Flapless application of enamel matrix derivative in periodontal retreatment: A multicentre randomized feasibility trial

Jentsch, Holger; Roccuzzo, Mario; Pilloni, Andrea; Kašaj, Adrian; Fimmers, Rolf; Jepsen, Søren

doi:10.1111/jcpe.13438

Cited by 14 publications

(44 citation statements)

References 40 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The enhanced pocket reduction and pocket closure observed in this study coincides with the results of adjunctive EMD application during initial non‐surgical therapy (Schallhorn et al, 2020) and re‐instrumentation of residual pockets persisting after steps 1 and 2 of periodontal therapy (Jentsch et al, 2021). Graziani et al (2019) also stated that a higher number of cases with no residual PPD ≥6 mm was observed with EMD application at 3 months.…”

Section: Discussionsupporting

confidence: 86%

Enamel matrix derivative as an adjunct to minimally invasive non‐surgical treatment of intrabony defects: A randomized clinical trial

Anoixiadou

Parashis

Vouros

2021

J Clinic Periodontology

View full text Add to dashboard Cite

Aim To compare the efficacy of minimally invasive non‐surgical technique (MINST) with or without enamel matrix derivative (EMD) in the treatment of intrabony defects ≤7 mm. Materials and methods Thirty‐six patients were randomly assigned to the two groups. The control group received MINST, while the experimental MINST+EMD. Clinical measurements were recorded at baseline and at 6 and 12 months, and radiographic measurements were made at baseline and 12 months. Results All subjects completed the study, 18 in each group. Significant improvements were observed in both groups at 12 months (p < .001) with no differences in mean PD reduction (4.0 ± 1.4 vs. 4.2 ± 1.7 mm), CAL gain (3.5 ± 1.4 vs. 3.4 ± 1.6 mm), and defect resolution (1.9 ± 1.1 vs. 1.8 ± 0.9 mm) for the MINST and the MINST+EMD groups, respectively (p > .05). A trend for greater pocket closure (PD ≤4 mm and no BoP) was achieved with the application of EMD (77.8% vs. 55.6% sites), particularly for sites with baseline PD ≤8 mm (92.3% vs. 69.2% sites), accompanied by an increased number of successful composite outcome results (61.1% vs. 44.4% sites). Conclusions MINST demonstrates significant improvements 12 months after treatment of intrabony defects ≤7 mm. The additional application of EMD does not further improve the mean clinical or radiographic outcomes. This study is registered in http://clinicaltrials.gov (NCT03622255).

show abstract

Section: Discussionsupporting

confidence: 86%

Enamel matrix derivative as an adjunct to minimally invasive non‐surgical treatment of intrabony defects: A randomized clinical trial

Anoixiadou

Parashis

Vouros

2021

J Clinic Periodontology

View full text Add to dashboard Cite

show abstract

“…When EMD was very recently evaluated for the nonsurgical treatment of residual pockets, even though in the study it was concluded that the results obtained were statistically better than SI alone, the percentage of shallow pockets (PPD ≤ 4 mm) obtained by EMD and HA at 6 months was 89% and 76%, respectively; meanwhile, at 12 months it was 80% and 77%, respectively [ 47 ]. Concerning the endpoint of therapy (PPD ≤ 4 mm without BOP), at 6 months, EMD and HA could obtain 69% and 58%, respectively, while at 12 months they could obtain 80% and 59%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial

et al. 2021

Self Cite

View full text Add to dashboard Cite

The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5–9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups.

show abstract

“…Characteristics of the included studies are shown in Table 1. Eight of the included studies were randomized clinical trials 22–25,30–33 : two of them were multi‐centre studies with one of them being conducted in the United States, Canada and Germany 24 and the other one in Germany and Italy 23 . The included articles were published between 2003 and 2021, and patients' recruitment was completed in private, 22,24 university 25 or both private and university dental clinics 23 .…”

Section: Resultsmentioning

confidence: 99%

“…The included articles were published between 2003 and 2021, and patients' recruitment was completed in private, 22,24 university 25 or both private and university dental clinics 23 . The included number of patients in each study population ranged from 12 32 to 49 24 and the majority of the studies included both smokers and non‐smokers 22–25,30–33 . The treatment outcome following non‐surgical periodontal treatment + EMD (SRP + EMD) and non‐surgical periodontal treatment alone or placebo (SRP alone or placebo) was assessed for a period of 3–12 months.…”

Section: Resultsmentioning

confidence: 99%

“…According to the results derived from the studies and the findings of this systematic review, there appears to be some potential In two studies, SRP + EMD and SRP alone compared when re-debridement was performed, 3-6 months after the initial periodontal therapy. 22,23 For the other included studies, EMD was applied simultaneously with non-surgical periodontal treatment. 25,28,[30][31][32][33] The present systematic review included a number of studies that performed SRP in conjunction with flapless application of EMD as well as SRP alone in patients with horizontal bone loss, [22][23][24][25]28 while other publications included the same test and control groups in sites with intrabony defects.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Flapless application of enamel matrix derivative in non‐surgical periodontal treatment: A systematic review

Chatzopoulos

Anastasopoulos

Zarenti

et al. 2022

Int J Dental Hygiene

View full text Add to dashboard Cite

Background and Objective To assess the effects of the flapless application of enamel matrix derivative (EMD) in combination with non‐surgical periodontal treatment (NSPT) when compared to non‐surgical periodontal treatment alone in adult patients. Material and methods An electronic literature search was conducted in MEDLINE, Scopus and Cochrane Library up to March 2021 complemented by a manual search. Human longitudinal studies of >5 participants and at least 3 months follow‐up were eligible for inclusion in the review. Clinical outcomes were extracted and pooled. Meta‐analysis of the included studies was not possible due to methodological differences. Results A total of 1199 publications were identified and reviewed for eligibility. Nine of them fulfilled the inclusion criteria. Eight studies were randomized clinical trials. The clinical findings of the majority of the included studies demonstrated that the adjunctive use of EMD with NSPT could lead to significantly improved treatment outcomes including higher PPD reduction, more CAL gain, more robust BOP reduction, higher number of sites with PPD < 5 mm and more frequent pocket closure which reduces the need for further periodontal surgical treatment. Limited biological, microbiological and histological findings were reported. Minimal adverse events were observed. Conclusion The flapless application of EMD during NSPT leads to an improved clinical outcome in regards to CAL gain and PPD reduction when compared to conventional treatment alone. The potential effect on the biological and microbiological outcome is unclear.

show abstract

Flapless application of enamel matrix derivative in periodontal retreatment: A multicentre randomized feasibility trial

Abstract: Subgingival instrumentation is an effective approach during initial periodontal therapy directed at the suppression/elimination of the subgingival bacterial load. Clinical endpoints of treatment that are usually assessed at re-evaluation after this first phase of therapy

Cited by 14 publications

References 40 publications

Enamel matrix derivative as an adjunct to minimally invasive non‐surgical treatment of intrabony defects: A randomized clinical trial

Enamel matrix derivative as an adjunct to minimally invasive non‐surgical treatment of intrabony defects: A randomized clinical trial

Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial

Flapless application of enamel matrix derivative in non‐surgical periodontal treatment: A systematic review

Contact Info

Product

Resources

About