Hydroxyapatite/beta-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial

Abstract

Objective To clinically evaluate proximal furcations treated with hydroxyapatite/-tricalcium phosphate (HA/-TCP) isolated or combined with enamel matrix derivative (EMD). Material and Methods Thirty patients, presenting at least one proximal class II furcation defect, probing pocket depth (PPD) 5mm and bleeding on probing, were included. The defects were assigned to the HA/-TCP group (n=15); open-flap debridement (OFD)+HA/-TCP filling, or, HA/-TCP-EMD group (n=15); OFD+HA/-TCP+EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position (RGMP), vertical and horizontal attachment level (RVAL and RHAL), vertical and horizontal bone level (RVBL and RHBL), and furcation diagnosis were evaluated at baseline and at 6months. Results Both groups presented improvements after therapies (p<0.05); however, no inter-group differences could be seen in any single parameter (p>0.05). At 6months, the gains in rVCAL in the HA/-TCP and HA/-TCP-EMD groups were 1.47 +/- 0.99 and 2.10 +/- 0.87mm, while the RHCAL gains were 1.47 +/- 1.46 and 1.57 +/- 1.58mm (p>0.05). The RVBL and RHBL gains for the HA/-TCP and HA/-TCP-EMD group were 1.47 +/- 1.13 and 1.70 +/- 1.26mm, and 1.90 +/- 1.11 and 1.70 +/- 1.37mm respectively (p>0.05). The HA/-TCP-EMD group showed seven closed furcations versus four in the HA/-TCP group (p>0.05). Conclusion Both treatments lead to improvements in all clinical variables studied in the present trial. However, the closure of proximal class II furcation defects is still unpredictable.