In most respects , all membranes and enamel matrix derivative ( EMD ) delivered better outcomes , in the range of 1 to 2 mm , than open flap debridement .
The use of any barrier type or EMD configuration was found to yield more Clinical Attachment Level ( CAL ) gain than any open flap configuration .
GTR was confirmed to be superior to open flap debridement
In a 1998 review article , Laurell and colleagues performed a meta- analysis of relevant guided tissue regeneration ( GTR ) articles over the previous 20 years ( 1 ) .
The purpose of the present research was to exp and on that work , particularly search ing for trends discriminating between bioabsorbable and non-bioabsorbable barriers , as well as the use of enamel matrix derivative , with respect to interproximal bony defects .
Treatment of intrabony defects with enamel matrix proteins or bioabsorbable membranes. A 4-year follow-up split-mouth study.
BACKGROUND Treatment with enamel matrix proteins ( EMD ) and guided tissue regeneration ( GTR ) with bioabsorbable membranes has been shown to promote periodontal regeneration ; however , until now , there were only limited data on the long-term clinical results following these regenerative techniques . Therefore , the aim of the present study was to present the 4-year results following treatment of intrabony defects with EMD or guided tissue regeneration ( GTR ) . METHODS Twelve patients , each displaying one pair of intrabony defects located contralaterally in the same jaw , were r and omly treated with EMD or with GTR by means of bioabsorbable membranes . The following clinical parameters were evaluated at baseline , at 1 year , and at 4 years after treatment : plaque index ( P1 ) , gingival index ( G1 ) , bleeding on probing ( BOP ) , probing depth ( PD ) , gingival recession ( GR ) , and clinical attachment level ( CAL ) . The primary outcome variable was CAL . No statistically significant differences between the groups were found at baseline . Power analysis to determine superiority of EMD treatment showed that the available sample size would yield 70 % power to detect a 1 mm difference . RESULTS The sites treated with EMD demonstrated mean CAL change from 9.8 + /- 2.0 mm to 6.4 + /- 1.6 mm ( P<0.001 ) and to 6.8 + /- 1.8 mm ( P<0.001 ) at 1 and 4 years , respectively . No statistically significant differences were found between the CAL mean at 1 and 4 years postoperatively . The sites treated with GTR showed a mean CAL change from 9.8 + /- 2.3 mm to 6.6 + /- 1.7 mm ( P<0.001 ) at 1 year and to 6.9 + /- 1.8 mm ( P<0.001 ) at 4 years . The CAL change between I and 4 years did not present statistically significant differences . No statistically significant differences in any of the investigated parameters were observed at 1 and 4 years between the treatment groups . CONCLUSIONS It was concluded that the CAL gain obtained following treatment with EMD or GTR can be maintained over a 4-year period
In most respects , all membranes and enamel matrix derivative ( EMD ) delivered better outcomes , in the range of 1 to 2 mm , than open flap debridement .
The use of any barrier type or EMD configuration was found to yield more Clinical Attachment Level ( CAL ) gain than any open flap configuration .
GTR was confirmed to be superior to open flap debridement
In a 1998 review article , Laurell and colleagues performed a meta- analysis of relevant guided tissue regeneration ( GTR ) articles over the previous 20 years ( 1 ) .
The purpose of the present research was to exp and on that work , particularly search ing for trends discriminating between bioabsorbable and non-bioabsorbable barriers , as well as the use of enamel matrix derivative , with respect to interproximal bony defects .