Long-term follow-up and tomographic assessment of an intrabony defect treated with enamel matrix derivative

Background: Enamel matrix derivative (EMD) has an extensive documentation of use in the treatment of periodontal defects. Digital volume tomography (DVT) has been in use in dental medicine since the late 1990s, with a major advantage of decreased radiation and cost-effectiveness compared to conventional computed tomography (CT). To the best of our knowledge, there is no peer-reviewed report documenting long-term tomographic assessment of an intrabony defect treated with EMD alone. Methods: In this case report, we document the long-term response of an isolated intrabony defect treated with flap surgery plus EMD and monitored for 30 months with a DVT scan. We also compare clinical and radiographic findings for the defect at 7 and 30 months postoperatively. Results: With regenerative treatment, significant improvements in probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were observed both short and long term. No recession occurred, and papillary heights were maintained throughout the monitoring period. Although intraoral radiography suggested bone fill at the defect site at 7 months, DVT confirmed that the intrabony defect was eliminated at 30 months. Conclusions: Treatment of an intrabony defect with surgery plus EMD demonstrated excellent bone fill as assessed with conventional radiographic and tomographic examinations performed over 30 months. Larger studies are needed to further assess the use of DVT imaging as an appropriate adjunctive diagnostic tool for evaluating the responses of intrabony defects to regenerative techniques.