Periodontal regenerative therapy with enamel matrix derivative in the treatment of intrabony defects: a prospective 2-year study

Abstract

ObjectiveTo date, enamel matrix derivative (EMD) has been considered to be one of the few biomaterials for clinical use capable of demonstrating true periodontal regeneration. The aim of this two-center prospective clinical study was to evaluate 2-year outcome of periodontal regenerative therapy using EMD in the treatment of intrabony defects, performed as an ‘advanced medical treatment’ under the national healthcare system in Japan.ResultsPatients with chronic periodontitis who have completed initial periodontal therapy at either of the two dental school clinics were enrolled. Each contributed at least one intrabony defect of ≥3 mm in depth. During surgery, EMD was applied to the defect following debridement. Twenty-two participants (mean age 55.2 years old, 9 men and 13 women) completed 2-year reevaluation, and a total of 42 defects were subjected to data analysis. Mean gains in clinical attachment level (CAL) at 1 and 2 years were 2.9 mm (38% of baseline CAL) and 3.1 mm (41%), respectively, both showing a significant improvement from baseline. There was also a significant reduction in probing depth (PD): mean reductions at 1 and 2 years were 3.2 and 3.3 mm, respectively. There was a progressive improvement in the mean percentages of bone fill from 26% at 1 year to 36% at 2 years. No significant difference in CAL gain at 2 years was found between 3-wall bone defects and other defect types combined. In multiple regression analysis, the baseline PD was significantly associated with CAL gain at 2 years. In this population of patients, the treatment of intrabony defects with EMD yielded clinically favorable outcomes, as assessed by periodontal and radiographical parameters, over a period of 2 years.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2572-2) contains supplementary material, which is available to authorized users.

Periodontal Regenerative Therapy Using Enamel Matrix Derivative for Treatment of Generalized Severe Chronic Periodontitis: A 2-year Case Report

“…Heijl et al observed a mild increase in bone fill until 36 months 9) . In the present case, also, a significant increase was observed in bone fill between 1Y and 2Y, which supports earlier findings 9,22) .…”

“…A number of studies have investigated the effect of periodontal regenerative therapies, and the results have been favorable. One such therapy, which uses enamel matrix derivative (EMD; Emdogain ® Gel, Straumann, Basel, Switzerland), has now been used for over 20 years, and various degrees of clinical resolution have been reported with this approach 8,9,17,22,23) .…”

Antimicrobial photodynamic active biomaterials for periodontal regeneration

“…In order to support regeneration of the injured periodontium grafting materials might be inserted [16]. These include a whole range of materials such as barrier membranes, autografts, demineralized and freeze-dried bone allografts, bovine-derived xenografts and the combination of membranes and filler substances as well as the local application of growth factors such as Emdogain® or GEM 21S® [15,[17][18][19].…”

Use of Autologous Stem Cells for the Regeneration of Periodontal Defects in Animal Studies: a Systematic Review and Meta-Analysis

“…These therapies result in an overall improvement to periodontal tissue health. However clinical results have limited predictability due to being sensitive to patient behaviour, surgical approach and periodontal defect morphology, favouring narrow, confined intrabony defects [ 7 , 8 ].…”