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 .
Clinical evaluation of demineralized freeze-dried bone allograft and enamel matrix derivative versus enamel matrix derivative alone for the treatment of periodontal osseous defects in humans.
BACKGROUND A recent study suggests that the addition of enamel matrix derivative to demineralized freeze-dried bone allograft may enhance osseoinduction . The purpose of this study was to evaluate the use of demineralized freeze-dried bone allograft ( DFDBA ) in combination with enamel matrix derivative ( EMD + DFDBA ) compared to enamel matrix derivative ( EMD ) alone in the treatment of human intrabony periodontal defects . METHODS Forty patients with a total of 67 sites ( intrabony defect > or = 3 mm deep ) were selected to participate in this single-masked , parallel design , r and omized , controlled clinical trial . Each subject received either EMD alone ( 34 sites ) or in combination with DFDBA ( 33 sites ) . Soft tissue measurements included probing depth ( PD ) , clinical attachment level ( CAL ) , and recession . Hard tissue measurements included defect depth , alveolar crestal resorption , and defect morphology . Following 6 months of healing , all soft tissue measurements were repeated . Forty-nine sites ( EMD + DFDBA = 26 sites , EMD alone = 23 sites ) were surgically reentered . Statistical analyses were performed using unpaired and paired Student t tests . RESULTS Analyses showed a significant improvement in soft tissue parameters for both treatment groups ( P < 0.001 ) as compared to preoperative measurements . There were no statistical differences between treatment groups . The probing depth reduction ( PDR ) for the EMD + DFDBA was 3.6 + /- 0.2 mm , while the EMD alone had a PDR of 4.0 + /- 0.3 mm . The CAL gain for the EMD + DFDBA group was 3.0 + /- 0.3 mm and 3.2 + /- 0.3 mm for the EMD alone group . The mean value for bone fill in the EMD + DFDBA group was 3.7 + /- 0.2 mm ( 74.9 % ) , while the EMD alone group demonstrated a mean bone fill of 2.6 + /- 0.4 mm ( 55.3 % ) . While there were no significant differences between the two treatments with regards to soft tissue measurements , the combination of EMD + DFDBA therapy yielded statistically significant improvements in bone fill , crestal resorption , and percentage of sites gaining greater than 50 % and 90 % bone fill when compared to EMD alone ( P < 0.001 ) . CONCLUSION The results of this study indicate that there may be an enhancement of hard tissue parameters when enamel matrix derivative is added to demineralized freeze-dried bone allograft
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 .