Enamel matrix proteins in the treatment of intra-bony defects: A prospective 24-month clinical trial

Luca Francetti, Massimo Del Fabbro, Matteo Basso, Tiziano Testori, Roberto Weinstein

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: A growing flow of recent evidence indicates enamel matrix derivative (EMD, Emdogain®) as a useful tool for the regeneration of periodontal tissues. This prospective clinical study aimed to evaluate the efficacy of EMD combined with surgical treatment of periodontal intra-bony defects, as compared with surgery alone, up to 24 months of follow-up. Methods: Twenty-four intra-bony defects were treated in 24 patients in a single clinical centre. Each defect had intra-bony depth (IBD) ≥ 4 mm and probing pocket depth (PPD) ≥ 6 mm. Patients were randomly assigned to either test or control group. Plaque index (PI), gingival index (GI), PPD and periodontal attachment level (PAL) were assessed at baseline pre-surgical examination at the site to be treated. Full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were also evaluated. Twelve patients were treated by simplified papilla preservation flap technique (control group), while 12 patients were treated with the same surgical technique plus EMD after ethylenediamine tetraacetic acid root conditioning (test group). Any probing at the involved sites was avoided in the first year post-surgery. Radiographs were taken at baseline, 12 and 24 months after surgery using customized bite blocks. Intra-bony defect depth (IBD) and angle (IBA) were measured from X-rays by a computer-aided technique. At 12 and 24 months post-surgery, FMPS, FMBS, PI, GI, PPD, PAL and radiographic IBD and IBA were assessed. The difference between each follow-up and baseline, and between groups at each follow-up was evaluated for the above parameters by standard statistical methods. Results: In both groups, clinical and radiographic parameters were improved at either 12 or 24 months when compared with baseline. The test group displayed better outcomes when compared with the control group for IBD, PPD, and PAL gain at 12 months, and only for PAL and IBD gain at 24 months. No adverse event related to the use of EMD was reported. Conclusions: The surgical procedure used in the present study, aiming for maximum preservation of the regenerative potential of periodontal tissues, showed per se excellent results. The use of EMD as an adjunct to periodontal surgery in the treatment of angular defects possibly enhances periodontal regeneration rate.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalJournal of Clinical Periodontology
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 2004

Fingerprint

Periodontal Pocket
Clinical Trials
Mouth
Periodontal Index
ethylenediamine
Control Groups
Regeneration
Hemorrhage
Therapeutics
Bites and Stings
Dental Enamel
X-Rays
enamel matrix proteins
Prospective Studies
Acids

Keywords

  • Enamel matrix proteins
  • Intra-bony defects
  • Open flap debridement
  • Periodontal attachment
  • Periodontal disease
  • Periodontal regeneration
  • Periodontal surgery

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Enamel matrix proteins in the treatment of intra-bony defects : A prospective 24-month clinical trial. / Francetti, Luca; Del Fabbro, Massimo; Basso, Matteo; Testori, Tiziano; Weinstein, Roberto.

In: Journal of Clinical Periodontology, Vol. 31, No. 1, 01.2004, p. 52-59.

Research output: Contribution to journalArticle

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AU - Weinstein, Roberto

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N2 - Background: A growing flow of recent evidence indicates enamel matrix derivative (EMD, Emdogain®) as a useful tool for the regeneration of periodontal tissues. This prospective clinical study aimed to evaluate the efficacy of EMD combined with surgical treatment of periodontal intra-bony defects, as compared with surgery alone, up to 24 months of follow-up. Methods: Twenty-four intra-bony defects were treated in 24 patients in a single clinical centre. Each defect had intra-bony depth (IBD) ≥ 4 mm and probing pocket depth (PPD) ≥ 6 mm. Patients were randomly assigned to either test or control group. Plaque index (PI), gingival index (GI), PPD and periodontal attachment level (PAL) were assessed at baseline pre-surgical examination at the site to be treated. Full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were also evaluated. Twelve patients were treated by simplified papilla preservation flap technique (control group), while 12 patients were treated with the same surgical technique plus EMD after ethylenediamine tetraacetic acid root conditioning (test group). Any probing at the involved sites was avoided in the first year post-surgery. Radiographs were taken at baseline, 12 and 24 months after surgery using customized bite blocks. Intra-bony defect depth (IBD) and angle (IBA) were measured from X-rays by a computer-aided technique. At 12 and 24 months post-surgery, FMPS, FMBS, PI, GI, PPD, PAL and radiographic IBD and IBA were assessed. The difference between each follow-up and baseline, and between groups at each follow-up was evaluated for the above parameters by standard statistical methods. Results: In both groups, clinical and radiographic parameters were improved at either 12 or 24 months when compared with baseline. The test group displayed better outcomes when compared with the control group for IBD, PPD, and PAL gain at 12 months, and only for PAL and IBD gain at 24 months. No adverse event related to the use of EMD was reported. Conclusions: The surgical procedure used in the present study, aiming for maximum preservation of the regenerative potential of periodontal tissues, showed per se excellent results. The use of EMD as an adjunct to periodontal surgery in the treatment of angular defects possibly enhances periodontal regeneration rate.

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