The aim of the present study was to evaluate histologically in humans the healing
of advanced intrabony defects following treatment with enamel matrix proteins (EMD)
or guided tissue regeneration (GTR). Fourteen patients, each of them displaying 1
advanced intrabony defect around teeth scheduled for extraction were included in the
study. The defects were treated randomly either with an enamel matrix protein derivative
(Emdogain, BIORA AB, Malmo, Sweden) or with a bioabsorbable membrane (Resolut, Regenerative
Material, W.L. Gore & Assoc., Flagstaff, Arizona, USA). At baseline the mean probing
pocket depth (PPD) in the EMD group was 11.3 +/- 1.8 mm and the mean clinical attachment
level (CAL) 12.1 +/- 2.0 mm, whereas in the GTR group the mean PPD was 11.4 +/- 2.2
mm and the mean CAL 13.3 +/- 2.3 mm. Healing was uneventful in all cases. Neither
allergic reactions against EMD or the bioabsorbable membrane, nor suppuration or abscesses
were observed. The clinical results revealed at 6 months in the EMD group a mean PPD
of 5.6 +/- 1.3 mm and a mean CAL of 9.1 +/- 1.5 mm. In the GTR group the mean PPD
was 5.6 +/- 1.3 mm and the mean CAL 10.1 +/- 1.5 mm. The histological analysis showed
in the EMD group a mean 2.6 +/- 1.0 mm of new attachment (i.e. new cementum with inserting
collagen fibers) and a mean 0.9 +/- 1.0 mm of new bone. In this group, the formation
of new attachment was not always followed by bone regeneration. In the GTR group,
the mean new attachment was 2.4 +/- 1.0 mm and the mean new bone 2.1 +/- 1.0 mm. In
every case treated with GTR, the formation of new attachment was followed by a varying
amount of new bone. After both types of regenerative treatment the newly formed cementum
displayed a predominantly cellular character. The findings of the present study indicate
that the treatment of intrabony defects with enamel matrix proteins or with bioabsorbable
membranes enhances the formation of a new connective tissue attachment in humans.
