Enamel matrix protein derivative plus synthetic bone substitute for the treatment of mandibular Class II furcation defects: a case series.
OBJECTIVE
The aim of this study is to report on the treatment of mandibular Class II furcation defects with enamel matrix protein derivative (EMD) combined with a βTCP/HA (β-tricalcium phosphate/hydroxyapatite) alloplastic material.


METHODS
Thirteen patients were selected. All patients were nonsmokers, systemically healthy, and diagnosed with chronic periodontitis; had not taken medications known to interfere with periodontal tissue health and healing; presented one Class II mandibular furcation defect with horizontal probing equal to or greater than 4 mm at buccal site. The clinical parameters evaluated were probing depth (PD), relative gingival margin position (RGMP), relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). A paired Student t test was used to detect differences between the baseline and 6-month measurements, with the level of significance of .05.


RESULTS
After 6 months, the treatment produced a statistically significant reduction in PD and a significant gain in RVCAL and RHCAL, but no observable change in RGMP. RVCAL ranged from 13.77 (± 1.31) at baseline to 12.15 (± 1.29) after 6 months, with a mean change of -1.62 ± 1.00 mm (P < .05). RHCAL ranged from 5.54 (± 0.75) to 2.92 (± 0.92), with a mean change of -2.62 ± 0.63 mm (P < .05). After 6 months, 76.92% of the patients improved their diagnosis to Class I furcation defects while 23.08% remained as Class II.


CONCLUSIONS
The present study has shown that positive clinical results may be expected from the combined treatment of Class II furcation defects with EMD and βTCP/HA, especially considering the gain of horizontal attachment level. Despite this result, controlled clinical studies are needed to confirm our outcomes.
Lucas Araujo
LA
Queiroz
Mauro
M
Santamaria
Marcio
M
Casati
Karina
K
Silverio
Francisco
F
Nociti-Junior
Enilson
E
Sallum
D016301:Alveolar Bone Loss / Q000601:surgery; D018786:Bone Substitutes / Q000494:pharmacology*; D055113:Chronic Periodontitis / Q000601:surgery*; D003746:Dental Enamel Proteins / Q000494:pharmacology*; D005260:Female; D017823:Furcation Defects / Q000145:classification / Q000601:surgery*; D005889:Gingival Recession / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D006882:Hydroxyapatites / Q000494:pharmacology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D016896:Treatment Outcome
D018786:Bone Substitutes; D003746:Dental Enamel Proteins; D006882:Hydroxyapatites; C109069:enamel matrix proteins; C074950:hydroxyapatite-beta tricalcium phosphate