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 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 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 .