Treatment of intrabony periodontal defects in controlled diabetic patients with an enamel matrix derivative: a split-mouth randomized clinical trial.

Abstract

This split-mouth randomized controlled trial aimed to evaluate the effect of enamel matrix derivative (EMD) associated with a simplified papilla preservation flap (SPPF) compared to SPPF alone in the surgical treatment of intrabony defects (ID) in type 2 diabetic mellitus (T2DM) patients. Thirteen patients with controlled T2DM presenting with ID in at least two quadrants were included. In each patient, the test site (TS) was treated with SPPF plus EMD, whereas the control site (CS) was treated only with SPPF. Prior to surgery and at 6months after intervention, the following parameters were evaluated: clinical attachment level (CAL), probing pocket depth (PPD), and gingival recession (GR). The TS and CS demonstrated a mean CAL gain of 3.31 ± 0.96mm and 1.61 ± 1.12mm, and a PPD reduction from 8.15 ± 0.98 to 3.00 ± 0.57mm and 7.53 ± 0.96 to 4.69 ± 0.63mm after 6months, respectively. In both sites, the mean CAL gain and PPD reduction improved significantly after 6months compared to baseline; however, the improvement was higher in the TS (p < 0.001). Both surgical procedures presented with clinical improvements in controlled T2DM patients. However, the additional use of EMD showed enhanced clinical results after 6months with regard to CAL gain and PPD reduction. This study showed a better PPD reduction and CAL gain when an EMD was applied in addition to SPPF. Therefore, EMD may be used to enhance clinical outcomes in periodontal ID of controlled T2DM patients.