Healing of two and three wall intrabony periodontal defects following treatment with an enamel matrix derivative combined with autogenous bone

P>Background There are still limited data on the outcomes of regenerative periodontal surgery using a combination of an enamel matrix protein derivative (EMD) and autogenous bone (AB). Aim To evaluate the healing of deep intrabony defects treated with either a combination EMD+AB or EMD alone. Materials and Methods Forty patients with advanced chronic periodontitis, with one deep intrabony defect, were randomly treated with either EMD+AB (test) or EMD (control). Clinical assessments were performed at baseline and at 1 year after treatment. The primary outcome variable was relative attachment level (RAL). Results Healing was uneventful in all patients. The test sites showed a reduction in the mean probing pocket depth (PPD) of 5.6 +/- 0.9 mm (p < 0.001), a gain in the mean RAL of 4.2 +/- 1.1 mm (p < 0.001) and a gain in the mean probing bone level (PBL) of 3.9 +/- 1.0 mm (p < 0.001). The control group displayed a mean PPD reduction of 4.6 +/- 0.4 mm (p < 0.001), a mean RAL gain of 3.4 +/- 0.8 mm (p < 0.001) and a mean PBL gain of 2.8 +/- 0.8 mm (p < 0.001). RAL gains of >= 4 mm were measured in 90% of the test defects and in 55% of the controls. PBL gains of >= 4 mm were obtained in 85% of the test defects and in 25% of the control ones. The test treatment resulted in statistically higher PPD reductions, RAL gains and PBL gains compared with the control (p < 0.01). Conclusions Within their limits, the present results indicate that: (i) at 1 year after surgery, both therapies resulted in statistically significant clinical improvements compared with baseline and (ii) although the combination of EMD+AB resulted in statistically significant higher soft and hard tissue improvements compared with treatment with EMD, the clinical relevance of this finding is unclear.