In conclusion , follow-up time ( < or > 2 years ) and the risk of bias influence the results of treatment with EMDP in IPD
Previous systematic review s have demonstrated better results with enamel matrix derivative proteins ( EMDP ) as compared with open flap debridement ( OFD ) for the management of infrabony periodontal defects ( IPD ) .
The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies .
Enamel matrix proteins in the regenerative therapy of deep intrabony defects.
AIM This prospect i ve multicentre r and omized controlled clinical trial was design ed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of enamel matrix proteins ( EMD ) . MATERIAL AND METHODS 172 patients with advanced chronic periodontitis were recruited in 12 centers in 7 countries . All patients had at least one intrabony defect of > or = 3 mm . Heavy smokers ( > or = 20 cigarettes/day ) were excluded . The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure . After debridement , roots were conditioned for 2 min with a gel containing 24 % EDTA . EMD was applied in the test subjects , and omitted in the controls . Postsurgically , a strict plaque control protocol was followed . At baseline and 1 year following the interventions , clinical attachment levels ( CAL ) , pocket probing depths ( PPD ) , recession ( REC ) , full-mouth plaque scores and full-mouth bleeding scores were assessed . A total of 166 patients were available for the 1-year follow-up . RESULTS At baseline , 86 test and 86 control patients presented with similar subject and defect characteristics . On average , the test defects gained 3.1+/-1.5 mm of CAL , while the control defects yielded a significantly lower CAL gain of 2.5+/-1.5 mm . Pocket reduction was also significantly higher in the test group ( 3.9+/-1.7 mm ) when compared to the controls ( 3.3+/-1.7 mm ) . A multivariate analysis indicated that the treatment , the clinical centers , cigarette smoking , baseline PPD , and defect corticalisation significantly influenced CAL gains . A frequency distribution analysis of the studied outcomes indicated that EMD increased the predictability of clinical ly significant results ( CAL gains > or = 4 mm ) and decreased the probability of obtaining negligible or no gains in CAL ( CAL gains < 2 mm ) . CONCLUSIONS The results of this trial indicated that regenerative periodontal surgery with EMD offers an additional benefit in terms of CAL gains , PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone
In conclusion , follow-up time ( < or > 2 years ) and the risk of bias influence the results of treatment with EMDP in IPD
Previous systematic review s have demonstrated better results with enamel matrix derivative proteins ( EMDP ) as compared with open flap debridement ( OFD ) for the management of infrabony periodontal defects ( IPD ) .
The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies .