Generalizability of the Added Benefits of Guided Tissue Regeneration in the Treatment of Deep Intrabony Defects. Evaluation in a Multi‐Center Randomized Controlled Clinical Trial

Tonetti, Maurizio S.; Cortellini, Pierpaolo; Suvan, Jean; Adriaens, Patrick A.; Baldi, Carlo; Dubravec, Dominik; Fonzar, Alberto; Fourmousis, Ioannis; Magnani, Cristina; Muller-Campanile, Veronique; Patroni, Stefano; Sanz, Mariano; Vangsted, Tine; Zabalegui, Ion; Prato, Giovanpaolo Pini; Lang, Niklaus P.

doi:10.1902/jop.1998.69.11.1183

Cited by 134 publications

(182 citation statements)

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“…Post-surgical controls and professional tooth cleaning consisting of supragingival prophylaxis with a rubber cup and 1 % chlorhexidine gel (Corsodyl) were performed at 3, 7, 14, 28 and 48 days post-surgery. All patients were maintained in a periodontal supportive programme, and they received professional prophylaxis and calculus removal at 3, 6 and 12 months as previously described [21].…”

Section: Post-surgical Instruction and Infection Controlmentioning

confidence: 99%

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

et al. 2015

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Section: Post-surgical Instruction and Infection Controlmentioning

confidence: 99%

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

et al. 2015

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“…Several factors can directly influence the clinical outcomes of GTR. Among these are factors related to the surgical technique (Cortellini et al, 1995a,b), the clinician's experience and surgical skill (Tonetti et al, 1999), tooth morphology (Lu, 1992), and defect morphology (Tonetti et al, 1993;Trombelli et al, 1997).Another factor potentially adversely affecting the outcome of every regenerative procedure is bacterial load. Several studies have shown that bacteria may heavily colonize exposed membranes, and that there is a negative relationship between attachment gain and bacterial colonization of the barrier material (Demolon et al, 1993;Machtei et al, 1993;Nowzari and Slots, 1994;Nowzari et al, 1995).…”

mentioning

confidence: 99%

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

Venezia

Goldstein

Boyan

et al. 2004

Critical Reviews in Oral Biology & Medicine

158

110

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Background-Periodontal disease results in the loss of the attachment apparatus. In the last three decades, an increasing effort has been placed on seeking procedures and materials to promote the regeneration of this tissue. The aim of this paper is to evaluate the effect of enamel matrix derivative (EMD) during regenerative procedures. In addition, a meta-analysis is presented regarding the clinical results during regeneration with EMD, to gain evidence as to what can be accomplished following treatment of intrabony defects with EMD in terms of probing depth reduction, clinical attachment level gain, defect fill (using re-entry studies), and radiographic parameters. Methods-The review includes in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findings. In addition, a meta-analysis is presented regarding the regenerative clinical results. For this purpose, we used 28 studies-including 955 intrabony defects treated with EMD that presented baseline and final data on probing depth, clinical attachment level (CAL) gain, or bone gain-to calculate weighted mean changes in the different parameters. The selected studies were pooled from the MEDLINE database at the end of May, 2003. Results-The meta-analysis of intrabony defects treated with EMD resulted in a mean initial probing depth of 7.94 ± 0.05 mm that was reduced to 3.63 ± 0.04 mm (p = 0.000). The mean clinical attachment level changed from 9.4 ± 0.06 mm to 5.82 ± 0.07 mm (p = 0.000). These results were significantly better than the results obtained for either open-flap debridement (OFD) or guided tissue regeneration (GTR). In contrast, histologically, GTR is more predictable than EMD in terms of bone and cementum formation. No advantage was found for combining EMD and GTR. Xenograft, or EMD and xenograft, yielded inferior results compared with EMD alone, but a limited number of studies evaluated this issue. Promising results were noted for the combination of allograft materials and EMD. Conclusions-EMD seems to be safe, was able to regenerate lost periodontal tissues in previously diseased sites based on clinical parameters, and was better than OFD or GTR. Its combination with allograft materials may be of additional benefit but still needs to be further investigated.Key words. Enamel matrix derivative, Emdogain ® , meta-analysis, periodontal regeneration. States Food and Drug Administration (FDA).In 1997, an alternative approach for periodontal regeneration was introduced that was based on embryonic tooth formation (Hammarström, 1997;Heijl et al., 1997). This approach uses an extract of embryonic enamel matrix, termed 'enamel matrix derivative' (EMD), thought to induce mesenchymal cells to mimic the processes that take place during the development of the nascent root and periodontal tissues. The present analysis reviews the data on the effect of EMD as a regenerative promoter. It encompasses in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findin...

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“…The presented clinical results demonstrated positive treatment outcomes regarding clinical attachment gain and probing pocket depth reduction, but these outcomes were very varying between the different studies, moreover, in a significant percentage of the cases a poor treatment outcome was observed due to membrane exposure [5].…”

Section: Discussionmentioning

confidence: 84%

Minimally Invasive Single Flap Approach With Connective Tissue Wall for Periodontal Regeneration

Kotsilkov¹

2017

JofIMAB

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Generalizability of the Added Benefits of Guided Tissue Regeneration in the Treatment of Deep Intrabony Defects. Evaluation in a Multi‐Center Randomized Controlled Clinical Trial

Abstract: These data indicate that GTR therapy of deep intrabony defects performed by different clinicians on various patient populations resulted in both greater amounts and improved predictability of CAL gains than access flap alone.

Cited by 134 publications

References 26 publications

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

Minimally Invasive Single Flap Approach With Connective Tissue Wall for Periodontal Regeneration

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