Graduation Date

Spring 5-4-2019

Document Type


Degree Name

Master of Science (MS)


Medical Sciences Interdepartmental Area

First Advisor

Richard A. Reinhardt, D.D.S., Ph.D.


The purpose of this study was to determine if local application of enamel matrix derivative (Emdogain; EMD), combined with minimally invasive papilla reflection/root preparation (PR/RP), is effective in improving probe depth (PD), clinical attachment level (CAL), and interproximal bone height (IBH) in persistent 6-9 mm periodontal pockets in patients on periodontal maintenance therapy (PMT). Fifty periodontal maintenance patients with advanced chronic periodontitis presenting with a 6-9 mm interproximal PD were included in study. Experimental (PR/RP+EMD; n=24) and control (PR/RP+S; n=26) therapies were randomly allocated. Roots were treated with reflection of interproximal papillae, root planing assisted with endoscope evaluation, and acid etching, followed by EMD or saline application. Clinical measurements were collected at baseline, six months, and 12 months post-therapy. IBH measurements were made on standardized vertical bitewing radiographs taken at baseline and 12 months. Both PR/RP+EMD and PR/RP+S resulted in significant improvements in clinical outcomes (PD: -2.3 ± 0.2 mm, -2.4 ± 0.2 mm, p0.05), from baseline to 12 months. No significant differences were found in clinical outcomes between the experimental group and the control. The addition of EMD to PR/RP does not significantly improve clinical outcomes compared to PR/RP alone in periodontal maintenance patients.