Treatment of intrabony defects with enamel matrix proteins or barrier membranes: Results from a multicenter practice-based clinical trial

被引:115
作者
Sanz, M
Tonetti, MS
Zabalegui, I
Sicilia, A
Blanco, J
Rebelo, H
Rasperini, G
Merli, M
Cortellini, P
Suvan, JE
机构
[1] Univ Complutense Madrid, Fac Odontol, Dept Periodontol, E-28040 Madrid, Spain
[2] UCL, Eastman Dent Inst, Dept Periodontol, London, England
关键词
clinical trials; controlled; randomized; comparison studies; guided tissue regeneration; membranes; bioabsorbable; multicenter studies; proteins; enamel matrix/therapeutic use;
D O I
10.1902/jop.2004.75.5.726
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Background: This prospective multicenter, randomized, controlled clinical trial compared the clinical outcomes of enamel matrix proteins (EMD) versus placement of a bioabsorbable membrane in conjunction with guided tissue regeneration (GTR). Methods: Seventy-five patients with advanced chronic periodontitis were recruited in seven centers in three countries. All patients had at least one intrabony defect of 3 mm. Heavy smokers (greater than or equal to20 cigarettes/day) were excluded. The surgical procedures included access for root instrumentation using the simplified papilla preservation flap and either the application of EMD or the placement of a GTR membrane. At baseline and I year following the interventions, clinical attachment levels (CAL), probing depths (PD), recession (REC), full-mouth plaque scores, and full-mouth bleeding scores were assessed. A total of 67 patients completed the study. Results: At 1 year, the EMD defects gained 3.1 +/- 1.8 mm of CAL, versus 2.5 +/- 1.9 mm for GTR defects. Probing depth reduction was 3.8 +/- 1.5 mm and 3.3 +/- 1.5 mm, respectively. A multivariate analysis indicated that the differences between EMD and GTR treatments were not significant while a center effect and baseline PD significantly influenced CAL gains. No significant differences in terms of frequency distribution of the outcomes were observed. All cases treated with GTR presented at least one surgical complication, mostly membrane exposure, while only 6% of EMD treated sites displayed complications (P < 0.0001). Conclusions: The results of this trial failed to demonstrate superiority of one treatment modality over the other. GTR outcomes in this trial were lower than anticipated based on previous evidence. This was attributed to the high prevalence of post-surgical complications in the GTR group.
引用
收藏
页码:726 / 733
页数:8
相关论文
共 35 条
[1]   ROOT SURFACE TEXTURE AND EARLY CELL AND TISSUE COLONIZATION AFTER DIFFERENT ETCHING MODALITIES [J].
BLOMLOF, J ;
LINDSKOG, S .
EUROPEAN JOURNAL OF ORAL SCIENCES, 1995, 103 (01) :17-24
[2]   Smear removal and collagen exposure after non-surgical root planing followed by etching with an EDTA gel preparation [J].
Blomlof, JPS ;
Blomlof, LB ;
Lindskog, SF .
JOURNAL OF PERIODONTOLOGY, 1996, 67 (09) :841-845
[3]   Comparison of ready-to-use EMDOGAIN®-gel and EMDOGAIN® in patients with chronic adult periodontitis -: A multicenter clinical study [J].
Bratthall, G ;
Lindberg, P ;
Havemose-Poulsen, A ;
Holmstrup, P ;
Bay, L ;
Söderholm, G ;
Norderyd, O ;
Andersson, B ;
Rickardsson, B ;
Hallström, H ;
Kullendorff, B ;
Bell, HS .
JOURNAL OF CLINICAL PERIODONTOLOGY, 2001, 28 (10) :923-929
[4]  
Cortellini P, 1999, INT J PERIODONT REST, V19, P589
[5]   The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: Clinical outcomes and postoperative morbidity [J].
Cortellini, P ;
Tonetti, MS ;
Lang, NP ;
Suvan, JE ;
Zucchelli, G ;
Vangsted, T ;
Silvestri, M ;
Rossi, R ;
McClain, P ;
Fonzar, A ;
Dubravec, D ;
Adriaens, P .
JOURNAL OF PERIODONTOLOGY, 2001, 72 (12) :1702-1712
[6]   Focus on intrabony defects: guided tissue regeneration [J].
Cortellini, P ;
Tonetti, MS .
PERIODONTOLOGY 2000, 2000, 22 :104-132
[7]   Periodontal regeneration of human intrabony defects with bioresorbable membranes. A controlled clinical trial [J].
Cortellini, P ;
Prato, GP ;
Tonetti, MS .
JOURNAL OF PERIODONTOLOGY, 1996, 67 (03) :217-223
[8]   Treatment of deep and shallow intrabony defects - A multicenter randomized controlled clinical trial [J].
Cortellini, P ;
Carnevale, G ;
Sanz, M ;
Tonetti, MS .
JOURNAL OF CLINICAL PERIODONTOLOGY, 1998, 25 (12) :981-987
[9]   Guided tissue regeneration therapy of 203 consecutively treated intrabony defects using a bioabsorbable matrix barrier. Clinical and radiographic findings [J].
Falk, H ;
Laurell, L ;
Ravald, N ;
Teiwik, A ;
Persson, R .
JOURNAL OF PERIODONTOLOGY, 1997, 68 (06) :571-581
[10]   ANALYSIS OF DATA FROM MULTICLINIC TRIALS [J].
FLEISS, JL .
CONTROLLED CLINICAL TRIALS, 1986, 7 (04) :267-275