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Int Poster J Dent Oral Med 13 (2011), No. 3     15. Sep. 2011

Int Poster J Dent Oral Med 2011, Vol 13 No 3, Poster 540

Treatment of intrabony defects with Ostim® or Emdogain®

Language: English
 

Authors:
Dr. Elyan Al-Machot, ZA. Ihssan Khalili, PD Dr. med. Barbara Noack, Prof. Dr. med. habil. Thomas Hoffmann,
Dresden University of Technology, Medical Faculty, Department of Periodontology, Dresden, Germany

Date/Event/Venue:
July 14-17, 2010
IADR General Session
Barcelona, Spain
 

Objectives

Comparison of the treatment outcomes after regenerative periodontal surgery using either an enamel matrix derivative (Emdogain®) or a synthetic bone graft (Ostim®) in wide intrabony defects.

 
Fig. 1a: Study Design
 
 

Material and Methods

Twenty-four patients with chronic periodontitis were recruited at a German university dental clinic. All patients showed intrabony defects of at least 4mm depth and 2mm width. Using a microsurgical technique, a modified papilla preservation flap was prepared. After debridement, patients were randomly assigned to Emdogain group (control) or Ostim group (test), figure 2 (a, b). Assessments at baseline and after 6 months included bone sounding, attachment level, probing pocket depth, and bleeding on probing. Early wound healing, adverse effects and patients perceptions were also recorded, figure 1.

Fig. 2a: Treatment with EMD Fig. 2a: Treatment with EMD
Fig. 2a: Treatment with EMD Fig. 2a: Treatment with EMD
Fig. 2a: Treatment with EMD 1 week Fig. 2a: Treatment with EMD 2 weeks
 
Fig. 2b: Treatment with Ostim Fig. 2b: Treatment with Ostim
Fig. 2b: Treatment with Ostim Fig. 2b: Treatment with Ostim
Fig. 2b: Treatment with Ostim 1 week Fig. 2b: Treatment with Ostim 2 weeks
Fig. 2c:Defect characteristics at baseline Fig. 2c:Defect characteristics at baseline
 

Results

Both treatment modalities led to significant clinical improvements. Change in bone fill 6 months after surgery was 1.5mm (±1.7) in the test group and 1.5mm (±1.3) in the control group, respectively. A gain in clinical attachment (RAL) of 1.7mm (±2.1) in the test group and 2.1mm (±1.8) in the control group was observed. A reduction in probing pocket depth (PPD) of 2.9mm (±1.8) in the test group and 3.2mm (±1.4) in the control group was recorded (Tables). One week after surgery, primary closure was maintained in 100% of both the test and control groups, figure 3 (a). No differences in patients' perceptions were found, figure 3 (b).

  EMD Ostim
  Baseline 6 Months Baseline 6 Months
Bone Sounding
Mean 11.6 10.4 11.1 9.5
Standard deviation 1.6 1.4 1.8 2.3
P-value   0.002   0.009
Relative Attachment Level (CAL)
Mean 9.5 7.5 9.2 7.5
Standard deviation 1.4 1.5 1.9 2.5
P-value   0.002   0.021
Probing Pocket Depth (PPD)
Mean 6.3 3.0 6.4 3.5
Standard deviation 1.0 1.0 1.5 1.2
P-value   <0.001   <0.001
Tab. 1: Comparison of Clinical outcomes (mm) after 6 months
 
Baseline vs. 6 months
EMD
Mean ± Standard deviation
Ostim
Mean ± Standard deviation
 
P-value
PPD Reduction 3.2 ± 1.4 2.9 ± 1.8 0.50
RAL Gain 2.1 ± 1.8 1.7 ± 2.1 0.82
Bone Fill 1.5 ± 1.3 1.5 ± 1.7 0.75
Tab. 2: Comparison of Clinical outcomes (mm) after 6 months
 
Fig. 3a: Early-Wound-Healing Index (EHI)
 
Fig. 3b: Patients' perceptions

Conclusions

In both treatment procedures (Emdogain® and Ostim®) regenerative periodontal surgery in deep intrabony defects resulted in significant clinical improvement after 6 months compared to baseline. Further investigation is needed to identify factors influencing individual responses.
 

Abbreviations

PI: plaque index
PPD: probing pocket depth
RAL: relative attachment level
BOP: bleeding on probing
PP: patients' perceptions
EHI: Early-Wound-Healing Index
PTC: professional teeth cleaning
 

This Poster was submitted by Dr. Elyan Al-Machot.
 

Correspondence address:
Dr. Elyan Al-Machot
Dresden University of Technology
Medical Faculty, Department of Periodontology
Fetscherstraße 74
01307 Dresden
Germany