Assessment of early discomfort and wound healing outcomes after periodontal surgery with and without enamel matrix derivative: an observational retrospective case-control study.

Abstract

The aim of this study was to evaluate and compare early postoperative discomfort and wound healing outcomes between patients who underwent periodontal surgery with and without enamel matrix derivative (EMD), using retrospective questionnaires and postoperative clinical examinations. All enrolled patients filled out the self-report questionnaire after suture removal. The severity and duration of subjective pain and swelling were evaluated using visual analog scale (VAS) scores and wound healing parameters (dehiscence/fenestration, spontaneous bleeding, persistent swelling, and ulceration). Chi-squared tests, two-tailed independent t tests, analysis of variance, and multiple logistic regression analysis were performed to identify significant differences between the two groups (surgery with EMD and surgery without EMD). The severity of pain and swelling did not differ between patients who underwent surgery with and without EMD, but the durations of pain (P < 0.001) and swelling (P = 0.019) were significantly lower in patients who underwent surgery with EMD. Multivariate analysis with adjustment for confounding variables showed that wound healing outcomes including dehiscence/fenestration, spontaneous bleeding, and ulceration did not differ significantly between the two groups, and only persistent swelling showed significant differences (odds ratio 4.03, 95% CI 1.17-13.78; P = 0.026). No difference was observed in the severity of early postoperative discomfort and wound healing outcomes between patients who underwent surgery with and without EMD, but shorter durations of postoperative pain and swelling were evident in patients who underwent surgery with EMD. Adjunctive EMD used in periodontal surgery has clinical advantages for reducing the durations of postoperative pain and swelling.