title: Five-year results evaluating the effects of platelet-rich plasma on the healing of intrabony defects treated with enamel matrix derivative and natural bone mineral.
abstract: BACKGROUND
  Regenerative periodontal surgery using the combination of enamel matrix derivative (EMD) and natural bone mineral (NBM) with and without addition of platelet-rich plasma (PRP) has been shown to result in substantial clinical improvements, but the long-term effects of this combination are unknown.
  
  
  METHODS
  The goal of this study was to evaluate the long-term (5-year) outcomes after regenerative surgery of deep intrabony defects with either EMD + NBM + PRP or EMD + NBM. Twenty-four patients were included. In each patient, one intrabony defect was randomly treated with either EMD + NBM + PRP or EMD + NBM. Clinical parameters were evaluated at baseline and 1 and 5 years after treatment. The primary outcome variable was clinical attachment level (CAL).
  
  
  RESULTS
  The sites treated with EMD + NBM + PRP demonstrated a mean CAL change from 10.5 ± 1.6 to 6.0 ± 1.7 mm (P <0.001) at 1 year and 6.2 ± 1.5 mm (P <0.001) at 5 years. EMD + NBM-treated defects showed a mean CAL change from 10.6 ± 1.7 to 6.1 ± 1.5 mm (P <0.001) at 1 year and 6.3 ± 1.4 mm (P <0.001) at 5 years. At 1 year, a CAL gain of ≥4 mm was measured in 83% (10 of 12) of the defects treated with EMD + NBM + PRP and in 100% (all 12) of the defects treated with EMD + NBM. Compared to baseline, in both groups at 5 years, a CAL gain of ≥4 mm was measured in 75% (nine of 12 in each group) of the defects. Four sites in the EMD + PRP + NBM group lost 1 mm of the CAL gained at 1 year. In the EMD + NBM group, one defect lost 2 mm and four other defects lost 1 mm of the CAL gained at 1 year. No statistically significant differences in any of the investigated parameters were observed between the two groups.
  
  
  CONCLUSIONS
  Within their limits, the present results indicate that: 1) the clinical outcomes obtained with both treatments can be maintained up to a period of 5 years; and 2) the use of PRP does not appear to improve the results obtained with EMD + NBM.
authors: Department of Periodontology, Semmelweis University, Budapest, Hungary.
authors: Ferenc
authors: F
authors: Döri
authors: Nicole
authors: N
authors: Arweiler
authors: Tamás
authors: T
authors: Húszár
authors: István
authors: I
authors: Gera
authors: Richard J
authors: RJ
authors: Miron
authors: Anton
authors: A
authors: Sculean
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D055113:Chronic Periodontitis / Q000601:surgery; D019551:Dental Disinfectants / Q000627:therapeutic use; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D012534:Dental Scaling / Q000379:methods; 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; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000601:surgery; D053657:Platelet-Rich Plasma / Q000502:physiology*; D016300:Radiography, Bitewing; D016745:Root Planing / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D019551:Dental Disinfectants; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins; D004492:Edetic Acid