The Applications of Enamel Matrix Derivative in Implant Dentistry: A Narrative Review

Abstract

Enamel matrix derivative (EMD) has been successfully used for periodontal regeneration in intrabony defects. Recently, its use for peri-implant bone regeneration has also been hypothesized. The aim of this paper is to review preclinical and clinical studies investigating the use of EMD in correspondence with titanium implants, alone or as an adjunct to other biomaterials. Clinical trials and case series with more than five cases were included. Seven in vitro studies evaluated the effect of EMD, placed on titanium surfaces: An increase in proliferation and viability of osteoblasts was observed in all but two studies. An increase in TGF-β1 and osteocalcin production, alkaline phosphatase activity, and angiogenesis was also reported. Nine animal studies investigated the use of EMD at implant placement or for bone regeneration of peri-implant bone defects, and some of them reported a significant increase in bone formation or bone-to-implant contact. In four of eleven clinical trials on humans, EMD was successfully used at implant placement. The other seven evaluated the use of EMD in protocols for the treatment of peri-implantitis. In conclusion, the results of EMD seem promising, but further randomized clinical trials are needed to evaluate its efficacy.

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

“…EMD have been proven to have osteogenic effects 12 , promote soft tissue healing 29 and reduce in ammation 14 . It is widely used in periodontal therapy 15 , bone regeneration of replanted teeth 30 , dental pulp treatment 9 and peri-implant in ammatory diseases 31 . Therefore, it is worth considering whether the auxiliary use of EMD during ARP can promote osteogenesis, promote the early healing of soft tissue and prevent peri-implant in ammation.…”

Biomimetic approaches and materials in restorative and regenerative dentistry: review article

“…EMD was reported to play a major role in regeneration of the periodontal ligament. The mechanism of action of EMD is still not fully explained, but it is believed that application of amelogenins onto a conditioned root surface forms an extracellular matrix with high affinity for hydroxyapatite and collagen, which interacts with the surrounding cells and thus initiates regeneration [90]. EMD has been also proved to induce reparative dentin in direct pulp capping and stimulating odontogenesis.…”

Enamel Matrix Derivative (Emdogain) for Wound Healing and Bone Regeneration: A Short-Review

“…stimulating/accelerating soft tissue formation/maturation, stimulating keratinised gingiva formation, protecting against oral pathogens, reducing early post-surgical inflammation (peri-implant mucositis & periimplantitis) and reducing the risk for postsurgical pain [20][21][22][23] ; all will aid in:…”