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 .
Enamel matrix proteins in the treatment of intra-bony defects. A prospective 24-month clinical trial.
BACKGROUND A growing flow of recent evidence indicates enamel matrix derivative ( EMD , Emdogain ) as a useful tool for the regeneration of periodontal tissues . This prospect i ve clinical study aim ed 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 ) > or = 4 mm and probing pocket depth ( PPD ) > or = 6 mm . Patients were r and omly 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 st and ard 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 , aim ing 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
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 .