Graduation Date

Spring 5-4-2019

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Amy C. Killeen

Abstract

The purpose of this double-blinded, randomized, controlled clinical trial was to determine if local application of enamel matrix protein derivative (Emdogain:EMD), combined with minimally-invasive papilla reflection is effective in reducing inflammation in periodontal pockets in patients on periodontal maintenance therapy (PMT).Fifty patients diagnosed with advanced chronic periodontitis presenting with a 6-9mm interproximal probing depth were included in the trial. Experimental (EMD; n=24) and control (saline, n=26) therapies were randomly allocated. Roots were treated with mini-flaps and root planing assisted with endoscope evaluation before EMD or saline application. Inflammation was assessed by bleeding on probing (BOP) at baseline, 6-, and 12-months and gingival crevicular fluid (GCF) samples at baseline, 2-weeks, 6-, and 12-months. GCF was evaluated for change in IL-1β and PGE2 levels using ELISA. A significant reduction in BOP at the treatment site was seen for both groups after 12-months. After adjustments, patients with BOP present at baseline had a higher risk of a poor BOP outcome at 12-months (AOR = 5.68, p = 0.048). At 2-weeks, there was a significant reduction in IL-1β with EMD (mean = -40.15 pg, p = 0.05) and at 12-months a trend for reduction in IL-1β with EMD (mean = -32.85 pg, p = 0.07). Differences in IL-1β between groups were not significant. The addition of EMD does not significantly improve BOP; however, EMD does significantly decrease IL-1β in the short-term compared to a control in periodontal maintenance patients.

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