{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T01:24:55Z","timestamp":1786929895667,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To evaluate whether minimally invasive non\u2010surgical therapy (MINST) with flapless application of enamel matrix derivative (EMD) achieves non\u2010inferior clinical and radiographic outcomes compared to minimally invasive surgical technique (MIST)\u2009+\u2009EMD, while improving patient\u2010reported outcome measures (PROMs).<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n Following CONSORT guidelines, 40 patients with mandibular Grade II furcation defects were randomised to MINST (\n n<\/jats:italic>\n \u2009=\u200920) or MIST (\n n<\/jats:italic>\n \u2009=\u200920) with EMD. Probing pocket depth (PPD), clinical attachment level (CAL) and cone\u2010beam computed tomography (CBCT) horizontal\/vertical bone loss were assessed at baseline and 9\u2009months. PROMs (visual analogue score [VAS] and Oral Health Impact Profile [OHIP\u201014]) were recorded longitudinally.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At 9\u2009months, the mean PPD reduction was 2.20\u2009\u00b1\u20092.24\u2009mm in the MIST group and 2.15\u2009\u00b1\u20091.76\u2009mm in the MINST group. The adjusted mean difference was \u22120.22\u2009mm (95% CI: \u22121.43 to 0.99\u2009mm). The one\u2010sided non\u2010inferiority\n p<\/jats:italic>\n \u2010value was 0.025. As the upper bound of the confidence interval remained below the prespecified non\u2010inferiority margin, MINST was considered non\u2010inferior to MIST for the primary outcome. When evaluated against the strict +1.0\u2009mm margin, MINST achieved statistical non\u2010inferiority for gingival recession (\n p<\/jats:italic>\n \u2009=\u20090.003) and vertical bone gain (\n p<\/jats:italic>\n \u2009=\u20090.015). However, non\u2010inferiority could not be formally established for CAL (\n p<\/jats:italic>\n \u2009=\u20090.067) or horizontal bone gain (\n p<\/jats:italic>\n \u2009=\u20090.157). PROMs revealed significantly lower root hypersensitivity and improved oral\u2010health\u2010related quality of life in the MINST group at 2\u2009weeks; however, these differences were not sustained at later timepoints.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Within the limitations of this randomised controlled trial, MINST with EMD showed clinical and radiographic outcomes generally comparable to MIST in mandibular Class II furcation defects. While non\u2010inferiority against a strict 1.0\u2009mm margin was successfully established for the primary outcome (PPD) and specific secondary parameters, it could not be formally confirmed for CAL or horizontal bone gain. MINST was associated with significantly improved short\u2010term PROMs during the early healing phase.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT05541614\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpe.70167","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T07:17:51Z","timestamp":1783754271000},"page":"1413-1422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, Radiographic and Patient\u2010Centred Outcomes of\n MINST<\/scp>\n Versus\n MIST<\/scp>\n With Enamel Matrix Derivative in Class\n II<\/scp>\n Mandibular Furcation Defects: A Randomised Controlled Trial"],"prefix":"10.1111","volume":"53","author":[{"given":"Georgios S.","family":"Chatzopoulos","sequence":"first","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0513-5110","authenticated-orcid":false,"given":"Eleftherios G.","family":"Kaklamanos","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"},{"name":"School of Dentistry, European University Cyprus Nicosia Cyprus"},{"name":"Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Vouros","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Mikrogeorgis","sequence":"additional","affiliation":[{"name":"Department of Endodontology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini\u2010Elissavet","family":"Doufexi","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Tsalikis","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology School of Dentistry, Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010020\u201003229\u20100"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2010.01614.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12601"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12048"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12056"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2006.050296"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051x.1975.tb01734.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2017.160505"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2004.00114.x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2011.110404"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2019.103246"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12443"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12497"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u201010\u20107"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.090663"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c332"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12467"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.14178"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18\u20100006"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12732"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03380-8"}],"container-title":["Journal 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