36 Participants Needed

Growth Factors vs EMD for Periodontal Defects

TK
IM
AD
Overseen ByArsalan Danesh, D.D.S
Age: 18+
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: Nova Southeastern University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

Trial Summary

What is the purpose of this trial?

Treatment of intra-bony defects is challenging and requires extensive knowledge of the etiology, anatomy, occlusion, and available biomaterials that can be used to treat this kind of defects. Patients who received scaling and root planing at the college of dental medicine due to periodontal disease, will be screened for inclusion. Only subjects who showed persistent deep probing depth associated with an intrabony defect will be included and will be randomly allocated to one of two treatment groups. One group will be treated using recombinant human platelet derived growth factor (GEM-21) (test) added to allogenic bone graft, second group will be treated using enamel matrix derivatives (EMD) (control) with allograft. Both groups will be treated using the same surgical protocol. Patients will be followed up for a period of 6 months, before getting re-evaluated for assessing the effectiveness of the applied therapies.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you've been on medications affecting periodontal status in the past 6 months, like Phenytoin or Alendronate.

What data supports the effectiveness of this treatment for periodontal defects?

Research shows that recombinant human platelet-derived growth factor (rhPDGF-BB) is effective in promoting wound healing and bone regeneration in periodontal defects, with long-term stability observed in a 36-month study. Additionally, enamel matrix derivative (EMD) has been compared to other treatments and shown to be effective in treating periodontal defects.12345

Is the treatment with growth factors and EMD safe for humans?

The safety of recombinant human growth hormone (rhGH), which is similar to growth factors, has been studied for over 30 years and is generally considered safe for approved uses. However, there are concerns about long-term risks like cancer, so ongoing monitoring is recommended.678910

How is the drug GEM-21 (rhPDGF-BB) different from other treatments for periodontal defects?

GEM-21 (rhPDGF-BB) is unique because it uses a growth factor to stimulate the growth and repair of bone and periodontal tissues, promoting regeneration of the entire attachment apparatus, including bone, ligament, and cementum, which is not typically achieved with other treatments.123511

Research Team

TK

Theofilos Koutouzis, DDS, MS

Principal Investigator

Nova Southeastern University

Eligibility Criteria

This trial is for adults over 18 who've had scaling and root planing for periodontal disease, with deep pockets next to bone defects in their teeth. They must be able to come back for a 6-month check-up and not have serious health issues or habits like heavy smoking that could affect the results.

Inclusion Criteria

I am 18 years old or older.
I do not have any major health issues.
I have single or multiple rooted teeth in my upper or lower jaw.
See 5 more

Exclusion Criteria

I have a root tip infection in the area being tested.
Heavy smokers (>10 cigarettes a day)
I am willing to follow the study's rules and procedures.
See 3 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants receive either rh-PDGF or EMD in combination with bone allograft for the treatment of intra-bony defects

6 months
Regular visits for treatment and monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks
2 visits (in-person)

Treatment Details

Interventions

  • Enamel matrix derivatives (EMD)
  • Recombinant human platelet derived growth factor (GEM-21)
Trial OverviewThe study compares two treatments on people with gum disease: one group gets human growth factor (Rh-PDGF) added to a bone graft, while the other gets enamel matrix derivatives (EMD) with a bone graft. Both groups follow the same surgery steps and are checked after six months.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: recombinant human platelet derived growth factor (rh-PDGF) in combination with bone allograftExperimental Treatment1 Intervention
recombinant human platelet derived growth factor is a protein that is found in blood serum. It helps to recruit stem cells into the area to aid in cell differentiation and proliferation. When added to mineralized bone allograft, it stimulates the angiogenesis in the area, and this in turn may increase the outcomes of regeneration.
Group II: Enamel matrix derivatives (EMD) in combination with bone allograft.Active Control1 Intervention
Enamel matrix derivatives are natural proteins that are produced in the developing dental follicle. It has been available for decades and has been proved to help in regeneration of intrabony defects when applied into the root surface. When combined with bone allograft, it results in regeneration of intrabony defects.

Recombinant human platelet derived growth factor (GEM-21) is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as GEM-21 for:
  • Periodontal intra-bony defects
🇪🇺
Approved in European Union as GEM-21 for:
  • Periodontal intra-bony defects

Find a Clinic Near You

Who Is Running the Clinical Trial?

Nova Southeastern University

Lead Sponsor

Trials
103
Recruited
12,000+

Findings from Research

Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) significantly improved linear defect fill (LDF) by 0.95 mm and clinical attachment level (CAL) gain by 0.34 mm compared to the control, indicating its efficacy in treating periodontal intra-bony defects.
Recombinant human fibroblast growth factor-2 (rhFGF-2) also showed significant improvement in LDF, with a 21.22% increase, suggesting it is effective as well, although rhPDGF-BB had a more pronounced effect overall.
Outcomes of regenerative treatment with rhPDGF-BB and rhFGF-2 for periodontal intra-bony defects: a systematic review and meta-analysis.Khoshkam, V., Chan, HL., Lin, GH., et al.[2018]
The study involved 9 adult patients with advanced periodontitis and demonstrated that using purified recombinant human platelet-derived growth factor BB (rhPDGF-BB) mixed with bone allograft led to significant periodontal regeneration, including new bone, periodontal ligament, and cementum in both interproximal intrabony defects and Class II furcation lesions.
There were no safety concerns during the study, and the treatment resulted in substantial clinical improvements, with an average clinical attachment level gain of 6.17 mm and a vertical probing depth reduction of 6.42 mm in interproximal defects, indicating effective wound healing and regeneration.
Periodontal regeneration in humans using recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and allogenic bone.Nevins, M., Camelo, M., Nevins, ML., et al.[2022]
In a study involving 30 patients with chronic periodontitis, both platelet-rich fibrin (PRF) and enamel matrix derivative (EMD) were effective in treating periodontal intrabony defects, showing improvements in clinical parameters after 6 months.
However, EMD demonstrated a significantly greater percentage of defect resolution (43.07%) compared to PRF (32.41%), indicating that EMD may be the more effective option for this type of periodontal treatment.
Efficacy of platelet-rich fibrin vs. enamel matrix derivative in the treatment of periodontal intrabony defects: a clinical and cone beam computed tomography study.Gupta, SJ., Jhingran, R., Gupta, V., et al.[2022]

References

Outcomes of regenerative treatment with rhPDGF-BB and rhFGF-2 for periodontal intra-bony defects: a systematic review and meta-analysis. [2018]
Periodontal regeneration in humans using recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and allogenic bone. [2022]
Efficacy of platelet-rich fibrin vs. enamel matrix derivative in the treatment of periodontal intrabony defects: a clinical and cone beam computed tomography study. [2022]
A new era in periodontal and periimplant regeneration: use of growth-factor enhanced matrices incorporating rhPDGF. [2018]
Platelet-derived growth factor promotes periodontal regeneration in localized osseous defects: 36-month extension results from a randomized, controlled, double-masked clinical trial. [2022]
Use of growth hormone in children. [2006]
Two years of replacement therapy in adults with growth hormone deficiency. [2019]
GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults. [2022]
Corroboration of Height Velocity Prediction Markers for rhGH With an Oral GH Secretagogue Treatment in Children With GHD. [2022]
Long-acting PEGylated recombinant human growth hormone (Jintrolong) for children with growth hormone deficiency: phase II and phase III multicenter, randomized studies. [2019]
11.Korea (South)pubmed.ncbi.nlm.nih.gov
Comparison of early wound healing using modified papilla preservation technique between enamel matrix derivative and recombinant human fibroblast growth factor. [2023]