Autogenous Tooth Bone Grafts with Enamel Matrix Derivates in Non-Contained Intrabony Periodontal Defects-A Case Series Study.

Background

The predictability of regenerative outcomes in non-contained intrabony periodontal defects remains limited. Autogenous tooth bone grafts (ATB) may represent a biologically active and osteoconductive scaffold with minimal residual graft material. This study evaluated the clinical and radiographic outcomes of ATB combined with enamel matrix derivative (EMD) in intrabony defects.

Methods

Nine systemically healthy patients (15 defects) were treated with ATB + EMD in a retrospective proof-of-concept design. Clinical parameters-probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR)-were recorded at baseline and 6 months. Radiographic changes in defect depth and width were also assessed. Statistical significance was set at p < 0.05.

Results

Mean PPD decreased from 7.73 ± 0.96 mm to 3.87 ± 0.74 mm (p < 0.001), and CAL improved from 9.20 ± 1.47 mm to 5.53 ± 1.36 mm (p < 0.001). GR changes were not significant. Radiographically, mean defect depth and width were reduced from 3.81 ± 1.59 mm and 2.56 ± 0.75 mm to 0.72 ± 1.08 mm and 0.44 ± 0.70 mm, respectively (p < 0.001).

Conclusions

The combination of ATB and EMD yielded substantial clinical and radiographic improvements in intrabony periodontal defects. These findings suggest that autogenous tooth bone grafts may serve as a reliable biologically active scaffold for regenerative periodontal surgery. This is the first study evaluating the combination of EMD and ATB. Within the study limitations, ATB + EMD demonstrated promising regenerative potential, warranting future controlled clinical trials.