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A novel flapless approach versus minimally invasive surgery in periodontal regeneration with enamel matrix derivative proteins: a 24-month randomized controlled clinical trial

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Abstract

Objectives

This investigation was designed to compare the effectiveness of enamel matrix derivative (EMD) proteins in combination with flapless or flap procedure in periodontal regeneration of deep intrabony defects.

Materials and methods

Thirty chronic periodontitis patients who had at least one residual periodontal defect with an intrabony component of ≥3 mm were consecutively enrolled. Defects were randomly assigned to test or control treatments which both consisted of the use of EMD to reach periodontal regeneration. Test sites (n = 15) were treated according to a novel flapless approach, whereas control sites (n = 15) by means of minimally invasive surgery (MIST). Clinical and radiographic parameters were recorded at baseline, 12 and 24 months post-operatively.

Results

Both therapeutic modalities yielded similar probing depth (PD) reduction and clinical attachment level (CAL) gain at 24 months. In flapless-treated sites, a mean PD reduction of 3.6 ± 1.0 mm and a CAL gain of 3.2 ± 1.1 mm were observed. In the MIST group, they were 3.7 ± 0.6 and 3.6 ± 0.9 mm. The operative chair time was twice as long in the MIST compared to the flapless group, whereas comparable patient-oriented outcomes were observed.

Conclusion

The flapless procedure may be successfully applied in the regenerative treatment of deep intrabony defects reaching clinical outcomes comparable with those of minimally invasive surgical approaches and may present important advantages in terms of reduction of operative chair time.

Clinical relevance

The use of EMD as an adjunct to non-surgical periodontal treatment may be considered a suitable option to treat defects mainly in the anterior sextants.

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Authors and Affiliations

  1. Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Via Nizza 230, 10126, Turin, Italy

    Mario Aimetti, Francesco Ferrarotti, Giulia Maria Mariani & Federica Romano

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  1. Mario Aimetti
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  2. Francesco Ferrarotti
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  3. Giulia Maria Mariani
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  4. Federica Romano
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Correspondence to Mario Aimetti.

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All procedures involving humans were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The authors declare that there were no financial supports from any external source regarding the current study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Aimetti, M., Ferrarotti, F., Mariani, G.M. et al. A novel flapless approach versus minimally invasive surgery in periodontal regeneration with enamel matrix derivative proteins: a 24-month randomized controlled clinical trial. Clin Oral Invest 21, 327–337 (2017). https://doi.org/10.1007/s00784-016-1795-2

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  • DOI: https://doi.org/10.1007/s00784-016-1795-2

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