Disease recurrence following reconstructive procedures: a 6- to 8-year follow-up observational study

The aims of the present study were to determine (i) the long-term disease recurrence in intraosseous defects that had undergone an open flap debridement (OFD) procedure with or without enamel matrix derivative (EMD); and (ii) whether and to what extent clinical changes recorded on teeth treated with surgery were similar at sites involved or adjacent to the intraosseous defect.

Eleven patients contributing twelve reconstructed intraosseous defects were retrospectively recruited and included for analysis. Immediately before surgery, at 12 months post-surgery and at long-term examination (6-8 years post-surgery), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at the test site (representative of the reconstructed intraosseous defect) and the control site (representative of an adjacent non-reconstructed site) of each tooth treated with surgery.

All patients received monthly professional maintenance up to 12 months after surgery, and every 6 months or less frequently thereafter. In test sites, CAL varied from 5.4 +/- 0.8 mm at 12 months to 6.5 +/- 1.0 mm at the long-term examination. PPD increased from 3.7 +/- 0.4 mm at 12 months to 4.3 +/- 0.6 mm at the long-term examination, the changes being not statistically significant. When PPD and CAL changes from 12 months to the long-term examination were compared between test and control sites, no significant differences were found.

Within its limitations and considering the limited sample size, the present study indicates that (i) the attachment gain that has been achieved by means of a surgical reconstructive procedure (based on OFD with/without EMD) may be mostly maintained over a 6-8 year follow-up period; and (ii) the extent of disease recurrence, as assessed by attachment loss and pocket deepening, was similar at sites involved or adjacent to the intraosseous defect.