Quintessence Int. 2021;52(5):402-410. doi: 10.3290/j.qi.b912657.
Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ± 0.5 mm and 0.04 ± 1.1 mm, and -0.65 ± 3.0 mm and -0.73 ± 3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task.
评估使用釉基质衍生物（EMD）进行牙周再生治疗在侵袭性牙周炎患者中的疗效，并确定通过定期的辅助牙周治疗来维持疗效的作用。方法和材料：共评估了 28 名患者，共涉及 74 个骨内位点。其中 50 个位点应用 EMD 凝胶，24 个位点应用 EMD 联合脱蛋白牛异种移植物。患者被分配到辅助牙周治疗方案中；18 名患者完成了方案，定义为维护良好（WM）组；10 名患者未完成方案，定义为未维护（NM）组。记录探诊深度（PD）、临床附着水平（CAL）和放射影像学骨水平（BL）。数据在术前（T0）、术后 6 个月（T1）和治疗后 3 至 10 年（T2）进行比较。结果：两种手术方式均能达到类似的 PD 减少、CAL 增加和 BL 增加，并能长期维持。T1 到 T2 显示 WM/NM 组的平均增益/损失分别为 0.21±0.5mm 和 0.04±1.1mm，以及-0.65±3.0mm 和-0.73±3.0mm，用于 PD 和 CAL。WM/NM 组的 BL 增益分别为 21.6%和 11.5%（P<.05）。在观察期间，WM 和 NM 组的 PD、CAL 和 BL 变化轨迹不同（P<.05）。结论：在侵袭性牙周炎病例中，使用 EMD 进行牙周再生治疗，联合或不联合脱蛋白牛异种移植物，可以维持疗效。定期的辅助牙周治疗似乎是实现这一目标的决定因素。
