Filippo Graziani1,2, Stefano Gennai1,2, Morena Petrini1,2, Laura Bettini1, Maurizio Tonetti3. 1. Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy. 2. Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy. 3. Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.
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.
RCT Entities:
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.
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