Three-year results following regenerative periodontal surgery of advanced intrabony defects with enamel matrix derivative alone or combined with a synthetic bone graft

Objectives This study aims to compare the clinical outcomes of a combination of enamel matrix derivatives (EMD) and a synthetic bone graft (biphasic calcium phosphate) with EMD alone in wide and deep one-and two-wall intrabony defects 36 months after treatment. Material and methods Thirty patients with chronic periodontitis and one wide (>= 2 mm) and deep (>= 4 mm) intrabony defect had been recruited in three centres in Germany. During surgery, defects were randomly assigned to EMD/synthetic bone graft (SBG) (test) or EMD (control). Assessments at baseline, after 6, 12 and 36 months, included bone sounding, relative clinical attachment levels, probing pocket depths and recessions. Results After 36 months, defects in both groups were significantly improved (p< 0.001) with regard to defect fill, attachment gain and probing pocket reduction. In the EMD/SBG group, a mean defect fill of 2.6 mm (+/- 1.7) was measured, and in the EMD group, the defect fill was 2.3 mm (+/- 1.5). A mean gain in clinical attachment of 4.1mm(+/- 3.6) and 3.8mm (+/- 2.2) was observed in the test and in the control group, respectively. There were no statistically significant differences in any of the investigated parameters between the two treatment modalities. Conclusions The clinical improvements of advanced intrabony defects obtained with both regenerative modalities could be maintained over a period of 3 years. The combination of EMD with SBG did not show any advantage compared to the use of EMD alone.