Five-year results following regenerative periodontal surgery with an enamel matrix derivative in patients with different smoking status

Objective:To evaluate the five-year results following regenera-tive periodontal surgery of intrabony defects using an enamel matrix derivative (EMD) in patients with different smoking status. Method and materials: The dental records of patients treated with regenerative periodontal surgery with EMD between 2001 and 2011 were screened. The clinical parameters at baseline (T0) and 6 months (T1) and 5 years (T2) after surgery were collected and analyzed in relation to patient's smoking status (smokers, former smokers, and nonsmokers). Results: A total of 71 sites were initially assessed in 38 patients. In total, 56 sites could be evaluated at T1, and 34 after 5 years (T2). At 6 months after sur-gery, a statistically significant mean probing pocket depth (PPD) reduction of 2.91 +/- 1.60 mm and a mean clinical attachment level (CAL) gain of 1.89 +/- 1.90 mm were measured. Nonsmokers revealed a greater, statistically not significant CAL gain compared to smokers (2.38 +/- 2.12 mm vs 1.50 +/- 1.71 mm). Although at 5 years the site-specific PPD values remained stable in nonsmokers, smokers showed an increase of 1.60 +/- 2.41 mm. Conclusions: The present study provides evidence that regenerative peri-odontal surgery with EMD may lead to clinically relevant im-provements even in smoking patients. However, the positive ef-fect of EMD seems to be limited in time and can only partially compensate for the negative influence of smoking.