Casarin Renato Corrêa Viana, Del Peloso Ribeiro Erica, Nociti Francisco Humberto, Sallum Antônio Wilson, Sallum Enilson Antônio, Ambrosano Gláucia Maria Bovi, Casati Márcio Zaffalon
Department of Prosthodontics and Periodontics, Division of Periodontics, Campinas State University, São Paulo, Brazil.
J Clin Periodontol. 2008 May;35(5):429-37. doi: 10.1111/j.1600-051X.2008.01202.x. Epub 2008 Mar 12.
The aim of the present randomized, double-blind study was to evaluate the clinical response of proximal furcations treated with enamel matrix derivative proteins (EMD).
Fifteen patients, each with a pair of contralateral class-II proximal furcation involvements, presenting probing depths (PDs) >/=5 mm and bleeding on probing (BOP) were selected. The patients were randomly assigned to: control group (n=15) - open flap debridement (OFD)+24% ethylenediaminetetraacetic acid (EDTA) conditioning; test group (n=15) - OFD+24% EDTA conditioning+EMD application. Plaque index (PI), BOP, PD, gingival margin position (GMP), relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated immediately before and 2, 4 and 6 months after the surgeries.
At 6 months, the RVCAL gains of the control and test group were 0.39 +/- 1.00 and 0.54 +/- 0.95 mm, while the RHCAL gains were 1.21 +/- 2.28 and 1.36 +/- 1.26 mm (p>0.05). The VBL and HBL gains of the control group were 1.04 +/- 1.12 and 1.00 +/- 1.79 mm, and 0.82 +/- 1.82 and 1.17 +/- 1.38 mm for the test group (p>0.05). In addition, a statistical difference was observed in the number of the remaining class-II furcations between the test and control groups (p<0.05) in this period.
It may be concluded that the use of EMD in proximal furcations did not promote a superior reduction in PD or a gain in clinical and osseous attachment levels, but resulted in a higher rate of class-II to class-I furcation conversion.
本随机双盲研究旨在评估用釉基质衍生蛋白（EMD）治疗的近中根分叉病变的临床反应。
选取15例患者，每位患者均有一对对侧的II类近中根分叉病变，探诊深度（PD）≥5mm且探诊出血（BOP）。患者被随机分为：对照组（n = 15）——翻开瓣清创术（OFD）+ 24%乙二胺四乙酸（EDTA）预处理；试验组（n = 15）——OFD + 24% EDTA预处理+应用EMD。在手术前即刻以及手术后2、4和6个月评估菌斑指数（PI）、BOP、PD、牙龈边缘位置（GMP）、相对垂直和水平临床附着水平（RVCAL和RHCAL）、垂直和水平骨水平（VBL和HBL）以及根分叉闭合情况。
在6个月时，对照组和试验组的RVCAL增加量分别为0.39±1.00和0.54±0.95mm，而RHCAL增加量分别为1.21±2.28和1.36±1.26mm（p>0.05）。对照组的VBL和HBL增加量分别为1.04±1.12和1.00±1.79mm，试验组分别为0.82±1.82和1.17±1.38mm（p>0.05）。此外，在此期间试验组和对照组之间剩余II类根分叉病变的数量存在统计学差异（p<0.05）。
可以得出结论，在近中根分叉病变中使用EMD并没有在PD降低或临床及骨附着水平增加方面表现出更优的效果，但导致了II类向I类根分叉病变转化的更高发生率。
