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 .
Clinical and radiographic outcomes of the modified minimally invasive surgical technique with and without regenerative materials: a randomized-controlled trial in intra-bony defects.
AIMS This three-arm study compared the clinical and radiographic efficacy of the modified minimally invasive surgical technique ( M-MIST ) alone and combined with enamel matrix derivative ( EMD ) or EMD plus bone mineral derived xenograph ( BMDX ) , in the treatment of isolated , inter-dental intra-bony defects . MATERIAL S AND METHODS Forty-five deep isolated intra-bony defects in 45 patients were included , accessed with the M-MIST and r and omly assigned to three balanced experimental groups . The M-MIST consisted of a small buccal flap without elevation of the defect-associated papilla . After removal of the granulation tissue by sharp dissection and root instrumentation the regenerative material was applied , when indicated , before obtaining primary closure with a single internal modified mattress suture . Surgery was performed with the aid of an operating microscope and microsurgical instruments . Outcomes were evaluated as pocket depth reduction , attachment level gain , radiographic bone fill and patient-related outcomes . RESULTS Primary wound closure was maintained in all treated sites with the exception of one M-MIST EMD+BMDX site . No patient reported intra-operative or post-operative pain . Within group differences between baseline and 1 year were statistically significant in the three groups in terms of probing pocket depth reduction , clinical attachment level ( CAL ) gain and bone fill ( p<0.0001 ) . Comparisons among the thre groups showed no statistically significant difference in any of the measured clinical outcomes . In particular , CAL gains of 4.1±1.4 mm were observed in the M-MIST control group , 4.1±1.2 mm in the EMD group and 3.7±1.3 mm in the EMD+BMDX one . The percentage radiographic bone fill of the intra-bony component was 77±19 % in the M-MIST control group , 71±18 % in the EMD group and 78±27 % in the EMD+BMDX group . CONCLUSIONS M-MIST with or without regenerative material s result ed in significant clinical and radiographic improvements . While this initial study did not have sufficient power to detect inter-group CAL differences < 0.96 mm , the observed outcomes were remarkably similar and warrant further investigations
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 .