combination of either EMD + NBM or EMD + β-TCP. Clinical evaluations were performed at baseline and at 1 and 10 years. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level (CAL). The primary outcome variable was CAL.
  
  
  RESULTS
  The defects treated with EMD + NBM demonstrated a mean CAL change from 8.9 ± 1.5 mm to 5.3 ± 0.9 mm (P <0.001) and to 5.8 ± 1.1 mm (P <0.001) at 1 and 10 years, respectively. The sites treated with EMD + β-TCP showed a mean CAL change from 9.1 ± 1.6 mm to 5.4 ± 1.1 mm (P <0.001) at 1 year and 6.1 ± 1.4 mm (P <0.001) at 10 years. At 10 years two defects in the EMD + NBM group had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. In the EMD + β-TCP group three defects had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. Compared with baseline, at 10 years, a CAL gain of ≥3 mm was measured in 64% (i.e., seven of 11) of the defects in the EMD + NBM group and in 82% (i.e., nine of 11) of the defects in the EMD + β-TCP group. No statistically significant differences were found between the 1- and 10-year values in either of the two groups. Between the treatment groups, no statistically significant differences in any of the investigated parameters were observed at 1 and 10 years.
  
  
  CONCLUSIONS
  Within their limitations, the present findings indicate that the clinical improvements obtained with regenerative surgery using EMD + NBM or EMD + β-TCP can be maintained over a period of 10 years.
authors.affiliation: Department of Periodontology, Semmelweis University, Budapest, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Döri
authors.forename: Nicole B
authors.initials: NB
authors.lastname: Arweiler
authors.forename: Erika
authors.initials: E
authors.lastname: Szántó
authors.forename: Anikó
authors.initials: A
authors.lastname: Agics
authors.forename: István
authors.initials: I
authors.lastname: Gera
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery*; D001857:Bone Matrix / Q000637:transplantation*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000601:surgery; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003774:Dental Plaque Index; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000145:classification / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D017622:Periodontal Attachment Loss / Q000145:classification / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000601:surgery; D016745:Root Planing / Q000379:methods; D013524:Surgical Flaps; D014092:Tooth Root / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D002130:Calcium Phosphates; D003746:Dental Enamel Proteins; D008903:Minerals; C485817:beta-tricalcium phosphate; C109069:enamel matrix proteins; D004492:Edetic Acid