Use of emdogain in the treatment of deep intrabony defects: 12-month clinical results. Histologic and radiographic evaluation

The objective of this study was to evaluate the application of an enamel ma trix derivative (Emdogain) in deep periodontal pocket therapy. Twenty-one p atients presenting intrabony and interproximal defects that could be treate d with guided tissue regeneration were selected. The intrabony defects were divided into deep (< 9 mm) and very deep (<greater than or equal to> 9 mm) defects. Bleeding on probing, Plaque index, probing pocket depth, mobility index, gingival recession, probing attachment level, and surgical bone lev el were measured at baseline. At 12 months, cases were reexamined and indic es recorded again. The mean probing depth decreased from 8.1 +/- 2.1 mm to 3.2 +/- 1.5 mm; attachment level decreased from 10.4 +/- 2.4 mm to 7.0 +/- 1.8 mm; recession increased from 2.3 +/- 1.4 mm to 3.8 +/- 1.8 mm; and surg ical bone level decreased from 9.6 +/- 1.9 mm to 7.1 +/- 1.5 mm. No signifi cant difference was noted between bone defects with one or 2 walls, between local and generalized periodontitis, or between smokers and nonsmokers. Si gnificant statistical difference was found, however, between deep infrabony defects and very deep defects when attachment gain was considered. No adve rse reaction to the substance was noted. The good clinical results obtained were not confirmed by radiologic results; standardized and computerized ra diographs at 12 months did not reveal significant improvement. The histolog ic examination carried out on 2 samples did not show evidence of new attach ment. Further studies are necessary to clarify the action mechanism and to evaluate the long-term results of this method.