LAUSR

BACKGROUND Modified Minimally Invasive Surgical Technique (M-MIST) optimizes wound stability in the treatment of intrabony defects. Short-term observations show similar results with flap alone or adjunctive regenerative materials. This study aims to compare stability of the long-term outcomes, complication free survival and costs of 3 treatment. MATERIALS AND METHODS 45 intrabony defects in 45 patients had been randomized to M-MIST alone (N=15), combined with enamel matrix derivative (M-MIST+EMD, N=15) or EMD plus Bone Mineral Derived Xenograph (M-MIST+EMD+BMDX, N=15). Supportive periodontal care (SPC) and necessary re-treatment were provided for 10 years. RESULTS Three subjects were lost to follow-up. Clinical attachment level differences between 1 and 10 years were -0.1±0.7mm for M-MIST, -0.1±0.8mm for M-MIST+EMD, and -0.3±0.6mm for M-MIST+EMD+BMDX (P>0.05 for within and between group differences). Four episodes of recurrence occurred in the M-MIST, 4 in the M-MIST+EMD, 5 in the M-MIST+EMD+BMDX. No significant differences in complication free-survival were observed between the three groups (P=0.47). The complication free survival was 7.46 years (95%CI: 7.05-7.87) for the whole population. M-MIST+EMD+BMDX group lost 1 treated tooth. Data indicated no significant intergroup difference of the total cost of recurrence over 10 years. When the baseline cost of treatment is considered, the total cost was lower for M-MIST alone. CONCLUSIONS Teeth with deep pockets associated with intrabony defects can be succesfully maintained long-term with either M-MIST alone or adding a regenerative material in the context of a careful SPC program. M-MIST alone provided similar short and long-term benefits as regeneration at a lower cost. The findings need to be confirmed in larger, independent studies. This article is protected by copyright. All rights reserved.