Background: Regenerative periodontal surgery utilizing a combination of an enamel matrix protein derivative (EMD) and a natural bone mineral (NBM) and platelet-rich plasma (PRP) has been shown to enhance the outcomes of regenerative surgery significantly. At present, it is unknown whether root conditioning with EMD, followed by defect fill with a combination of NBM+PRP may additionally enhance the clinical results obtained with EMD+NBM. Aim: To compare clinically the treatment of deep intrabony defects with either EMD+NBM+PRP or EMD+NBM. Material and Methods: Twenty-six patients suffering from advanced chronic periodontitis, and each of whom displayed one advanced intrabony defect were randomly treated with either EMD+NBM+PRP (test) or EMD+NBM (control). The following clinical parameters were evaluated at baseline and at 1 year after treatment: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). The primary outcome variable was CAL. Results: Healing was uneventful in all patients. At 1 year after therapy, the test sites showed a reduction in mean PD from 8.8±1.9 mm to 3.1±0.9 mm (p<0.001) and a change in mean CAL from 10.8±2.0 mm to 6.0±1.5 mm (p<0.001). In the control group the mean PD was reduced from 8.8±2.0 mm to 2.8±1.6 mm (p<0.001) and the mean CAL changed from 10.5±1.6 mm to 5.5±1.4 mm (p<0.001). CAL gains of ≥4 mm were measured in 77% (i.e. in 10 out of 13 defects) of the cases treated with EMD+NBM+PRP and in 100% (i.e. in all 13 defects) treated with EMD+NBM. No statistically significant differences in any of the investigated parameters were observed between the two groups. Conclusions: Within its limits, the present study has shown that (i) 1 year after regenerative surgery, both treatments resulted in statistically significant PD reductions and CAL gains and (ii) the use of PRP failed to enhance the results obtained with EMD+NBM.
- Controlled clinical trial
- Enamel matrix protein derivative
- Intrabony defects
- Natural bone mineral
- Platelet-rich plasma
- Regenerative periodontal therapy
ASJC Scopus subject areas