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Ten‐Year Results Following Treatment of Intrabony Defects With an Enamel Matrix Protein Derivative Combined With Either a Natural Bone Mineral or a β‐Tricalcium Phosphate
Author(s) -
Döri Ferenc,
Arweiler Nicole B.,
Szántó Erika,
Ágics Anikó,
Gera István,
Sculean Anton
Publication year - 2013
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2012.120238
Subject(s) - enamel matrix derivative , dentistry , medicine , gingival recession , bone mineral , periodontitis , osteoporosis , biology , regeneration (biology) , microbiology and biotechnology
Background: The purpose of the present study is to evaluate the 10‐year results following treatment of intrabony defects treated with an enamel matrix protein derivative (EMD) combined with either a natural bone mineral (NBM) or β‐tricalcium phosphate (β‐TCP). Methods: Twenty‐two patients with advanced chronic periodontitis and displaying one deep intrabony defect were randomly treated with a combination of either EMD + NBM or EMD + β‐TCP. Clinical evaluations were performed at baseline and at 1 and 10 years. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level (CAL). The primary outcome variable was CAL. Results: The defects treated with EMD + NBM demonstrated a mean CAL change from 8.9 ± 1.5 mm to 5.3 ± 0.9 mm ( P <0.001) and to 5.8 ± 1.1 mm ( P <0.001) at 1 and 10 years, respectively. The sites treated with EMD + β‐TCP showed a mean CAL change from 9.1 ± 1.6 mm to 5.4 ± 1.1 mm ( P <0.001) at 1 year and 6.1 ± 1.4 mm ( P <0.001) at 10 years. At 10 years two defects in the EMD + NBM group had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. In the EMD + β‐TCP group three defects had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. Compared with baseline, at 10 years, a CAL gain of ≥3 mm was measured in 64% (i.e., seven of 11) of the defects in the EMD + NBM group and in 82% (i.e., nine of 11) of the defects in the EMD + β‐TCP group. No statistically significant differences were found between the 1‐ and 10‐year values in either of the two groups. Between the treatment groups, no statistically significant differences in any of the investigated parameters were observed at 1 and 10 years. Conclusion: Within their limitations, the present findings indicate that the clinical improvements obtained with regenerative surgery using EMD + NBM or EMD + β‐TCP can be maintained over a period of 10 years.