Effects of EMD in combination with bone swaging and calcium phosphate bone cement on periodontal regeneration in one-wall intrabony defects in dogs

J Periodontal Res. 2013 Feb;48(1):37-43. doi: 10.1111/j.1600-0765.2012.01499.x. Epub 2012 Jul 8.

Abstract

Background and objective: Although the application of EMD is a widely accepted periodontal-regenerative therapy, its effects on noncontained intrabony defects are unpredictable because of the lack of a space-making property. The combined use of EMD and autogenous bone grafts reportedly stimulates significant periodontal regeneration in intrabony defects. The aim of the present study was to evaluate the effects of EMD in combination with bone swaging (BS) and injectable calcium phosphate bone cement (CPC), which was placed into the spaces between the grafted swaged bone and the proximal host bone, on periodontal healing in one-wall intrabony defects in dogs.

Material and methods: One-wall intrabony defects (3 mm wide and 5 mm deep) were surgically created on the mesial and distal sides of the bilateral mandibular premolars in four dogs. The 16 defects were assigned to one of the following treatments: EMD only, BS only, EMD with BS (EMD + BS), or EMD with BS and CPC (EMD + BS + CPC). The animals were killed 8 wk after surgery for histologic evaluation.

Results: The height of newly formed bone was significantly greater in the EMD + BS + CPC group (3.73 ± 0.30 mm) than in the BS-only (2.74 ± 0.33 mm; p < 0.05) and EMD + BS (2.88 ± 0.98 mm; p < 0.05) groups. The area of newly formed bone was significantly larger in the EMD + BS + CPC group (5.68 ± 1.66 mm(2)) than in the EMD-only (3.68 ± 0.33 mm(2); p < 0.05), BS-only (3.48 ± 1.26 mm(2); p < 0.05) and EMD + BS (3.38 ± 1.37 mm(2); p < 0.05) groups. The EMD-only (4.63 ± 0.42 mm), EMD + BS (4.67 ± 0.30 mm) and EMD + BS + CPC (4.78 ± 0.54 mm) groups showed significantly greater cementum formation than did the BS-only group (3.93 ± 0.56 mm; p < 0.05).

Conclusion: These results indicate that treatment with EMD + BS + CPC promotes favorable periodontal healing in one-wall intrabony defects in dogs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Bone Loss / surgery*
  • Alveolar Process / drug effects
  • Alveolar Process / pathology
  • Animals
  • Bone Cements / therapeutic use*
  • Bone Regeneration / drug effects
  • Bone Transplantation / methods*
  • Calcium Phosphates / therapeutic use*
  • Cementogenesis / drug effects
  • Collagen / drug effects
  • Connective Tissue / drug effects
  • Connective Tissue / pathology
  • Dental Cementum / drug effects
  • Dental Cementum / pathology
  • Dental Enamel Proteins / therapeutic use*
  • Dogs
  • Epithelial Attachment / drug effects
  • Epithelial Attachment / pathology
  • Male
  • Mandible / surgery
  • Osteogenesis / drug effects
  • Periodontal Ligament / drug effects
  • Periodontal Ligament / pathology
  • Tooth Cervix / drug effects
  • Tooth Cervix / pathology
  • Tooth Root / drug effects
  • Tooth Root / pathology
  • Wound Healing / physiology

Substances

  • Bone Cements
  • Calcium Phosphates
  • Dental Enamel Proteins
  • enamel matrix proteins
  • Collagen