Hydroxyapatite/β-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial

J Clin Periodontol. 2013 Mar;40(3):252-9. doi: 10.1111/jcpe.12054.

Abstract

Objective: To clinically evaluate proximal furcations treated with hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) isolated or combined with enamel matrix derivative (EMD).

Material and methods: Thirty patients, presenting at least one proximal class II furcation defect, probing pocket depth (PPD) ≥5 mm and bleeding on probing, were included. The defects were assigned to the HA/β-TCP group (n = 15); open-flap debridement (OFD) + HA/β-TCP filling, or, HA/β-TCP-EMD group (n = 15); OFD + HA/β-TCP + EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position (RGMP), vertical and horizontal attachment level (RVAL and RHAL), vertical and horizontal bone level (RVBL and RHBL), and furcation diagnosis were evaluated at baseline and at 6 months.

Results: Both groups presented improvements after therapies (p < 0.05); however, no inter-group differences could be seen in any single parameter (p > 0.05). At 6 months, the gains in rVCAL in the HA/β-TCP and HA/β-TCP-EMD groups were 1.47 ± 0.99 and 2.10 ± 0.87 mm, while the RHCAL gains were 1.47 ± 1.46 and 1.57 ± 1.58 mm (p > 0.05). The RVBL and RHBL gains for the HA/β-TCP and HA/β-TCP-EMD group were 1.47 ± 1.13 and 1.70 ± 1.26 mm, and 1.90 ± 1.11 and 1.70 ± 1.37 mm respectively (p > 0.05). The HA/β-TCP-EMD group showed seven closed furcations versus four in the HA/β-TCP group (p > 0.05).

Conclusion: Both treatments lead to improvements in all clinical variables studied in the present trial. However, the closure of proximal class II furcation defects is still unpredictable.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alveolar Bone Loss / surgery
  • Bone Substitutes / therapeutic use*
  • Chronic Periodontitis / surgery
  • Debridement
  • Dental Enamel Proteins / therapeutic use*
  • Dental Plaque Index
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Furcation Defects / surgery*
  • Gingival Recession / surgery
  • Guided Tissue Regeneration, Periodontal / methods
  • Humans
  • Hydroxyapatites / therapeutic use*
  • Male
  • Middle Aged
  • Periodontal Attachment Loss / surgery
  • Periodontal Index
  • Periodontal Pocket / surgery
  • Prospective Studies
  • Surgical Flaps
  • Treatment Outcome

Substances

  • Bone Substitutes
  • Dental Enamel Proteins
  • Hydroxyapatites
  • enamel matrix proteins
  • hydroxyapatite-beta tricalcium phosphate