PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
PERIO - Periodontal Practice Today 2 (2005), No. 4 (01.12.2005)
Treatment of Class II Furcation Defects with Guided Tissue Regeneration or Enamel Matrix Derivative Proteins - A 12-Month Comparative Clinical Study
Barros, Raquel R. M./Oliveira, Rafael R./Novaes Jr, Arthur B./Grisi, Márcio F. M./Souza, Sérgio L. S./Taba Jr, Mário/Palioto, Daniela B.
Recently the use of enamel matrix derivative proteins (EMD) has been introduced as a treatment alternative for periodontal regeneration. However, its clinical effects in human Class II furcations are still poorly investigated. The aim of this study was to compare the clinical results obtained for Class II furcations treated with guided tissue regeneration (GTR) to those obtained with the application of EMD. Twenty paired Class II mandibular furcations were treated in 10 non-smoker patients included in this study. Each defect was randomly treated with an e-PTFE membrane (GTR) or with EMD. Following basic therapy, baseline measurements were recorded, including probing depth (PD) and relative clinical attachment level (CAL-R). Hard-tissue measurements were performed during surgery to determine vertical (BDL-V) and horizontal bone defect level (BDL-H). At the 12-month re-entry procedures soft and hard-tissue measurements were reevaluated. Both procedures resulted in statistically significant PD reduction and gain in CAL-R with no significant differences between the groups. BDL-V resolution was statistically significant in both groups (GTR: 2.5 ± 1.14 mm and EMD: 1.5 ± 0.77 mm), as well as BDL-H resolution (GTR: 3.3 ± 1.82 mm and EMD: 2.2 ± 1.75 mm), without significant differences between the groups. Based on this, GTR and EMD therapies may be recommended for the treatment of Class II furcations, producing similar soft and hard-tissue improvements. However, once the GTR technique achieved numerically better results in hard-tissue parameters, it seems to provide a slight advantage for this procedure when dealing with these defects.
Keywords: guided tissue regeneration, enamel matrix derivative proteins, furcation lesions, randomized clinical study