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J Clin Periodontol. 2008 Sep;35(9):817-24. doi: 10.1111/j.1600-051X.2008.01295.x. Epub 2008 Jul 21.

Ten-year results following treatment of intra-bony defects with enamel matrix proteins and guided tissue regeneration.

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Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.



Surgery utilizing an enamel matrix protein derivative (EMD) or guided tissue regeneration (GTR) has been shown to promote periodontal regeneration.


To evaluate the 10-year results following treatment with EMD, GTR, EMD+GTR, and open flap debridement (OFD).


Thirty-eight patients out of an initial group of 56 participants were treated with one of the four modalities. Results were evaluated before surgery, at 1 year, and at 10 years. Primary outcome variable was CAL change.


Treatment with EMD yielded a mean CAL gain of 3.4+/-1.0 mm (p<0.001) and 2.9+/-1.4 mm (p<0.001) at 1 and 10 years, respectively. GTR resulted in a mean CAL gain of 3.2+/-1.4 (p<0.001) at 1 year and 2.8+/-1.2 mm (p<0.001) at 10 years. Mean CAL gain in the EMD+GTR group was of 3.3+/-1.1 mm (p<0.001) and 2.9+/-1.2 mm (p<0.001) at 1 and 10 years, respectively. Treatment with OFD demonstrated a mean CAL gain of 2.0+/-1.2 mm (p<0.01) at 1 year and 1.8+/-1.1 mm (p<0.01) at 10 years. Compared with OFD, the three regenerative treatments resulted in statistically significant (p<0.05) higher CAL gain, at both 1 and 10 years. The CAL change between 1 and 10 years did not present statistically significant differences in any of the four groups.


The present results indicate that the clinical outcomes obtained with all four approaches can be maintained over a period of 10 years.

[Indexed for MEDLINE]

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