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Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial
Author(s) -
Graziani Filippo,
Gennai Stefano,
Petrini Morena,
Bettini Laura,
Tonetti Maurizio
Publication year - 2019
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.13074
Subject(s) - enamel matrix derivative , medicine , dentistry , periodontitis , bleeding on probing , gastroenterology , regeneration (biology) , microbiology and biotechnology , biology
Aim An acute phase response is induced after non‐surgical periodontal treatment ( SRP ). The main aim of this study was to compare acute phase (24‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative ( EMD ) in sites with probing pocket depth ( PPD ) ≥ 6 mm. Methods Thirty‐eight periodontitis‐affected subjects were randomized to SRP or SRP + EMD . Periodontal parameters were recorded at baseline and 3 months. Serum samples were collected at baseline, 1 and 90 days after treatment. Results Both treatments triggered an intense acute inflammation on day 1, which regressed to baseline values at 3 months. D‐dimer and cystatin C levels did not show sharp increases in SRP + EMD group 24 hr after treatment, compared to SRP . Significant difference between groups was observed for D‐dimer ( p < 0.001). EMD application was also associated with better periodontal healing as shown by greater PPD reduction and clinical attachment level gain in sites with PPD ≥ 6 mm, and higher number of cases with no residual PPD ≥ 6 mm ( p < 0.05) at 3 months. Conclusions EMD application after non‐SRP resulted in lower fibrinolysis, and better periodontal healing of deep pockets. These initial observations warrant further investigations on the potential to modulate both local and systemic outcomes of non‐SRP. NCT 03544931