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 .
Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study.
BACKGROUND Utilisation of enamel matrix proteins ( EMD ) and application of the guided tissue regeneration principle ( GTR ) are treatment modalities which both have been shown to result in periodontal regeneration . However , it is yet unknown whether the combination of EMD and GTR may additionally favor the regeneration process . AIM The aim of the present controlled study was to evaluate clinical ly the treatment effect of EMD , GTR , combination of EMD and GTR , and flap surgery ( control ) on intrabony defects . MATERIAL AND METHODS 56 patients each of whom displaying one intrabony defect of a depth of at least 6 mm were r and omly treated with one of the treatment modalities . Prior to surgery and at one year after , the following parameters were evaluated by a blinded examiner : Plaque index ( PlI ) , gingival index ( GI ) , bleeding on probing ( BOP ) , probing pocket depth ( PPD ) , gingival recession ( GR ) and clinical attachment level ( CAL ) . No statistical significant differences between the four groups were observed at baseline for any of the investigated parameters . RESULTS At 1 year after therapy , the sites treated with EMD demonstrated a mean PPD reduction of 4.1 + /- 1.7 mm and a mean CAL gain of 3.4 + /- 1.5 mm ( p<0.001 ) . The sites treated with GTR showed a mean PPD reduction of 4.2 + /- 1.9 mm and a mean CAL gain of 3.1 + /- 1.5 mm ( p<0.001 ) . The sites treated with the combined treatment showed a mean PPD reduction of 4.3 + /- 1.4 mm and a mean CAL gain of 3.4 + /- 1.1 mm ( p<0.001 ) . In the control group , the mean PPD reduction was 3.7 + /- 1.4 mm ( p<0.001 ) and the mean CAL gain measured 1.7 + /- 1.5 mm ( p<0.01 ) . All 4 treatments led to statistically significant PPD reduction and CAL gain . All three regenerative treatments led to higher CAL gain than the control treatment ( p<0.05 ) . No statistical significant differences in PPD reduction and CAL gain were observed between the three regenerative treatments . CONCLUSION It may be concluded that ( a ) all 3 regenerative treatment modalities may lead to higher CAL gain than the control one , and ( b ) the combined treatment does not seem to improve the outcome of the regenerative procedure
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 .