Clinical and radiographic evaluation of intrabony periodontal defects treated with hyaluronic acid or enamel matrix proteins. A 6-month prospective study
Surgical treatment of intrabony vertical defects in patients with Periodontitis stage III, grades A and B
A randomized prospective 6-month, single-blind clinical, single-center, interventional study with a 1:1 allocation ratio according to computer-generated tables composed of two groups (test group: open flap debridement + hyaluronic acid application and control group: open flap debridement + enamel matrix proteins application), one surgeon will perform all surgeries using identical techniques, another specialist in periodontology, other than the surgeon will obtain the clinical and radiographical measurements. The patients will be randomly assigned with a 1:1 ratio to one of the two groups through simple randomization, using a computerized random number generator(www.randomization.com). The allocation concealment will be performed using numbers associated with the test or control procedure. Even numbers will be associated with the test procedure, while odd numbers with the control procedure. The numbers on the cards will be enclosed in opaque envelopes. Treatment allocation will be performed at the time of surgery after debridement of the suprabony defects, by opening the envelope containing the number. Test group (hyaluronic acid group): An access flap will be prepared after local anesthesia. Scaling and root planning will be performed by combining the use of metal curettes and power-driven instrumentation using an ultrasonic scaler. The hyaluronic acid gel (Hyadent) will be applied to the exposed root surface respecting manufacturer indications, followed by a tension-free primary closure of the surgery wound using 6-0 monofilament (polypropylene) non-resorbable suturing material. Control group (enamel matrix proteins (Emdogain) group): An access flap will be prepared after local anesthesia. Scaling and root planning will be performed by combining the use of metal curettes and power-driven instrumentation using an ultrasonic scaler. Enamel matrix proteins (Emdogain) will be applied to the exposed root surface respecting manufacturer indications, followed by a ten
1. No systemic diseases that could influence the outcome of the therapy 2. Presence of 2-3 walls IBD ≥ 3 mm 3. An interproximal PD ≥ 6 mm 4. 6 weeks after subgingival instrumentation at the experimental sites 5. Good oral hygiene 6. Non-smokers
1. Patients with systemic diseases known to affect the outcome of periodontal therapy 2. Immunocompromised individuals 3. Pregnant or lactating females 4. Tobacco smokers or tobacco use in any form 5. Non-compliant patients 6. Prolonged antibiotic treatment or anti-inflammatory treatment within 6 months prior the surgery 7. Grade C periodontitis 8. Furcation involvement at the same tooth 9. Mobility grade II/III 10. Poor oral hygiene 11. Patients with parafunctional habits 12. Patients who had periodontal surgery in the last 6 months 13. Orthodontic treatment during the previous year 14. Occlusion trauma 15. Interproximal open contact points 16. One-walled or combined one- and two-walled defects confirmed upon surgical exposure