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Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri‐implantitis. A randomized controlled trial
Author(s) -
Isehed Catrine,
Holmlund Anders,
Renvert Stefan,
Svenson Björn,
Johansson Ingegerd,
Lundberg Pernilla
Publication year - 2016
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12583
Subject(s) - peri implantitis , enamel matrix derivative , medicine , bleeding on probing , dentistry , debridement (dental) , randomized controlled trial , mucositis , implant , anaerobic exercise , surgery , periodontitis , regeneration (biology) , biology , physiology , microbiology and biotechnology , chemotherapy
Objective This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri‐implantitis alone or in combination with enamel matrix derivative ( EMD ). Methods Twenty‐six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD . Bone level ( BL ) change was primary outcome and secondary outcomes were changes in pocket depth ( PD ), plaque, pus, bleeding and the microbiota of the peri‐implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months. Results In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD , the number of osseous walls in the peri‐implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram−/anaerobic microbial flora and presence of bleeding and pus, with a cross‐validated predictive capacity ( Q 2 ) of 36.4%. Similar, but statistically non‐significant, trends were seen for BL , PD , plaque, pus and bleeding in univariate analysis. Conclusion Adjunctive EMD to surgical treatment of peri‐implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow‐up period and increased marginal BL 12 months after treatment.