Long-term stability of adjunctive use of enamel matrix protein derivative on porcine-derived xenograft for the treatment of one-wall intrabony defects: A 4-year extended follow-up of a randomized controlled trial

Background: The long-term outcomes of demineralized porcine bone matrix (DPBM) in combination with enamel matrix protein derivative (EMD) for the treatment of one-wall intrabony defects have not yet been evaluated. Therefore, this study aimed to assess the clinical, radiographic, and patient-reported outcomes of regenerative therapy using DPBM with EMD (test group) in comparison with DPBM alone (control group) for the treatment of one-wall intrabony defects in the molar regions. Methods: Thirty-four patients (control group, n = 18, and test group, n = 16) were available at the 4-year follow-up assessment. Clinical (probing pocket depth and clinical attachment level [CAL]), radiographic (defect depth and width), and patient-reported (Oral Health Impact Profile [OHIP]-14) parameters were evaluated at baseline, 2 years, and 4 years after regenerative treatment. Results: Both treatment modalities, with and without adjunctive use of EMD, resulted in significant improvement of clinical (mean gain in CAL of 1.58 ± 1.34 mm), radiographic (mean defect width fill of 2.41 ± 0.90 mm), and oral health-related quality of life outcomes at 2 years after regenerative treatment of one-wall intrabony defects (P < 0.001), which has been sustained over a 4-year follow-up period. Particularly, OHIP-14 scores revealed a statistically significant reduction in physical pain, psychological discomfort, and physical disability (P < 0.05). Conclusions: The clinical, radiographic, and patient-reported outcomes were significantly improved when DPBM was used in the regenerative treatment, but no additional benefits were observed with the adjunctive use of EMD.