Effect of autogenous cortical bone particulate in conjunction with enamel matrix derivative in the treatment of periodontal intraosseous defects.

BACKGROUND: The aim of the present study was to assess the additional clinical benefit of autogenous cortical bone particulate (ACBP) when added to enamel matrix derivative (EMD), compared to EMD alone, in the treatment of deep periodontal intraosseous defects. METHODS: A total of 28 intraosseous lesions in 27 patients with advanced periodontitis were included in this controlled clinical trial and randomly assigned to the EMD group (14 defects) or to the EMD + ACBP group (14 defects). Immediately before surgery (baseline) and after 6 and 12 months, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC) were recorded. Radiographic depth of the defect (DEPTH) was also measured at baseline and 12 months post-surgery. RESULTS: At 6 and 12 months, PD and CAL significantly improved from baseline in both groups (P <0.000). No significant differences in terms of CAL gain and PD reduction were detected between groups. However, defect distribution according to CAL gain was significantly different between groups (P <0.05). DEPTH significantly decreased from baseline to 12 months in both groups (P <0.000); between-group differences were not significant. At 12 months, a significantly greater REC increase in the EMD group (1.1 +/- 0.7 mm) compared to the EMD + ACBP group (0.3 +/- 0.8 mm) was observed (P <0.05). CONCLUSIONS: Both EMD and EMD + ACBP treatments led to a significant improvement in clinical and radiographic parameters at follow-up with respect to presurgery condition. The combined approach resulted in reduced post-surgery recession and increased proportion of defects with substantial CAL gain (> or = 6 mm).