J Yeungnam Med Sci.  2022 Oct;39(4):322-331. 10.12701/jyms.2022.00325.

Regenerative potential of biphasic calcium phosphate and enamel matrix derivatives in the treatment of isolated interproximal intrabony defects: a randomized controlled trial

• Pal PC
• Bali A
• Boyapati R
• Show S
• Tejaswi KS
• Khandelwal S

• KMID: 2534660
• DOI: http://doi.org/10.12701/jyms.2022.00325

Abstract

Background
The combined use of biomaterials for regeneration may have great biological relevance. This study aimed to compare the regenerative potential of biphasic calcium phosphate (BCP) alone and with growth factor enamel matrix derivatives (EMDs) for the regeneration of intrabony defects at 1 year.
Methods
This randomized controlled trial included 40 sites in 29 patients with stage II/III periodontitis and 2/3 wall intrabony defects that were treated with BCP alone (control group) or a combination of BCP and EMD (test group). BCP alloplastic bone grafts provide better bio-absorbability and accelerate bone formation. EMDs are commercially available amelogenins. Mean values and standard deviations were calculated for the following parameters: plaque index (PI), papillary bleeding index (PBI), vertical probing pocket depth (V-PPD), vertical clinical attachment level (V-CAL), and radiographic defect depth (RDD). Student paired and unpaired t-tests were used to compare the data from baseline to 12 months for each group and between the groups, respectively. The results were considered statistically significant at p<0.05.
Results
At 12 months, the PI and PBI scores of the control and test groups were not significantly different (p>0.05). The mean V-PPD difference, V-CAL gain, and RDD difference were statistically significant in both groups at 12 months (p<0.001 for all parameters). Intergroup comparisons showed that the mean V-PPD reduction (2.13±1.35 mm), V-CAL gain (2.53±1.2 mm), and RDD fill (1.33±1.0 mm) were statistically significant between the groups at 12 months (p<0.001 for all parameters).
Conclusion
BCP and EMDs combination is a promising modality for the regeneration of intrabony defects.

Keyword

Amelogenin; Periodontitis; Regeneration

Figure

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  Fig. 1. Treatment of the control group. (A) Placement of biphasic calcium phosphate bone graft after debridement of the bone defect in the control group sites. (B) Baseline measurement of V-PPD and V-CAL in the control group. (C) Twelve-month postoperative measurement of V-PPD and V-CAL in the control group. (D) Baseline measurement of RDD in the control group. (E) Twelve-month postoperative measurement of RDD in the control group. V-PPD, vertical probing pocket depth; V-CAL, vertical clinical attachment level; RDD, radiographic defect depth.

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  Fig. 2. Treatment of the test group. (A) Application of enamel matrix derivative to the defect site in the test group. (B) Placement of biphasic calcium phosphate bone graft and enamel matrix derivative after debridement of the bone defect in the test group sites. (C) Baseline measurement of V-PPD and V-CAL in the test group. (D) Twelve-month postoperative measurement of V-PPD and V-CAL in the test group. (E) Baseline measurement of RDD in the test group. (F) Twelve-month postoperative measurement of RDD in the test group. V-PPD, vertical probing pocket depth; V-CAL, vertical clinical attachment level; RDD, radiographic defect depth.

Reference

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