The effectiveness of enamel matrix proteins used in combination with bovine porous bone mineral in the treatment of intrabony defects in humans

Objective: The purpose of this study was to evaluate the effectiveness of enamel matrix proteins (EMPs) used in combination with bovine porous bone mineral (BPBM), compared to open flap debridment (OFD) in the treatment of intrabony defects in humans. Material and Methods: Using a split-mouth design, 24 paired intrabony defects were surgically treated and re-entered 6 months later. Experimental sites were treated with EMPs and grafted with BPBM. Control sites were treated with an OFD. The primary outcomes evaluated in the study were changes in pocket depth, clinical attachment level and defect bone fill. Results: Preoperative pocket depths, attachment levels and intra-operative bone measurements were similar for control and experimental sites. 6-month post surgical measurements revealed a significantly greater reduction in pocket depth (differences of 2.35 +/-0.86 mm on buccal and 2.28 +/-0.90 mm on lingual measurements) and more gain in clinical attachment (differences of 2.04 +/-0.28 mm on buccal and 1.99 +/-0.26 mm on lingual measurements) in the experimental sites. Surgical reentry of the defects revealed a significantly greater amount of defect fill in favor of the experimental sites (differences of 2.85 +/-0.28 mm on buccal and 2.67 +/-0.33 mm on lingual measurements). Conclusions: The results of this study suggest that combining EMPs and BPBM as a regenerative technique for intraosseous defects results in statistically and clinically significant more favorable results than OFD. The nature of the attachment between the newly regenerated tissue and the root surfaces needs to be evaluated histologically to confirm the presence of new attachment.