Enamel Matrix Derivative Stabilizes Blood Clot and Improves Clinical Healing in Deep Pockets After Flapless Periodontal Therapy: a Randomized Clinical Trial.

AIM: An acute phase response is induced after non-surgical periodontal treatment (SRP). The main aim of this study was to compare acute-phase (24-h) and medium-term (3-months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with PPD≥6mm.

METHODS: Thirty-eight periodontitis-affected subjects were randomized to SRP or SRP+EMD. Periodontal parameters were recorded at baseline and 3 months. Serum samples were collected at baseline, 1, and 90 days after treatment.

RESULTS: Both treatments triggered an intense acute inflammation on day 1, which regressed to baseline values at 3 months. D-dimer and cystatin C levels did not show sharp increases in SRP+EMD group 24-h after treatment, compared to SRP. Significant difference between groups was observed for D-dimer (p<0.001). EMD application was also associated with better periodontal healing as shown by greater PPD reduction and CAL gain in sites with PPD≥6mm, and higher number of cases with no residual PPD≥6mm (p<0.05) at 3 months.

CONCLUSIONS: EMD application after non-surgical periodontal treatment resulted in lower fibrinolysis, and better periodontal healing of deep pockets. These initial observations warrant further investigations on the potential to modulate both local and systemic outcomes of non-surgical periodontal treatment. NCT03544931 This article is protected by copyright. All rights reserved.