Clinical outcomes following regenerative therapy of non-contained intrabony defects using a deproteinized bovine bone mineral combined with either enamel matrix derivative or collagen membrane.
BACKGROUND
The purpose of this study is to compare clinical outcomes in the treatment of deep non-contained intrabony defects (i.e., with ≥70% 1-wall component and a residual 2- to 3-wall component in the most apical part) using deproteinized bovine bone mineral (DBBM) combined with either enamel matrix protein derivative (EMD) or collagen membrane (CM).


METHODS
Forty patients with multiple intrabony defects were enrolled. Only one non-contained defect per patient with an intrabony depth ≥3 mm located in the interproximal area of single- and multirooted teeth was randomly assigned to the treatment with either EMD + DBBM (test: n = 20) or CM + DBBM (control: n = 20). At baseline and after 12 months, clinical parameters including probing depth (PD) and clinical attachment level (CAL) were recorded. The primary outcome variable was the change in CAL between baseline and 12 months.


RESULTS
At baseline, the intrabony component of the defects amounted to 6.1 ± 1.9 mm for EMD + DBBM and 6.0 ± 1.9 mm for CM + DBBM sites (P = 0.81). The mean CAL gain at sites treated with EMD + DBBM was not statistically significantly different (P = 0.82) compared with CM + DBBM (3.8 ± 1.5 versus 3.7 ± 1.2 mm). No statistically significant difference (P = 0.62) was observed comparing the frequency of CAL gain ≥4 mm between EMD + DBBM (60%) and CM + DBBM (50%) or comparing the frequency of residual PD ≥6 mm between EMD + DBBM (5%) and CM + DBBM (15%) (P = 0.21).


CONCLUSIONS
Within the limitations of the present study, regenerative therapy using either EMD + DBBM or CM + DBBM yielded comparable clinical outcomes in deep non-contained intrabony defects after 12 months.
University of Naples "Federico II," Department of Dental and Maxillofacial Sciences, Naples, Italy.
Vincenzo
V
Iorio-Siciliano
Gianmaria
G
Andreuccetti
Andrea
A
Blasi
Marco
M
Matarasso
Anton
A
Sculean
Giovanni E
GE
Salvi
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D000818:Animals; D018786:Bone Substitutes / Q000627:therapeutic use*; D002417:Cattle; D055113:Chronic Periodontitis / Q000601:surgery; D003094:Collagen; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D013524:Surgical Flaps / Q000601:surgery; D016896:Treatment Outcome
D018786:Bone Substitutes; D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C109069:enamel matrix proteins; D003094:Collagen
Bone substitutes; chronic periodontitis; dental enamel proteins; guided tissue regeneration; membranes; periodontal pocket