Effect of Enamel Matrix Derivative and bone grafts on Alveolar Ridge Preservation in Bone Healing: A Systematic Review and Meta-Analysis

Abstract

Objectives The purpose of this systematic review and meta-analysis was to compare the effectiveness of using bone grafts alone to alveolar ridge preservation (ARP) using a combination of enamel matrix derivative (EMD) and bone grafts. Materials and Methods Searches were conducted via electronic approaches for articles published up to July 2022. Changes in buccal ridge height (BH), palatal ridge height (PH), ridge width (RW) and the fraction of new bone (%NB), residual graft (%RG), soft tissue matrix (%STM) were extracted from original articles for meta-analysis. ResultsThis review covered four randomized controlled clinical trials. The weighted mean difference (WMD) of BH, PH, RW2 with RW1, and RW2 with RW3 were 0.32mm (95% CI = -0.03~0.67, P = 0.08), 0.00mm (95% CI = -0.23 ~ 0.23, P = 0.99), 0.01 mm (95% CI= -0.20~ 0.21, P = 0.95), and 0.09mm (95% CI = -0.17 ~ 0.35, P = 0.50), respectively. The WMD of %NB, %RG, and %STM were 22.48% (95% CI = 9.24~35.71, P = 0.0009), -5.62% (95% CI = -28.14~16.89, P = 0.62), and -11.90% (95% CI = -19.29~-5.73, P = 0.002), respectively. Conclusion This review revealed that bone healing in sockets under ARP with EMD and bone grafts was better than that with bone grafts alone. There was significant difference in the %NB and %STM. Clinical Relevance When compared to bone grafts alone, the use of EMD with bone grafts during ARP has supernumerary advantages for bone healing.