Periodontal Regeneration With Enamel Matrix Derivative in Reconstructive Periodontal Therapy: A Systematic Review

Koop, R.; Merheb, Joe; Quirynen, Marc

doi:10.1902/jop.2011.110266

Cited by 138 publications

(119 citation statements)

References 86 publications

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“…Venezia et al (44) also found results favorable to the enamel matrix derivatives, however, their systematic review with meta-analysis presents some methodological issues that prevent safe extrapolation of their findings. The obtained results are in line with two well-conducted systematic reviews about the same subject (30,31). However, differently from these two reviews, this study performed analyses by subgroups, considering follow-up time, suggesting that the magnitude of differences between the use of EMDP and OFD considerably decreases over time.…”

Section: Discussionsupporting

confidence: 87%

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

Zanatta

Souza²,

Pinto

et al. 2013

Braz. Dent. J.

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Previous systematic reviews have demonstrated better results with enamel matrix derivative proteins (EMDP) as compared with open flap debridement (OFD) for the management of infrabony periodontal defects (IPD). The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies. Cochrane Central Register of Controlled Trials, Medline/PubMed, Lilacs, Embase and Web of Science electronic databases were searched up to August 2013 for randomized clinical trials.Eligible outcomes were changes in probing depth (PD), clinical attachment level (CAL),gingival recession (GR) and bone changes (BC). Studies with follow-up of 12 months showed differences of 0.97 mm (CI95% 0.52 -1.43) and 1.19 mm (CI95% 0.77 -1.60) for PD and CAL, respectively, favorable for EMDP. Studies with follow-up ≥ 24 months presented advantages of 1.11 mm (CI95% 0.74 -1.48) for CAL and 0.83 mm (CI95% 0.19 -1.48) for PD,with use of EMDP. Considering the quality of studies, those with low risk of bias showed lower difference between groups, presenting 0.8 mm (CI95% 0.24-1.36) for CAL, favorable for EMDP and without differences for PS (0.51 mm, CI95% -0.21 -1.23). In conclusion, follow-up time (< or > 2 years) and the risk of bias influence the results of treatment with EMDP in IPD.

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Section: Discussionsupporting

confidence: 87%

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

Zanatta

Souza²,

Pinto

et al. 2013

Braz. Dent. J.

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“…A systematic review of the treatment of intrabony defects with EMD reported a significant additional gain in CAL of 1.3 mm compared with open-flap debridement, but no significant difference compared with resorbable membranes was shown [17]. In our previous study of the periodontal regenerative study using a deproteinized bovine bone mineral in combination with a collagen membrane [12], mean gain in CAL at 2.5 years was 1.4 mm, which is smaller than the 2-year value in the present study.…”

Section: Discussionmentioning

confidence: 99%

Periodontal regenerative therapy with enamel matrix derivative in the treatment of intrabony defects: a prospective 2-year study

et al. 2017

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ObjectiveTo date, enamel matrix derivative (EMD) has been considered to be one of the few biomaterials for clinical use capable of demonstrating true periodontal regeneration. The aim of this two-center prospective clinical study was to evaluate 2-year outcome of periodontal regenerative therapy using EMD in the treatment of intrabony defects, performed as an ‘advanced medical treatment’ under the national healthcare system in Japan.ResultsPatients with chronic periodontitis who have completed initial periodontal therapy at either of the two dental school clinics were enrolled. Each contributed at least one intrabony defect of ≥3 mm in depth. During surgery, EMD was applied to the defect following debridement. Twenty-two participants (mean age 55.2 years old, 9 men and 13 women) completed 2-year reevaluation, and a total of 42 defects were subjected to data analysis. Mean gains in clinical attachment level (CAL) at 1 and 2 years were 2.9 mm (38% of baseline CAL) and 3.1 mm (41%), respectively, both showing a significant improvement from baseline. There was also a significant reduction in probing depth (PD): mean reductions at 1 and 2 years were 3.2 and 3.3 mm, respectively. There was a progressive improvement in the mean percentages of bone fill from 26% at 1 year to 36% at 2 years. No significant difference in CAL gain at 2 years was found between 3-wall bone defects and other defect types combined. In multiple regression analysis, the baseline PD was significantly associated with CAL gain at 2 years. In this population of patients, the treatment of intrabony defects with EMD yielded clinically favorable outcomes, as assessed by periodontal and radiographical parameters, over a period of 2 years.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2572-2) contains supplementary material, which is available to authorized users.

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“…Narrative and systematic reviews have provided evidence indicating that the use of EMD in conjunction with open flap debridement (OFD) significantly improved the clinical outcomes in intrabony defects compared with OFD alone (OFD) [4][5][6]. In several studies [7][8][9][10] it was recognized that the morphology of the osseous defect plays an important role in the healing capacity of the defect itself.…”

Section: Introductionmentioning

confidence: 99%

Enamel matrix derivative and bone grafts for periodontal regeneration of intrabony defects. A systematic review and meta-analysis

et al. 2015

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Objective: To assess the clinical efficacy of regenerative periodontal surgery of intrabony defects using a combination of enamel matrix derivative (EMD) and bone graft compared with that of EMD alone. Materials and methods:The Cochrane Oral Health Group specialist trials, MEDLINE and EMBASE databases were searched for entries up to February 2014. The primary outcome was gain of clinical attachment (CAL). Weighted means and Forest plots were calculated for CAL gain, probing depth (PD) and gingival recession (REC).Results: Twelve studies reporting on 434 patients and 548 intrabony defects were selected for the analysis. Mean CAL gain amounted to 3.76 ± 1.07 mm (median 3.63 95% CI: 3.51-3.75) following treatment with a combination of EMD and bone graft and to 3.32±1.04 mm (median 3.40; 95% CI 3.28; 3.52) following treatment with EMD alone. Clinical relevance: The present findings support the use of EMD and bone grafts for the treatment of intrabony periodontal defects.3

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Periodontal Regeneration With Enamel Matrix Derivative in Reconstructive Periodontal Therapy: A Systematic Review

Cited by 138 publications

References 86 publications

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

Periodontal regenerative therapy with enamel matrix derivative in the treatment of intrabony defects: a prospective 2-year study

Enamel matrix derivative and bone grafts for periodontal regeneration of intrabony defects. A systematic review and meta-analysis

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