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 .
The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study.
UNLABELLED In the present prospect i ve clinical trial , the effect of various regenerative procedures performed at sites with angular bone defects were evaluated . The main outcome variable was probing attachment alteration . MATERIAL AND METHODS 40 subjects , aged 32 - 61 years participated . They met the following inclusion criteria : ( i ) presence of generalized , advanced periodontal tissue destruction ; ( ii ) presence of 2 similar , contralateral , angular bone defects ( experimental sites ) located in either the maxilla or the m and ible ; ( iii ) the defect site must exhibit a probing pocket depth ( PPD ) of > or = 6 mm , a probing attachment level ( PAL ) of > or = 7 mm , and a depth of the intrabony component of > or = 3 mm . All subjects had a good oral hygiene st and ard , were in good general health and did not use any medication . Prior to the start of the study , all subjects received non-surgical treatment for periodontal disease .  Baseline clinical measurements ( plaque , gingivitis , PPD , PAL and soft tissue recession ) of the selected experimental sites were obtained 6 months after the completion of basic therapy . The 40 subjects were r and omly divided into 4 treatment groups including 10 subjects each : 3 membrane groups and one Emdogain group . 1 h before surgery , the patients were given 3 g of Amoxicillin . No other antibiotics were prescribed . The test and control sites were treated during the same surgical session . Full thickness flaps were elevated and the exposed root surfaces were planed . Membrane placement : The root surface was rinsed with saline . A barrier membrane ( Guidor or Resolut or Periodontal ( e-PTFE ) material ) was positioned to cover the defect and the adjacent 2 - 3 mm of bone tissue . The control treatment was identical to the test treatment with the exception of barrier placement . Emdogain placement : The exposed root surfaces at both the test and control sites were , during a 2-min period , conditioned with a 24 % EDTA gel . Emdogain was applied to the exposed root surface of the test site . In the control site , the vehicle , the PGA gel , was used as placebo control . The flaps were closed and sutured to obtain a complete coverage of the intrabony defect . RESULTS Re-examinations , which were performed 12 months after surgery , disclosed that regenerative therapy , including either the use of barrier membranes or application of enamel matrix proteins to an instrumented root surface in an angular , intrabony defect , enhanced outcome variables such as probing pocket depth and probing attachment gain . It was furthermore demonstrated that clinical improvements were better at sites with deep , than at sites with shallow , intrabony defects . CONCLUSION The 4 regenerative modalities tested appeared to be equally effective in terms of PPD reduction and PAL gain , and superior to open flap curettage alone
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 .