Comparison of Two Different Regenerative Procedures

Enamel matrix protein derivative (EMD) and demineralized freeze- dried bone allograft (DFDBA) have both shown clinically superior results in probing depth reduction and gain in clinical attachment when compared with open flap debridement alone. Objective: To compare the clinical outcomes obtained from the use of EMD alone or in combination with a bone grafting material DFDBA in the treatment of human intrabony defects. Methods: Thirty patients with chronic periodontitis, each of whom displayed one intrabony defect with loss of attachment ³6mm, and a radiographically detectable defect of at least 4 mm, participated in this study. Baseline clinical measures of probing depth (PD), clinical attachment level (CAL), and recession (REC) were performed. During the surgical phase the defects were randomly assigned to receive either (EMD) in combination with DFDBA (test) or (EMD) alone (control). All patients were maintained on a 2 to 3 month recall. Soft tissue measurements were evaluated after one year of therapy. Results: No differences in any of the investigated parameters were observed at baseline between the 2 groups. After one year of therapy, clinically and statistically significant outcomes in PD and CAL were achieved for both treatment groups when compared to baseline (p<0.001). There was no statistically significant difference for any of the measured clinical parameters between the two groups. Mean probing depth reduction for the test and control group was 3.46±1.53 mm and 3.32±2.58 mm, respectively (p=0.84). Mean gain in clinical attachment level for the test and control group was 2.46±1.39 mm and 2.82±2.17 mm, respectively (p=0.62). Mean recession changes for the test and control group was -0.771.03 mm and -0.460.97 mm, respectively (p=0.44). Conclusions: The regenerative outcome obtained from the EMD therapy in intrabony defects was not enhanced by the addition of DFDBA.