The impact of supportive periodontal treatment on the outcome of regenerative surgical therapy in aggressive periodontitis patients

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the con tribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with depro teinized bovine xenograft. Patients were assigned to a sup portive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radio graphic bone level (BL) were recorded. Data were compared presurgically (T₀), 6 months postsurgery (T₁), and 3 to 10 years posttreatment (T₂). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T₁ to T₂ showed a mean gain/loss of 0.21 ± 0.5 mm and 0.04 ± 1.1 mm, and −0.65 ± 3.0 mm and −0.73 ± 3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respect ively (P <.05). The courses of the PD, CAL, and BL differed be tween the WM and NM groups during the observation periods (P <.05). Conclusion: Periodontal regeneration via EMD with/ without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determi nant factor in achieving this task.