Membrane-free guided tissue regeneration with enamel matrix derivative and bone graft materials improves 3-dimensional periodontal outcomes in small dogs

Objective: To evaluate the clinical and radiographic outcomes of membrane-free guided tissue regeneration (GTR) using enamel matrix derivative (EMD) with bone grafts in dogs with vertical infrabony periodontal defects. Methods: This retrospective study reviewed cases of client-owned dogs that underwent membrane-free GTR using EMD in combination with bone grafts between August 1, 2023, and September 30, 2025. Outcomes were assessed from records and cone-beam computed tomography (CBCT) datasets using 2-D measurements of clinical attachment loss (CAL) and vertical bone defect ratio (VBDR) and 3-D volumetric analysis. Success was defined as CAL improvement (≥ 1 mm) and VBDR reduction (> 10%). Volumetric analysis was used to quantify infrabony defect fill. Results: 20 periodontal defects in 16 dogs were included (allograft, n = 10; xenograft, 10). Median follow-up was 7 months (range, 6 to 14 months). All defects met the success criteria. Median CAL decreased from 5.0 mm (range, 3.0 to 8.0 mm) to 2.0 mm (range, 1.0 to 3.0 mm), and median VBDR decreased from 0.42 (range, 0.16 to 0.78) to 0.18 (range, 0.04 to 0.46). Volumetric analysis revealed a median infrabony defect fill of 98.49% (range, 71.86% to 100.00%). Conclusions: Membrane-free GTR with EMD was associated with clinically meaningful periodontal improvement and substantial infrabony defect fill in appropriately selected canine patients with vertical infrabony defects. Prospective, controlled studies are warranted to further evaluate its efficacy and indications. Clinical Relevance: This membrane-free regenerative approach may provide a practical tooth-preserving treatment option for selected small-breed dogs when conventional barrier-membrane placement is technically challenging.