Autogenous Tooth Bone Grafts with Enamel Matrix Derivates in Non-Contained Intrabony Periodontal Defects—A Case Series Study

<b>Background:</b> The predictability of regenerative outcomes in non-contained intrabony periodontal defects remains limited. Autogenous tooth bone grafts (ATB) may represent a biologically active and osteoconductive scaffold with minimal residual graft material. This study evaluated the clinical and radiographic outcomes of ATB combined with enamel matrix derivative (EMD) in intrabony defects. <b>Methods:</b> Nine systemically healthy patients (15 defects) were treated with ATB + EMD in a retrospective proof-of-concept design. Clinical parameters-probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR)-were recorded at baseline and 6 months. Radiographic changes in defect depth and width were also assessed. Statistical significance was set at <i>p</i> < 0.05. <b>Results:</b> Mean PPD decreased from 7.73 ± 0.96 mm to 3.87 ± 0.74 mm (<i>p</i> < 0.001), and CAL improved from 9.20 ± 1.47 mm to 5.53 ± 1.36 mm (<i>p</i> < 0.001). GR changes were not significant. Radiographically, mean defect depth and width were reduced from 3.81 ± 1.59 mm and 2.56 ± 0.75 mm to 0.72 ± 1.08 mm and 0.44 ± 0.70 mm, respectively (<i>p</i> < 0.001). <b>Conclusions:</b> The combination of ATB and EMD yielded substantial clinical and radiographic improvements in intrabony periodontal defects. These findings suggest that autogenous tooth bone grafts may serve as a reliable biologically active scaffold for regenerative periodontal surgery. This is the first study evaluating the combination of EMD and ATB. Within the study limitations, ATB + EMD demonstrated promising regenerative potential, warranting future controlled clinical trials.