Primary flap closure combined with Emdogain® alone or Emdogain® and Cerasorb® in the treatment of intra-bony defects

Objectives: To compare clinical outcomes of three different modalities of treatment for deep intra-bony defects. Material and methods: Fifty-six patients were paralleled for clinical parameters and randomly assigned to treatment. They displayed one angular defect each with an intrabony component >= 3 mm, probing pocket depth (PPD) and probing attachment level (PAL) >= 7 mm, and plaque index (PI) < 1. Nineteen defects were treated, respectively, with enamel matrix derivative (EMD)+tricalcium phosphate (TCP) or EMD alone and 18 defects with modified Widman flap (MWF). Primary flap closure was used in all three groups. PI, gingival index, bleeding on probing, PPD, PAL, and recession (REC) were measured before and 12 months after treatment. Results: Treatment with EMD alone yielded a 3.9 +/- 1.3 mm PPD decrease and a 3.7 +/- 1.0 mm PAL gain (p < 0.001), whereas EMD + beta-TCP produced a 4.1 +/- 1.2 mm PPD reduction and a 4.0 +/- 1.0 mm PAL gain (p < 0.001). These outcome parameters did not differ between the two groups. REC increased by 0.7 +/- 1.3 mm. After MWF treatment, attachment gain was 2.1 +/- 1.4 mm (p<0.001) and PPD reduction was 3.8 +/- 1.8 mm, whereas REC increased by 1.5 +/- 0.7 mm (p = 0.042 versus EMD). Conclusion: Both EMD treatments showed similar clinical effects, with significant PAL gain and a significantly lower REC increase in comparison with MWF treatment.