Influence of aging on periodontal regenerative therapy using enamel matrix derivative: A 3-year prospective cohort study

Aim To investigate the influence of chronological aging on periodontal regenerative therapy (PRT) outcomes with enamel matrix derivative (EMD). Materials and Methods In total, 253 intra-bony defects (151 patients) including 44 furcation involvement were prospectively investigated for 3 years after regenerative therapy with EMD by evaluating probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone defect depth (RBD). The influence of age on these outcomes was assessed using multilevel regression analyses adjusting for confounders. Results Participants' mean age was 55.9 +/- 12.3 years (range: 22-85). Baseline PPD, CAL, and RBD were 6.14 +/- 1.82, 7.22 +/- 2.14, and 5.08 +/- 2.04 mm, respectively. Significant improvement was observed with PPD reductions of 2.84 +/- 1.73 and 2.87 +/- 1.87 mm, CAL gains of 2.40 +/- 1.87 and 2.47 +/- 1.89 mm, and RBD gains of 1.76 +/- 1.98 and 2.39 +/- 2.41 mm at 1- and 3-year examinations, respectively. At the 1-year examination, multivariate analysis revealed a significant negative association between age and improvement in PPD and CAL (coefficients: -0.13, -0.23 mm per 10 years). However, by the 3-year examination, no significant association was noted between age and improvement in PPD, CAL, or RBD. Conclusion Although the statistical difference was detected with age at 1-year examination, PRT with EMD significantly improved clinical outcomes on long-term observation, irrespective of the patient's age. Clinical trial registration number UMIN000039846.