A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans

Background: It has been shown that clinical improvement of intrabony period ontal defects can be achieved with the use of enamel matrix proteins (EMPs) or by grafting with bovine porous bone mineral (BPBM). There is no report on the potential synergistic effect of EMPs and BPBM in periodontal regener ative therapy. The purpose of this study was to compare the clinical effect iveness of EMPs used alone or in combination with BPBM in the treatment of periodontal intrabony defects in humans. Methods: Twenty-one paired intrabony defects were surgically treated using a split-mouth design. Intrabony defects were treated either with enamel mat rix proteins (EMP group) or with enamel matrix proteins combined with bovin e porous bone mineral (EMP/BPBM group). Re-entry surgeries were performed a t 6 months. Results: Preoperative probing depths, attachment levels, and trans-operativ e bone measurements were similar for the EMP and EMP/BPBM groups. Postsurgi cal measurements taken at 6 months revealed a significantly greater reducti on in probing depth in the EMP/BPBM group (3.43 +/- 1.32 mm on buccal sites and 3.36 +/- 1.35 mm on lingual sites) when compared to the EMP group (1.9 1 +/- 1.42 mm on buccal sites and 1.85 +/- 1.38 mm on lingual sites). The E MP/BPBM group also presented with significantly more attachment gain (3.13 +/- 1.41 mm on buccal sites and 3.11 +/- 1.39 mm on lingual sites) than the EMP group (1.72 +/- 1.33 mm on buccal sites and 1.75 +/- 1.37 mm on lingua l sites). Surgical re-entry of the treated defects revealed a significantly greater amount of defect fill in favor of the EMP/BPBM group (3.82 +/- 1.4 3 mm on buccal sites and 3.74 +/- 1.38 mm on lingual sites) as compared to the EMP group (1.33 +/- 1.17 mm on buccal sites and 1.41 +/- 1.19 mm on lin gual sites). Conclusions: The results of this study indicate that BPBM has the ability t o augment the effects of EMPs in reducing probing depth, improving clinical attachment levels, and promoting defect fill when compared to presurgical levels.