Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative in the treatment of intrabony periodontal defects

Aim of the study

To determine if the repeated application of enamel matrix derivatives (EMD) can affect the healing of intraosseous defects by stimulating an immune reaction to a foreign substance and to evaluate the efficacy of EMD in terms of reduction in probing depths and gain of new attachment.

Materials and methods

Thirty-two patients suffering from moderate to advanced periodontitis were enrolled in the study. Two sites were treated with EMD with an interval of at least 8 weeks, then the healing between the first and second procedure was compared. In addition, a questionnaire was used for the patients to indicate the presence and severity of headache, root hypersensitivity, pain, Ïdema and itching during the five post-operative days.

Results

Apart from the normal post-operative effects there were no adverse reactions and there seemed not to be any differences between the symptoms reported after the first and second intervention. However, smokers experienced more post-operative oedema and more root hypersensitivity than the non-smokers. The mean reduction in probing depth was 3.8 ± 1.5 mm and the mean gain of attachment was 2.8 ± 1.7 mm.

Conclusion

EMD are safe products for the treatment of intraosseous defects, even when used repeatedly and provide beneficial results.

Commentaries

This study confirms the results of Zetterstrom et al. in 1997 which showed no increase in levels of IgG, IgE, IgA, even after several exposures to EMD.