Gingival Perfusion after Regenerative Surgery using EMD: Prospective Clinical Trial

This prospective clinical controlled trial evaluates the influence of Enamel Matrix Derivative (EMD) on gingival blood flow after completion of minimal invasive periodontal flap surgery.

Method:

Thirty-four patients were enrolled in this clinical trial. The test group includes twenty patients/sites, being treated with a minimal invasive periodontal flap surgery using EMD (Emdogain®) and biphasic calcium phosphate (BoneCeramic®) whereas fourteen patients, assigned as a control group, were treated with apically repositioned flap surgery for the purpose of surgical crown lengthening.

Laser Doppler Flowmetry (LDF) recordings were performed preoperatively as baseline and immediately after surgery, as well as on days 1, 3, 8, 15 and 42 post-op. Contralateral periodontally healthy site in every subject was selected as a control site.

To standardize the reference point for LDF an individual stent was customized guiding the probe to the middle of the papilla base.

Result:

Both, tests and controls showed similar progression outline in flap perfusion during  the early healing phase. Directly after surgery the values were the lowest. Later blood flowmetry showed increasing rates  reaching the highest level on day 8 postoperatively and returning to baseline levels on day 15; remaining than almost constant until day 42.

Mann-Whitney U test showed no significant differences in gingival perfusion between test and control groups at all time points (p>0.5). 

Conclusion:

Flap perfusion returns to baseline values within 8 days of postoperative healing remaining unchanged during observation period. Statistically, EMD had none significant effect on blood flow during the early healing stage.