title: Treatment of supra-alveolar-type defects by a simplified papilla preservation technique for access flap surgery with or without enamel matrix proteins.
abstract: BACKGROUND
  In this study, we compare the effectiveness of enamel matrix derivative (EMD) associated with a simplified papilla preservation flap (SPPF) technique to SPPF alone when surgically treating supra-alveolar-type defects.
  
  
  METHODS
  Fifty patients, from 54 initially selected, presenting horizontal bone loss around ≥4 adjacent teeth, were treated by an SPPF technique; 25 participants also received EMD (test group) and 25 patients underwent flap surgery alone (control group). A complete clinical and radiographic examination was performed at baseline and 12 months after treatment. Pre- and post-therapy probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and radiographic bone level (BL) were compared between treatments.
  
  
  RESULTS
  After 12 months, PD, CAL, and GR in both groups showed significant differences from baseline (P <0.001). No differences in BL scores were observed within the groups at the 12-month examination. After 1 year, the test group showed significantly (P <0.001) greater PD reduction (3.4 ± 0.7 mm) and CAL gain (2.8 ± 0.8 mm) and a smaller GR increase (0.6 ± 0.4 mm) compared to the control group (PD, 2.2 ± 0.8 mm; CAL, 1.0 ± 0.6 mm; GR, 1.2 ± 0.7 mm.) BL changes did not significantly differ between the experimental groups.
  
  
  CONCLUSIONS
  The results of this study suggest that combining EMD and SPPF in the treatment of suprabony defects may lead to a greater clinical improvement compared to SPPF alone.
authors.affiliation: Department of Oral Sciences, Nano and Biotechnologies, G. D'Annunzio University, Chieti-Pescara, Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Di Tullio
authors.forename: Beatrice
authors.initials: B
authors.lastname: Femminella
authors.forename: Andrea
authors.initials: A
authors.lastname: Pilloni
authors.forename: Luigi
authors.initials: L
authors.lastname: Romano
authors.forename: Camillo
authors.initials: C
authors.lastname: D'Arcangelo
authors.forename: Paolo
authors.initials: P
authors.lastname: De Ninis
authors.forename: Michele
authors.initials: M
authors.lastname: Paolantonio
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000187:drug effects; D001861:Bone Regeneration / Q000187:drug effects; D055113:Chronic Periodontitis / Q000601:surgery; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000601:surgery; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D013524:Surgical Flaps / Q000601:surgery*; D014092:Tooth Root / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D003746:Dental Enamel Proteins; C109069:enamel matrix proteins