Four-year results following treatment of intrabony periodontal defects with an enamel matrix protein derivative: a report of 46 cases.

Treatment of intrabony periodontal defects with an enamel matrix derivative (EMD) has been shown to predictably enhance periodontal regeneration. The aim of the present study was to evaluate the 4-year results following treatment of intrabony defects with EMD. Thirty-three patients with a total of 46 intrabony defects were treated. Each patient exhibited at least one intrabony defect with a probing depth > or = 6 mm as identified by probing and on radiographs. The following clinical parameters were evaluated prior to and 1 and 4 years after treatment: probing depth, recession of the gingival margin, and clinical attachment level. The primary outcome variable was clinical attachment. Mean probing depth was reduced from 8.1 +/- 1.8 mm to 3.8 - +/-.2 mm at 1 year and to 4.0 +/- 1.2 mm at 4 years. No statistically significant differences were found between the mean probing depth 1 and 4 years postoperative. At 1 year, the mean recession increased from 1.9 +/- 1.5 mm to 3.2 +/- 1.8 mm; at 4 years, it was 2.8 +/- 1.2 mm, a statistically significant improvement compared to the 1-year results, but still significantly increased compared to the baseline. The mean attachment level changed from 10.0 +/- 2.4 mm to 7.0 +/- 2.1 mm at 1 year and 6.8 +/- 1.9 mm at 4 years (no statistically significant difference). The clinical improvements obtained following treatment with EMD can be maintained over a 4-year period.