Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative in the treatment of intrabony periodontal defects
Rh. Heard et al., Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative in the treatment of intrabony periodontal defects, J PERIODONT, 71(11), 2000, pp. 1715-1721
Background: Multiple exposures to enamel matrix protein derivative (EMD) du
ring periodontal therapy have been shown to be safe for the patient. The pu
rpose of this study was to clinically determine if an altered course of wou
nd healing would occur after multiple exposures to EMD in the treatment of
intrabony defects. A secondary aim was to assess the efficacy of EMD in pro
bing depth reduction and clinical attachment level gain.
Methods: Thirty-two systemically healthy patients (18 females, 14 males, 33
to 69 years old) who were being treated for moderate to advanced periodont
al disease were selected for the study. Surgical procedures involving 2 sit
es were separated by at least 8 weeks, and wound healing comparisons were m
ade between the first and second procedure. Patients were given a diary car
d the day of surgery, which consisted of questions concerning the presence
and severity of headaches, root hypersensitivity, tooth pain, swelling, and
itching. Patients were also examined at postoperative visits to clinically
assess wound healing and discuss responses to the questionnaire. Soft tiss
ue measurements were taken the day of surgery and 6 months postoperatively
to ascertain probing depth reduction (PD) and gains in clinical attachment
levels (CAL).
Results: The results revealed no clinically detectable reaction that could
not be attributed to normal postoperative sequelae. There were no differenc
es in reported symptoms between patient gender, first and second procedures
, or intrabony and non-intrabony defects. Smokers were found to have a stat
istically significantly higher incidence of severe symptoms in root hyperse
nsitivity, tooth pain, and swelling compared to non-smokers (n = 21). The m
ean probing depth reduction was 3.8 +/- 1.5 mm (2 to 9 mm), while the mean
clinical attachment level gain was 2.8 +/- 1.7 mm (0 to 8 mm).
Conclusions: The findings of this study demonstrate that EMD is a clinicall
y safe product to use in the treatment of periodontal defects and that mult
iple uses do not have a negative impact on periodontal wound healing. In ad
dition, a statistically significant gain in clinical attachment and reducti
on in probing depth were demonstrated.