A clinical study evaluating the treatment of supra-alveolar-type defects with access flap surgery with and without an enamel matrix protein derivative: a pilot study

Aim: There is evidence that regenerative treatment of intra-bony and mandibular class II furcation defects with access flap and an application of an enamel matrix protein derivative (EMD) can result in a clinical benefit compared with access flap alone. The aim of this pilot study was to check if the results of access flap surgery in suprabony defects are improved by additional application of EMD. Material and Methods: Thirty-nine adult subjects with supra-alveolar-type defects were randomly assigned to a test (n = 25) and a control group (n = 14). Seventy teeth were treated with EMD; 28 teeth were treated by access flap. Probing depth (PD), clinical attachment level and bleeding on probing were evaluated at baseline and after 12 months. Results: PD of the operated teeth was improved in both groups (P < 0.001 to p = 0.041) but always better in the test group. The attachment gain was 2.72 +/- 1.80 mm at sites with an initial PD >= 7 mm in the test group and 0.78 +/- 0.62 mm in the control group (p = 0.004). In the test group the mean attachment gain was 0.97 +/- 0.92 mm (p < 0.001); the mean reduction of PD was 1.55 +/- 0.90 mm (P < 0.001). Conclusions: The data suggest a significant clinical benefit of supplementary application of EMD during surgical treatment of periodontitis of supra-alveolar pockets, especially in deeper pockets.