Histologic Evaluation of Human Intrabony Defects Following Non‐Surgical Periodontal Therapy With and Without Application of an Enamel Matrix Protein Derivative

BACKGROUND: Surgical periodontal treatment with enamel matrix protein derivative (EMD) has been shown to promote periodontal regeneration. However, it is not known whether nonsurgical periodontal therapy with additional subgingival application of EMD may also enhance periodontal regeneration. The purpose of this study was to clinically and histologically evaluate healing of human intrabony defects following non-surgical periodontal treatment with and without application of EMD. METHODS: Sixteen patients, each of whom displayed one advanced intrabony defect around teeth or roots scheduled for extraction, were included in the study. The defects were treated as follows: 1) scaling and root planing with hand instruments and application of EMD; 2) scaling with an ultrasonic instrument and application of EMD; or 3) scaling with an ultrasonic instrument alone. Healing was uneventful in all cases. Six months after surgery, the teeth or roots were extracted together with some of their surrounding soft and hard tissues and processed for histologic evaluation. RESULTS: Clinical examination revealed a probing depth reduction and a gain of clinical attachment after all 3 treatment modalities. The histological evaluation, however, revealed that healing in all 3 procedures was predominantly characterized by formation of a long junctional epithelium along the instrumented root surface and no predictable regeneration of attachment apparatus. CONCLUSION: Within its limits, the present study failed to show periodontal regeneration in advanced human intrabony defects following non-surgical treatment with subgingival application of EMD.