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Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study.
J Clin Periodontol 2001; 28(5):397-403JC

Abstract

BACKGROUND

Utilisation of enamel matrix proteins (EMD) and application of the guided tissue regeneration principle (GTR) are treatment modalities which both have been shown to result in periodontal regeneration. However, it is yet unknown whether the combination of EMD and GTR may additionally favor the regeneration process.

AIM

The aim of the present controlled study was to evaluate clinically the treatment effect of EMD, GTR, combination of EMD and GTR, and flap surgery (control) on intrabony defects.

MATERIAL AND METHODS

56 patients each of whom displaying one intrabony defect of a depth of at least 6 mm were randomly treated with one of the treatment modalities. Prior to surgery and at one year after, the following parameters were evaluated by a blinded examiner: Plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), gingival recession (GR) and clinical attachment level (CAL). No statistical significant differences between the four groups were observed at baseline for any of the investigated parameters.

RESULTS

At 1 year after therapy, the sites treated with EMD demonstrated a mean PPD reduction of 4.1 +/- 1.7 mm and a mean CAL gain of 3.4 +/- 1.5 mm (p<0.001). The sites treated with GTR showed a mean PPD reduction of 4.2 +/- 1.9 mm and a mean CAL gain of 3.1 +/- 1.5 mm (p<0.001). The sites treated with the combined treatment showed a mean PPD reduction of 4.3 +/- 1.4 mm and a mean CAL gain of 3.4 +/- 1.1 mm (p<0.001). In the control group, the mean PPD reduction was 3.7 +/- 1.4 mm (p<0.001) and the mean CAL gain measured 1.7 +/- 1.5 mm (p<0.01). All 4 treatments led to statistically significant PPD reduction and CAL gain. All three regenerative treatments led to higher CAL gain than the control treatment (p<0.05). No statistical significant differences in PPD reduction and CAL gain were observed between the three regenerative treatments.

CONCLUSION

It may be concluded that (a) all 3 regenerative treatment modalities may lead to higher CAL gain than the control one, and (b) the combined treatment does not seem to improve the outcome of the regenerative procedure.

Authors+Show Affiliations

Department of Periodontology and Conservative Dentistry, University of Saarland, Homburg, Germany. zmkascu@krzsun.med-rz.uni-sb.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11350501

Citation

Sculean, A, et al. "Treatment of Intrabony Defects With Enamel Matrix Proteins and Guided Tissue Regeneration. a Prospective Controlled Clinical Study." Journal of Clinical Periodontology, vol. 28, no. 5, 2001, pp. 397-403.
Sculean A, Windisch P, Chiantella GC, et al. Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study. J Clin Periodontol. 2001;28(5):397-403.
Sculean, A., Windisch, P., Chiantella, G. C., Donos, N., Brecx, M., & Reich, E. (2001). Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study. Journal of Clinical Periodontology, 28(5), pp. 397-403.
Sculean A, et al. Treatment of Intrabony Defects With Enamel Matrix Proteins and Guided Tissue Regeneration. a Prospective Controlled Clinical Study. J Clin Periodontol. 2001;28(5):397-403. PubMed PMID: 11350501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study. AU - Sculean,A, AU - Windisch,P, AU - Chiantella,G C, AU - Donos,N, AU - Brecx,M, AU - Reich,E, PY - 2001/5/15/pubmed PY - 2002/1/5/medline PY - 2001/5/15/entrez SP - 397 EP - 403 JF - Journal of clinical periodontology JO - J. Clin. Periodontol. VL - 28 IS - 5 N2 - BACKGROUND: Utilisation of enamel matrix proteins (EMD) and application of the guided tissue regeneration principle (GTR) are treatment modalities which both have been shown to result in periodontal regeneration. However, it is yet unknown whether the combination of EMD and GTR may additionally favor the regeneration process. AIM: The aim of the present controlled study was to evaluate clinically the treatment effect of EMD, GTR, combination of EMD and GTR, and flap surgery (control) on intrabony defects. MATERIAL AND METHODS: 56 patients each of whom displaying one intrabony defect of a depth of at least 6 mm were randomly treated with one of the treatment modalities. Prior to surgery and at one year after, the following parameters were evaluated by a blinded examiner: Plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), gingival recession (GR) and clinical attachment level (CAL). No statistical significant differences between the four groups were observed at baseline for any of the investigated parameters. RESULTS: At 1 year after therapy, the sites treated with EMD demonstrated a mean PPD reduction of 4.1 +/- 1.7 mm and a mean CAL gain of 3.4 +/- 1.5 mm (p<0.001). The sites treated with GTR showed a mean PPD reduction of 4.2 +/- 1.9 mm and a mean CAL gain of 3.1 +/- 1.5 mm (p<0.001). The sites treated with the combined treatment showed a mean PPD reduction of 4.3 +/- 1.4 mm and a mean CAL gain of 3.4 +/- 1.1 mm (p<0.001). In the control group, the mean PPD reduction was 3.7 +/- 1.4 mm (p<0.001) and the mean CAL gain measured 1.7 +/- 1.5 mm (p<0.01). All 4 treatments led to statistically significant PPD reduction and CAL gain. All three regenerative treatments led to higher CAL gain than the control treatment (p<0.05). No statistical significant differences in PPD reduction and CAL gain were observed between the three regenerative treatments. CONCLUSION: It may be concluded that (a) all 3 regenerative treatment modalities may lead to higher CAL gain than the control one, and (b) the combined treatment does not seem to improve the outcome of the regenerative procedure. SN - 0303-6979 UR - https://www.unboundmedicine.com/medline/citation/11350501/Treatment_of_intrabony_defects_with_enamel_matrix_proteins_and_guided_tissue_regeneration__A_prospective_controlled_clinical_study_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0303-6979&amp;date=2001&amp;volume=28&amp;issue=5&amp;spage=397 DB - PRIME DP - Unbound Medicine ER -