Enamel Matrix Derivative, Alone or Associated With a Synthetic Bone Substitute, in the Treatment of 1- to 2-Wall Periodontal Defects

In this study, we compare the effects of enamel matrix derivative (EMD) associated with a hydroxyapatite and β-tricalcium phosphate (HA/β-TCP) implant to EMD alone and to open-flap debridement (OFD) when surgically treating 1- to 2-wall intrabony defects.Thirty-four patients, exhibiting ≥3 intraosseous defects in different quadrants, were each treated by OFD, EMD, or EMD + HA/β-TCP in each defect. At baseline and 12 and 24 months, a complete clinical and radiographic examination was done. Pre-therapy and post-therapy clinical (probing depth [PD], clinical attachment level [CAL], and gingival recession [GR]) and radiographic (defect bone level [DBL] and radiographic bone gain [RBG]) parameters for the different treatments were compared.After 12 and 24 months, almost all the clinical and radiographic parameters showed significant changes from baseline within each group (P0.001). Differences in PD, CAL, and DBL scores were also seen among the three groups at the 12- and 24-month visits (P0.001). At 12 and 24 months after treatment, the EMD + HA/β-TCP group showed significantly greater PD reduction (4.00 ± 0.42 mm; 4.25 ± 0.63 mm), CAL gain (3.47 ± 0.65 mm; 3.63 ± 0.91 mm), and RBG (3.17 ± 0.69 mm; 3.35 ± 0.80 mm) and less GR increase (0.56 ± 0.37 mm; 0.63 ± 0.42 mm) compared with the OFD and EMD groups (P0.05).Our data support the hypothesis that the adjunct of an HA/β-TCP composite implant with EMD may improve the clinical and radiographic outcomes of the surgical treatment of unfavorable intrabony defects.