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Enamel Matrix Derivative and Xenograft for Mandibular Molar Furcation Defects

17. August 2026 aktualisiert von: Vy Truong Tuong Huynh, University of Medicine and Pharmacy at Ho Chi Minh City

Efficacy of Enamel Matrix Derivative Combined With Xenograft in the Treatment of Furcation Defects in Mandibular Molars

This randomized controlled clinical trial aims to compare two regenerative surgical approaches for the treatment of mandibular molar Class II furcation defects in patients with periodontitis. Eligible furcation defects will be randomly assigned to receive either xenograft bone combined with enamel matrix derivative (EMD) or xenograft bone combined with a collagen membrane. Both approaches are used to support periodontal tissue regeneration.

Participants will be followed for approximately 7 months. The study will evaluate postoperative pain and patient-reported satisfaction, periodontal clinical parameters, changes in furcation defect volume and relative bone density on cone-beam computed tomography (CBCT), and changes in gingival crevicular fluid TWEAK levels. Clinical and radiographic outcomes will be assessed before surgery and during follow-up, including at 3 and 6 months after surgery.

The study is intended to determine whether xenograft bone combined with EMD provides clinical, radiographic, biological, and patient-reported outcomes comparable or superior to xenograft bone combined with a collagen membrane in the regenerative treatment of mandibular molar Class II furcation defects.

Studienübersicht

Detaillierte Beschreibung

This is a randomized controlled clinical trial involving patients with periodontitis who have Class II furcation defects affecting mandibular first and/or second molars. A total of 24 eligible teeth are planned, with 12 teeth assigned to each treatment group.

Before surgery, participants will undergo clinical periodontal examination, intraoral three-dimensional scanning, CBCT imaging, and gingival crevicular fluid collection. Clinical measurements include plaque index (PI), gingival index (GI), probing pocket depth (PPD), vertical clinical attachment loss (VCAL), and horizontal clinical attachment loss (HCAL).

Eligible defects will be randomly assigned to one of two regenerative surgical treatments. Following flap elevation, debridement, root surface cleaning, and conditioning with 24% EDTA, the control group will receive xenograft bone covered with a resorbable collagen membrane. The experimental group will receive enamel matrix derivative applied to the defect-related root surface, followed by xenograft bone combined with enamel matrix derivative. The flap will then be repositioned and sutured.

Postoperative pain will be assessed using a visual analog scale, together with analgesic consumption and patient-reported satisfaction regarding swelling and chewing ability. Participants will return for follow-up at approximately 2 weeks, 1 month, 3 months, and 6 months after surgery. Gingival crevicular fluid will be collected during follow-up for measurement of TWEAK concentration.

At 3 months, selected periodontal and biological assessments will be repeated. At 6 months, periodontal clinical measurements, intraoral three-dimensional scanning, furcation defect classification, and CBCT imaging will be repeated to evaluate changes in defect volume and relative bone density.

The primary purpose of the study is to compare the regenerative effectiveness of xenograft bone combined with enamel matrix derivative with that of xenograft bone combined with a collagen membrane for the treatment of mandibular molar Class II furcation defects.

Studientyp

Interventionell

Einschreibung (Geschätzt)

24

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • Binh Phu
      • Ho Chi Minh City, Binh Phu, Vietnam, 700000
        • Rekrutierung
        • Faculty of Dentistry, University of Medicine and Pharmacy at Ho Chi Minh City
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • Age 18 years or older.
  • Full-mouth plaque score (FMPS) ≤ 20%.
  • Full-mouth bleeding score (FMBS) ≤ 20%.
  • Willingness to participate in the study and provide informed consent.
  • Mandibular first and/or second molar with a buccal Class II furcation defect classified as subgroup A2 or B2.
  • Probing pocket depth (PPD) ≥ 5 mm at the eligible furcation site.
  • Keratinized gingival height ≥ 2 mm at the eligible site.
  • No gingival recession extending apically beyond the buccal furcation roof; the furcation entrance must not be clinically exposed above the gingival margin.

Exclusion Criteria:

  • Systemic diseases or conditions that may affect periodontal treatment outcomes, including uncontrolled diabetes mellitus, heart disease requiring anticoagulant therapy, hematologic disorders, or immunodeficiency.
  • Pregnancy or breastfeeding.
  • Untreated endodontic pathology involving the study tooth.
  • Class III furcation involvement according to the Hamp classification.
  • Untreated occlusal trauma involving the study tooth.
  • Grade II tooth mobility that has not been stabilized by splinting, or Grade III tooth mobility according to the Miller classification.
  • Defective restorations at the surgical site, including overhanging, bulky, or poorly adapted restorations.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Xenograft + Enamel Matrix Derivative
Periodontal regenerative surgery is performed using xenograft bone combined with enamel matrix derivative (EMD). After flap elevation, thorough defect debridement, and root surface conditioning with 24% EDTA for 2 minutes, EMD is applied to the root surface associated with the furcation defect. The xenograft bone is mixed with EMD and placed to completely fill the defect. The flap is then repositioned and sutured.
Aktiver Komparator: Xenograft + Collagen Membrane
Periodontal regenerative surgery is performed using xenograft bone combined with a resorbable collagen membrane. After flap elevation, thorough defect debridement, and root surface conditioning with 24% EDTA for 2 minutes, the xenograft bone is mixed with sterile saline and placed to completely fill the furcation defect. A trimmed resorbable collagen membrane is positioned to completely cover the defect and secured before flap repositioning and suturing.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in Probing Pocket Depth (PPD)
Zeitfenster: Baseline and 6 months after surgery
Probing pocket depth (PPD) is measured in millimeters from the gingival margin to the base of the periodontal pocket using a UNC-15 periodontal probe at the mesiobuccal, buccal, and distobuccal sites of the treated tooth. Measurements are standardized using an individualized acrylic stent. The change in PPD from baseline to 6 months after surgery will be compared between the two treatment groups.
Baseline and 6 months after surgery
Change in Horizontal Clinical Attachment Loss (HCAL)
Zeitfenster: Baseline and 6 months after surgery
Horizontal clinical attachment loss (HCAL) is measured in millimeters from the buccal entrance of the furcation to the deepest horizontal point of the furcation defect using a Nabers periodontal probe and an individualized acrylic stent.
Baseline and 6 months after surgery

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in Vertical Clinical Attachment Loss (VCAL)
Zeitfenster: Baseline and 6 months after surgery
Baseline and 6 months after surgery
Change in Buccal Gingival Recession (REC)
Zeitfenster: Baseline, 3 months, and 6 months after surgery
Baseline, 3 months, and 6 months after surgery
Change in Plaque Index (PI)
Zeitfenster: Baseline, 3 months, and 6 months after surgery
Baseline, 3 months, and 6 months after surgery
Change in Gingival Index (GI)
Zeitfenster: Baseline and 6 months after surgery
Baseline and 6 months after surgery
Change in Furcation Defect Volume on CBCT
Zeitfenster: Baseline and 6 months after surgery
Baseline and 6 months after surgery
Change in Relative Bone Density on CBCT
Zeitfenster: Baseline and 6 months after surgery
Baseline and 6 months after surgery
Change in Gingival Crevicular Fluid TWEAK Concentration
Zeitfenster: Baseline, 1 month, and 3 months after surgery
Baseline, 1 month, and 3 months after surgery
Postoperative Pain Assessed by Visual Analog Scale (VAS)
Zeitfenster: 12 hours, 24 hours, and 72 hours after surgery
12 hours, 24 hours, and 72 hours after surgery
Postoperative Analgesic Consumption
Zeitfenster: During the first 3 days after surgery
During the first 3 days after surgery
Patient Satisfaction With Postoperative Swelling
Zeitfenster: 3 and 7 days after surgery
Patient-reported satisfaction with postoperative swelling will be assessed using a 5-point Likert scale, where 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, and 5 = very satisfied. Higher scores indicate better satisfaction (better outcome).
3 and 7 days after surgery
Patient Satisfaction With Chewing Ability
Zeitfenster: 3 and 7 days after surgery
Patient-reported satisfaction with chewing ability after surgery will be assessed using a 5-point Likert scale, where 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, and 5 = very satisfied. Higher scores indicate better satisfaction (better outcome).
3 and 7 days after surgery

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

29. Juni 2026

Primärer Abschluss (Geschätzt)

29. September 2027

Studienabschluss (Geschätzt)

30. September 2027

Studienanmeldedaten

Zuerst eingereicht

12. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

17. August 2026

Zuerst gepostet (Tatsächlich)

20. August 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

20. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

17. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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