J Periodontal Implant Sci.  2024 Aug;54(4):236-252. 10.5051/jpis.2303080154.

Comparison of early wound healing using modified papilla preservation technique between enamel matrix derivative and recombinant human fibroblast growth factor

• Nakayama Y
• Tabe S
• Igarashi K
• Moriya S
• Katsumata T
• Kobayashi R
• Nakagawa S
• Nishino T
• Fukuoka N
• Hosono K
• Yamasaki M
• Yamazaki Y
• Ogihara-Takeda M
• Ito S
• Saito Y
• Yamaguchi A
• Tsuruya Y
• Yamazaki-Takai M
• Yoshino S
• Takai H
• Ogata Y

• KMID: 2563202
• DOI: http://doi.org/10.5051/jpis.2303080154

Abstract

Purpose
Enamel matrix derivative (EMD) has demonstrated beneficial effects on wound healing following surgery. However, the effects of recombinant human fibroblast growth factor 2 (rhFGF-2) in periodontal regeneration therapy have not been extensively studied. This retrospective study was conducted to compare the wound healing outcomes of the modified papilla preservation technique (mPPT) between EMD and rhFGF-2 therapies.
Methods
A total of 79 sites were evaluated for early wound healing using the modified early wound healing index (mEHI), which included 6 items: incision, fibrin clotting, step, redness, swelling, and dehiscence. A numeric analog scale, along with postoperative images of the 6 mEHI items, was established and used for the evaluations. The inter-rater reliability of the mEHI was assessed via intraclass correlation coefficients (ICCs). After adjusting for factors influencing the mPPT, the differences in mEHI scores between the EMD and rhFGF-2 groups were statistically analyzed. Additionally, radiographic bone fill (RBF) was evaluated 6 months after surgery.
Results
The ICC of the mEHI was 0.575. The mEHI, redness score, and dehiscence scores were significantly higher in the rhFGF-2 group (n=33) than in the EMD group (n=46). Similar results were observed in the subgroup of patients aged 50 years or older, but not in those younger than 50 years. In the subgroup with non-contained bone defects, related results were noted, but not in the subgroup with contained bone defects. However, early wound healing did not correlate with RBF at 6 months after surgery.
Conclusions
Within the limitations of this study, the findings suggest that early wound healing following the use of mPPT with rhFGF-2 is somewhat superior to that observed after mPPT with EMD. However, mEHI should be improved for use as a predictive tool for early wound healing and to reflect clinical outcomes after surgery.

Keyword

Fibroblast growth factor 2; Inflammation; Wound healing