Emdogain and Straumann Bone Ceramic in Infrabony Defects

• Change in Distance Between the Cementum-enamel-junction and the Base of the Vertical Bone Defect [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: No ]
• Change in Probing Pocket Depth (PPD) [ Time Frame: Baseline and 12 months ] [ Designated as safety issue: No ]
  PPD is measured using a periodontal probe from the gingival margin to the bottom of the pocket.
• Change in Clinical Attachment Level (CAL) [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: No ]
  CAL is calculated as the sum of Probing Pocket Depth (PPD) and Recession (REC). PPD is measured using a periodontal probe from the gingival margin to the bottom of the pocket. REC is measured using a periodontal probe from the gingival margin to the cemento-enamel junction (CEJ).
• Change in Probing Pocket Depth (PPD) [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: No ]
  PPD is measured using a periodontal probe from the gingival margin to the bottom of the pocket.
• Change in Distance Between the Cementum-enamel-junction and the Base of the Vertical Bone Defect [ Time Frame: Baseline and 12 months ] [ Designated as safety issue: No ]

• Radiographic bone gain [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]
• Probing Pocket Depth (PD) [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]
• Clinical Attachment Level [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Bleeding on Probing (BOP) [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]
• Plaque Index (PI) [ Time Frame: 6 months and 12 months ] [ Designated as safety issue: No ]

To compare the clinical effect of the combination of bone ceramic and enamel matrix proteins (test) versus autogenous bone graft alone (control) in the treatment of deep-wide intrabony defects

• Device: Emdogain PLUS
  Emdogain treatment followed by Straumann Bone Ceramic application during periodontal surgery
• Device: Autogenous bone
  Autogenous bone application during periodontal surgery

• Active Comparator: Emdogain PLUS
  Straumann Emdogain in combination with Straumann BoneCeramic
  Intervention: Device: Emdogain PLUS
• Active Comparator: Autogenous bone
  Autogenous bone from the patient
  Intervention: Device: Autogenous bone

Inclusion Criteria:

• Males and females must be at least 18 years and not more than 75 years of age
• The patient will have to be able to understand and sign the informed consent prior to starting the study.
• The patient also will have to have the ability and the willingness to comply with all study requirements.
• The patients will be in good general health without any systemic diseases.
• The teeth included in the study will be mandibular molars, maxillary and mandibular premolars, and canines.
• The patients will have to have at least one defect with pocket depth ≥ 5 mm.
• Intra-bony defects will have to have 1 or 2-wall morphology (at least 2/3 of the defect).
• Depth of the intrabony component of at least 3 mm
• The selected sites will have to have vertical intra-bony component ≥ 3 mm and an angle ≥ 30 degrees as assessed from standardized intra-oral radiographs.
• Oral hygiene parameters: Plaque Index (PI) ≤ 20 % and bleeding on probing (BoP) ≤ 20%

Exclusion Criteria:

• Heavy smokers: more than 20 cigarettes per day
• Mucosal diseases such as erosive lichen planus
• History of local radiation therapy
• Presence of oral lesions (such as ulceration, malignancy)
• Teeth with untreated endodontic or cardiologic problems
• Physical handicap that will interfere with patient's ability to exercise good oral hygiene on a regular basis.
• Patients presenting antibiotic treatment within the 3 months preceding the surgical procedure.
• Patients using anti-inflammatory drugs on a regular basis.
• Intra-bony defects with a 3-wall morphology.
• Intra-bony defects with furcation involvement.
• Incisors and maxillary molars, will be excluded.
• Alcoholism or chronically drug abuse causing systemic compromize
• Medical conditions requiring prolonged use of steroids
• Current pregnancy at the time of recruitment and/or breastfeeding women.
• Conditions or circumstances, in the opinion of the investigator, which could represent a general contra-indication for surgical procedure or would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, or unreliability.