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

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


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

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

Material and methods: 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.

Results: 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.

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

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants
  • Alveolar Bone Loss / surgery*
  • Alveolar Process / pathology
  • Debridement
  • Dental Enamel Proteins / therapeutic use*
  • Dental Plaque Index
  • Follow-Up Studies
  • Gingival Hemorrhage / surgery
  • Gingival Recession / surgery
  • Guided Tissue Regeneration, Periodontal / methods*
  • Humans
  • Membranes, Artificial
  • Middle Aged
  • Periodontal Attachment Loss / surgery
  • Periodontal Index
  • Periodontal Pocket / surgery
  • Single-Blind Method
  • Surgical Flaps
  • Suture Techniques
  • Tooth Cervix / pathology
  • Treatment Outcome


  • Dental Enamel Proteins
  • Membranes, Artificial
  • enamel matrix proteins