Study on the Benefit of Adjunctive EMD in Periodontal Therapy

Periodontists from the Centre of Periodontology, Department for Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Leipzig, Germany recently found out that there is a benefit of adjunctive EMD during non‐surgical retreatment (step 3 of periodontal therapy) of residual deep pockets, as published in the Journal of Clinical Periodontology.

Holger F.R. Jentsch and colleagues conducted the present study to investigate the potential benefit of enamel matrix derivative (EMD) as adjunct to re‐instrumentation of residual pockets persisting after steps 1 and 2 of periodontal therapy.

44 adult patients participated in a multicenter feasibility randomized clinical trial with split‐mouth design. They had presented at re‐evaluation after initial non‐surgical periodontal therapy (steps 1 and 2 of periodontal therapy) for generalized periodontitis with at least 2 teeth with residual probing pocket depths (PPD) ≥ 5 and ≤ 8 mm, with bleeding on probing (BOP).

Two teeth with similar PPD were randomized to receive re‐instrumentation either with (test) or without (control) adjunctive flapless administration of EMD. Differences in the changes of PPD and BOP from baseline to 6 and 12 months were analyzed, and the frequencies of pocket closure (PPD ≤ 4 mm and no BOP) compared.

Findings

• For the primary outcome "change of mean PPD after 6 months" a significant additional benefit of 0.79 ± 1.3 mm (p < 0.0001) could be observed for the test group.
• At 12 months, this difference could be maintained (0.85 ± 1.1 mm; p < 0.0001).
• The frequency of pocket closure in the test group was 69% at 6 and 80% at 12 months and significantly higher than in the control group with 34% and 42%, respectively (p < 0.01).

Therefore, the authors concluded that "there is a benefit of adjunctive EMD during non‐surgical retreatment (step 3 of periodontal therapy) of residual deep pockets."