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Enamel matrix protein derivative and/or synthetic bone substitute for the treatment of mandibular class II buccal furcation defects. A 12-month randomized clinical trial

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Abstract

Objective

This study aims to clinically evaluate the treatment of mandibular class II furcation defects with enamel matrix derivative (EMD) and/or a bone substitute graft made of β-tricalcium phosphate/hydroxyapatite (βTCP/HA).

Materials and methods

Forty-one patients, presenting a mandibular class II buccal furcation defect, probing pocket depth (PPD) ≥4 mm and bleeding on probing, were included. They were randomly assigned to the groups: 1—EMD (n = 13); 2—βTCP/HA (n = 14); 3—EMD + βTCP/HA (n = 14). Plaque index (PI), gingival index (GI), relative gingival margin position (RGMP), relative vertical and horizontal attachment level (RVCAL and RHCAL), and PPD were evaluated at baseline and 6 and 12 months. The mean horizontal clinical attachment level gain was considered the primary outcome variable.

Results

No significant intragroup differences were observed for RGMP, but significant changes were observed for RVCAL, RHCAL, and PPD for all groups (p < 0.05). After 12 months, the mean horizontal clinical attachment level gain was 2.77 ± 0.93 mm for EMD, 2.64 ± 0.93 mm for βTCP/HA, and 2.93 ± 0.83 mm for EMD + βTCP/HA, with no significant differences among the groups. At the end of the study, 85.3 % of the sites were partially closed; however, no complete closure was observed.

Conclusion

EMD + βTCP/HA does not provide a significant advantage when compared to the isolated approaches. All three tested treatments promote significant improvements and partial closure of class II buccal furcation defects. Based on its potential to induce periodontal regeneration, EMD may be considered an attractive option for this type of defect, but complete closure remains an unrealistic goal.

Clinical relevance

The partial closure of buccal furcation defects can be achieved after the three tested approaches. However, the combined treatment does not provide a significant benefit when compared to the isolated approaches.

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Acknowledgments

The authors thank Dr. Joao Sangiorgio and Dr. Renato Casarin for the assistance with the statistical analysis and suggestions to the manuscript.

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Authors and Affiliations

  1. Faculty of Odontology of Piracicaba, Piracicaba, São Paulo, Brazil

    Lucas Araujo Queiroz, Mauro Pedrine Santamaria, Marcio Z. Casati, Karina Silverio Ruiz, Francisco Nociti Jr., Antonio Wilson Sallum & Enilson A. Sallum

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  1. Lucas Araujo Queiroz
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  2. Mauro Pedrine Santamaria
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  3. Marcio Z. Casati
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  4. Karina Silverio Ruiz
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Correspondence to Enilson A. Sallum.

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The authors declare that they have no competing interests.

Research involving human participants

All procedures performed in this study were in accordance with the ethical standards of the Ethical Committee of the Piracicaba Dental School—University of Campinas—UNICAMP and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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

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Queiroz, L.A., Santamaria, M.P., Casati, M.Z. et al. Enamel matrix protein derivative and/or synthetic bone substitute for the treatment of mandibular class II buccal furcation defects. A 12-month randomized clinical trial. Clin Oral Invest 20, 1597–1606 (2016). https://doi.org/10.1007/s00784-015-1642-x

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