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 .
Evaluation of efficacy of enamel matrix derivative in the treatment of intrabony defects: a 24-month multicenter study.
The aim of this prospect i ve multicenter controlled clinical study was to evaluate the efficacy of Emdogain ( Biora ) , an enamel matrix derivative ( EMD ) , when combined with surgical treatment of periodontal angular defects , as compared to surgery alone , for up to 24 months of follow-up . The study was performed at six Italian universities and 11 private practice s. Patients with one- , two- , or three-wall angular defects were enrolled if intrabony defect depth ( IBD ) was 4 mm or more and probing pocket depth ( PPD ) was at least 6 mm . They were r and omly allocated to either test or control groups . The test group was treated by the simplified papilla preservation ( SPP ) flap plus Emdogain after root conditioning with ethylenediaminetetraacetic acid . The control group was treated by SPP alone .  Plaque Index , Gingival Index , PPD , and periodontal attachment level ( PAL ) at surgical sites were assessed at the presurgical examination ( baseline ) . IBD was measured intraoperatively after debridement . IBD was also evaluated with a computer-aided technique , from periapical radiographs . Plaque Index , Gingival Index , PPD , PAL , and IBD were assessed at 12 and 24 months postsurgery . Data were further divided in two subgroups according to baseline IBD ( 6 mm or less and more than 6 mm ) . The differences between each follow-up and baseline , and between groups at each follow-up , for the above parameters were evaluated by st and ard statistical methods . One hundred fifty-three patients were recruited , accounting for 195 intrabony defects : 83 patients ( 108 defects ) and 70 patients ( 87 defects ) were allocated to the test and control groups , respectively . All parameters were improved at both 12 and 24 months , compared to baseline in both groups . In the test group , IBD , PPD , and PAL at 12 months were significantly better than these parameters in the control group . The test subgroup with IBD of more than 6 mm at baseline displayed a better outcome when compared to the 6 mm or less IBD subgroup . No significant adverse events related to the use of Emdogain were reported . The use of EMD as an adjunct to periodontal surgery in the treatment of angular defects significantly enhanced the rate and degree of periodontal regeneration . The control group also displayed significant tissue regeneration , but at a slower rate compared to the Emdogain group . The surgical procedure itself , with its goal of maximum preservation of the regenerative potential of periodontal tissues , proved to be effective in the treatment of periodontal angular defects . Pockets with IBD greater than 6 mm showed major improvement when treated with Emdogain
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 .