Effect of EDTA root conditioning on regenerative treatment with Emdogain

Background: Regenerative periodontal therapy with an enamel matrix protein derivative (Emdogain®, Straumann, Waldenburg, Switzerland) has been shown to promote regeneration in intrabony defects. However, in now most clinical studies root surface conditioning was performed in conjunction with the application of Emdogain®, and thus it cannot be excluded that the results may also be influenced by the root conditioning procedure. Aim: To determine the effect of root conditioning on the healing of intrabony periodontal defects treated with Emdogain®. Methods: Twenty four patients each of whom exhibited one deep intrabony defect were randomly treated with either root surface conditionig and application of Emdogain® (test) or with Emdogain® alone (control). The following parameters were recorded at baseline and at one year: plaque index (PlI), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). Results: No statistical significant differences in any of the investigated parameters between the two groups were observed at baseline. The results have shown that in the test group mean PD decreased from 8.9 ± 0.8 mm to 4.1 ± 1.0 mm (p<0.001) and the CAL changed from 10.9 ± 0.7 mm to 7.8 ± 1.0 mm (p<0.001). In the control group the PD decreased from 8.7 ± 0.5 mm to 4.6 ± 1.6 mm (p<0.001) and the CAL changed from 10.6 ± 1.9 mm to 7.4 ± 2.4 mm (p<0.001). There were no significant differences in any of the investigated parameters between the two groups. Conclusion: In intrabony periodontal defects regenerative surgery including root surface conditioning with EDTA and application of Emdogain® does not seem to produce superior PD reduction and CAL gain when compared to treatment with Emdogain® alone.