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 and guided tissue regeneration with titanium-reinforced expanded polytetrafluoroethylene membranes in the treatment of infrabony defects: a comparative controlled clinical trial.
BACKGROUND Several studies have documented the clinical efficacy of guided tissue regeneration ( GTR ) with non-resorbable exp and ed polytetrafluoroethylene ( ePTFE ) membranes and enamel matrix proteins ( EMP ) in the treatment of infrabony defects . The objective of this controlled clinical study was to compare the clinical outcomes of 3 surgical modalities in the treatment of deep interproximal infrabony defects . METHODS Ninety ( 90 ) defects in 90 healthy subjects affected by chronic periodontitis were assigned to 1 of 3 treatment groups by blocking to prognostic variables . The test group was treated with the application of EMP and the simplified papilla preservation ( SPP ) technique ; the second group was treated with titanium-reinforced ePFTE membranes and the SPP technique ; and the third group was treated with the SPP technique used as access flap control procedure . No differences were observed in terms of baseline oral hygiene and defect characteristics among the 3 groups , indicating that the blocking approach was effective . A stringent infection control program was adopted for 1 year . RESULTS The 1-year results indicated that : 1 ) all treatment modalities result ed in clinical ly significant improvements in clinical attachment levels ( CAL ) and reduction in probing depth ( PD ) ; 2 ) a statistically significant treatment effect was demonstrated comparing the EMP test , the membrane control , and the flap control groups in terms of CAL gains ; 3 ) both the EMP test and the membrane control groups showed significant CAL gains compared to the flap control group ; 4 ) a statistically significantly greater amount of CAL gain was demonstrated in GTR-treated compared to EMP-treated patients ; 5 ) deeper residual probing depths but smaller increases in gingival recession were demonstrated following EMP therapy ; and 6 ) smoking habits reduced the clinical outcomes of both regenerative procedures . CONCLUSIONS The use of a regenerative procedure is indicated in the treatment of deep vertical bony defects since both the regenerative techniques ( GTR and EMD ) in the present study result ed in clinical ly and statistically significant improvements in clinical parameters compared to the access flap procedure . The use of EMP can be helpful in esthetically-sensitive sites and in reducing patient morbidity
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 .