Ten-year results following treatment of intra-bony defects with enamel matrix proteins and guided tissue regeneration

Background: Surgery utilizing an enamel matrix protein derivative (EMD) or guided tissue regeneration (GTR) has been shown to promote periodontal regeneration. Aim: To evaluate the 10-year results following treatment with EMD, GTR, EMD+GTR, and open flap debridement (OFD). Material and Methods: Thirty-eight patients out of an initial group of 56 participants were treated with one of the four modalities. Results were evaluated before surgery, at 1 year, and at 10 years. Primary outcome variable was CAL change. Results: Treatment with EMD yielded a mean CAL gain of 3.4 +/- 1.0 mm (p < 0.001) and 2.9 +/- 1.4 mm (p < 0.001) at 1 and 10 years, respectively. GTR resulted in a mean CAL gain of 3.2 +/- 1.4 (p < 0.001) at 1 year and 2.8 +/- 1.2 mm (p < 0.001) at 10 years. Mean CAL gain in the EMD+GTR group was of 3.3 +/- 1.1 mm (p < 0.001) and 2.9 +/- 1.2 mm (p < 0.001) at 1 and 10 years, respectively. Treatment with OFD demonstrated a mean CAL gain of 2.0 +/- 1.2 mm (p < 0.01) at 1 year and 1.8 +/- 1.1 mm (p < 0.01) at 10 years. Compared with OFD, the three regenerative treatments resulted in statistically significant (p < 0.05) higher CAL gain, at both 1 and 10 years. The CAL change between 1 and 10 years did not present statistically significant differences in any of the four groups. Conclusion: The present results indicate that the clinical outcomes obtained with all four approaches can be maintained over a period of 10 years.