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‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with pro...
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| Veröffentlicht in: | Journal of clinical periodontology 2019-02, Vol.46 (2), p.231-240 |
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| container_title | Journal of clinical periodontology |
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| creator | Graziani, Filippo Gennai, Stefano Petrini, Morena Bettini, Laura Tonetti, Maurizio |
| description | 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‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with probing pocket depth (PPD) ≥ 6 mm.
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 hr after treatment, compared to SRP. Significant difference between groups was observed for D‐dimer (p |
| doi_str_mv | 10.1111/jcpe.13074 |
| format | Article |
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An acute phase response is induced after non‐surgical periodontal treatment (SRP). The main aim of this study was to compare acute phase (24‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with probing pocket depth (PPD) ≥ 6 mm.
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 hr 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 clinical attachment level gain in sites with PPD ≥ 6 mm, and higher number of cases with no residual PPD ≥ 6 mm (p < 0.05) at 3 months.
Conclusions
EMD application after non‐SRP 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‐SRP. NCT03544931</description><identifier>ISSN: 0303-6979</identifier><identifier>EISSN: 1600-051X</identifier><identifier>DOI: 10.1111/jcpe.13074</identifier><identifier>PMID: 30663788</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Blood coagulation ; Clinical trials ; Cystatin C ; C‐reactive protein ; Dental enamel ; Dental Enamel Proteins ; Dental Scaling ; Dentistry ; Enamel ; enamel matrix derivative ; Fibrinolysis ; Gum disease ; Humans ; Periodontal Attachment Loss ; Periodontitis ; Thrombosis ; Wound Healing</subject><ispartof>Journal of clinical periodontology, 2019-02, Vol.46 (2), p.231-240</ispartof><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4234-6cc48521dcc38f680fcd02d2dd22a0d67b8eb5459805bb40a265ccca866949503</citedby><cites>FETCH-LOGICAL-c4234-6cc48521dcc38f680fcd02d2dd22a0d67b8eb5459805bb40a265ccca866949503</cites><orcidid>0000-0002-2743-0137 ; 0000-0002-1554-9966 ; 0000-0002-3849-4304 ; 0000-0001-8780-7306</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpe.13074$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpe.13074$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30663788$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Graziani, Filippo</creatorcontrib><creatorcontrib>Gennai, Stefano</creatorcontrib><creatorcontrib>Petrini, Morena</creatorcontrib><creatorcontrib>Bettini, Laura</creatorcontrib><creatorcontrib>Tonetti, Maurizio</creatorcontrib><title>Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial</title><title>Journal of clinical periodontology</title><addtitle>J Clin Periodontol</addtitle><description>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‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with probing pocket depth (PPD) ≥ 6 mm.
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 hr 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 clinical attachment level gain in sites with PPD ≥ 6 mm, and higher number of cases with no residual PPD ≥ 6 mm (p < 0.05) at 3 months.
Conclusions
EMD application after non‐SRP 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‐SRP. NCT03544931</description><subject>Blood coagulation</subject><subject>Clinical trials</subject><subject>Cystatin C</subject><subject>C‐reactive protein</subject><subject>Dental enamel</subject><subject>Dental Enamel Proteins</subject><subject>Dental Scaling</subject><subject>Dentistry</subject><subject>Enamel</subject><subject>enamel matrix derivative</subject><subject>Fibrinolysis</subject><subject>Gum disease</subject><subject>Humans</subject><subject>Periodontal Attachment Loss</subject><subject>Periodontitis</subject><subject>Thrombosis</subject><subject>Wound Healing</subject><issn>0303-6979</issn><issn>1600-051X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc-KFDEQh4Mo7rh68QEk4EWEXitJJ532tgzjPxYUWcFbk06q3YzpTpv0jI7P4sOadXY9eLAuKcKXryr8CHnM4IyVerG1M54xAU19h6yYAqhAss93yQoEiEq1TXtCHuS8BWCNEOI-ORGglGi0XpFfm8mMGOholuR_UIfJ783i90jzYnof_E_MtA8xOmpDXKiZHPXjnOK-3NvgJ29NoFdoSvuF-qkYcKZztF9xydQMCyY6BDMHzJnOxR5dnJbyZLnCZObDS3pOPxZpHMskR9e3xsvkTXhI7g0mZHx0c56ST682l-s31cX712_X5xeVrbmoK2VtrSVnzlqhB6VhsA64485xbsCpptfYy1q2GmTf12C4ktZao5Vq61aCOCXPjt7yr287zEs3-mwxBDNh3OWOs6YVLde8LejTf9Bt3KWpbFcoLYBLyetCPT9SNsWcEw7dnPxo0qFj0F1n1l1n1v3JrMBPbpS7fkT3F70NqQDsCHz3AQ__UXXv1h82R-lvxcqj0A</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Graziani, Filippo</creator><creator>Gennai, Stefano</creator><creator>Petrini, Morena</creator><creator>Bettini, Laura</creator><creator>Tonetti, Maurizio</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2743-0137</orcidid><orcidid>https://orcid.org/0000-0002-1554-9966</orcidid><orcidid>https://orcid.org/0000-0002-3849-4304</orcidid><orcidid>https://orcid.org/0000-0001-8780-7306</orcidid></search><sort><creationdate>201902</creationdate><title>Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial</title><author>Graziani, Filippo ; Gennai, Stefano ; Petrini, Morena ; Bettini, Laura ; Tonetti, Maurizio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4234-6cc48521dcc38f680fcd02d2dd22a0d67b8eb5459805bb40a265ccca866949503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Blood coagulation</topic><topic>Clinical trials</topic><topic>Cystatin C</topic><topic>C‐reactive protein</topic><topic>Dental enamel</topic><topic>Dental Enamel Proteins</topic><topic>Dental Scaling</topic><topic>Dentistry</topic><topic>Enamel</topic><topic>enamel matrix derivative</topic><topic>Fibrinolysis</topic><topic>Gum disease</topic><topic>Humans</topic><topic>Periodontal Attachment Loss</topic><topic>Periodontitis</topic><topic>Thrombosis</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Graziani, Filippo</creatorcontrib><creatorcontrib>Gennai, Stefano</creatorcontrib><creatorcontrib>Petrini, Morena</creatorcontrib><creatorcontrib>Bettini, Laura</creatorcontrib><creatorcontrib>Tonetti, Maurizio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical periodontology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Graziani, Filippo</au><au>Gennai, Stefano</au><au>Petrini, Morena</au><au>Bettini, Laura</au><au>Tonetti, Maurizio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial</atitle><jtitle>Journal of clinical periodontology</jtitle><addtitle>J Clin Periodontol</addtitle><date>2019-02</date><risdate>2019</risdate><volume>46</volume><issue>2</issue><spage>231</spage><epage>240</epage><pages>231-240</pages><issn>0303-6979</issn><eissn>1600-051X</eissn><abstract>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‐hr) and medium‐term (3‐months) inflammation and clinical outcomes after SRP with or without application of enamel matrix derivative (EMD) in sites with probing pocket depth (PPD) ≥ 6 mm.
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 hr 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 clinical attachment level gain in sites with PPD ≥ 6 mm, and higher number of cases with no residual PPD ≥ 6 mm (p < 0.05) at 3 months.
Conclusions
EMD application after non‐SRP 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‐SRP. NCT03544931</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>30663788</pmid><doi>10.1111/jcpe.13074</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2743-0137</orcidid><orcidid>https://orcid.org/0000-0002-1554-9966</orcidid><orcidid>https://orcid.org/0000-0002-3849-4304</orcidid><orcidid>https://orcid.org/0000-0001-8780-7306</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Blood coagulation Clinical trials Cystatin C C‐reactive protein Dental enamel Dental Enamel Proteins Dental Scaling Dentistry Enamel enamel matrix derivative Fibrinolysis Gum disease Humans Periodontal Attachment Loss Periodontitis Thrombosis Wound Healing |
| title | Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial |
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