Local application of enamel matrix derivative prevents acute systemic inflammation after periodontal regenerative surgery: A randomized controlled clinical trial

Abstract

Aim: The aim of this study was to compare surgical treatment of periodontal intra‐bony defects (IBD) with or without the adjunct of enamel matrix derivative (EMD) in terms of acute‐phase responses in healthy patients.

Methods: Thirty‐eight periodontitis‐affected subjects, one IDB each, were randomized to minimally invasive periodontal surgery (MIS) with or without EMD. Periodontal parameters were recorded at baseline and 6‐months. Blood samples were collected at baseline, 1, 7 and 180 days after treatment.

Results: At 24 hr, the group treated MIS with EMD showed lower values of C‐reactive protein (CRP; p < .01) as no inflammatory perturbation was noticed. Conversely, MIS group resulted in an acute inflammatory response at 24 hr (p < .05) that regressed to its baseline values at day 7. The EMD group showed a higher number of cases without residual BOP or PPD ≥ 5mm 6 months after surgery (p < .05), and post‐surgical gingival recession was lower (p < .05).

Conclusions: The adjunctive application of EMD during surgical treatment resulted in a minor increase in serum CRP 24‐hr after surgery. These findings suggest a possible systemic anti‐inflammatory effect of EMD. Within its limitations, this pilot trial confirmed better clinical periodontal outcomes in the EMD group. NCT03590093.