Enamel matrix proteins in the treatment of intra-bony defects. A prospective 24-month clinical trial
Articolo
Data di Pubblicazione:
2004
Citazione:
Enamel matrix proteins in the treatment of intra-bony defects. A prospective 24-month clinical trial / L. Francetti, M. Del Fabbro, M. Basso, T. Testori, R. Weinstein. - In: JOURNAL OF CLINICAL PERIODONTOLOGY. - ISSN 0303-6979. - 31:1(2004), pp. 52-59.
Abstract:
Background: A growing flow of recent evidence indicates enamel matrix derivative
(EMD, Emdogains) as a useful tool for the regeneration of periodontal tissues. This
prospective clinical study aimed to evaluate the efficacy of EMD combined with
surgical treatment of periodontal intra-bony defects, as compared with surgery alone,
up to 24 months of follow-up.
Methods: Twenty-four intra-bony defects were treated in 24 patients in a single
clinical centre. Each defect had intra-bony depth (IBD) X4mm and probing pocket
depth (PPD) X6 mm. Patients were randomly assigned to either test or control group.
Plaque index (PI), gingival index (GI), PPD and periodontal attachment level (PAL)
were assessed at baseline pre-surgical examination at the site to be treated. Full mouth
plaque score (FMPS) and full mouth bleeding score (FMBS) were also evaluated.
Twelve patients were treated by simplified papilla preservation flap technique (control
group), while 12 patients were treated with the same surgical technique plus EMD
after ethylenediamine tetraacetic acid root conditioning (test group). Any probing at
the involved sites was avoided in the first year post-surgery. Radiographs were taken
at baseline, 12 and 24 months after surgery using customized bite blocks. Intra-bony
defect depth (IBD) and angle (IBA) were measured from X-rays by a computer-aided
technique. At 12 and 24 months post-surgery, FMPS, FMBS, PI, GI, PPD, PAL and
radiographic IBD and IBA were assessed. The difference between each follow-up and
baseline, and between groups at each follow-up was evaluated for the above
parameters by standard statistical methods.
Results: In both groups, clinical and radiographic parameters were improved at either
12 or 24 months when compared with baseline. The test group displayed better
outcomes when compared with the control group for IBD, PPD, and PAL gain at 12
months, and only for PAL and IBD gain at 24 months. No adverse event related to the
use of EMD was reported.
Conclusions: The surgical procedure used in the present study, aiming for maximum
preservation of the regenerative potential of periodontal tissues, showed per se
excellent results. The use of EMD as an adjunct to periodontal surgery in the treatment
of angular defects possibly enhances periodontal regeneration rate.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
enamel matrix proteins ; intra-bony
defects ; open flap debridement ; periodontal
attachment ; periodontal disease ; periodontal
regeneration ; periodontal surgery
Elenco autori:
L. Francetti, M. Del Fabbro, M. Basso, T. Testori, R. Weinstein
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