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

The combination of enamel matrix derivative (EMD) with an autogenous bone graft in periodontal regeneration has been proposed to improve clinical outcomes, especially in case of deep non-contained periodontal defects, with variable results. The aim of the present systematic review and meta-analysis was to assess the efficacy of EMD in combination with autogenous bone graft compared with the use of EMD alone for the regeneration of periodontal intrabony defects. A literature search in PubMed and in the Cochrane Central Register of Controlled Trials was carried out on February 2019 using an ad-hoc search string created by two independent and calibrated reviewers. All randomized controlled trials (RCTs) comparing a combination of EMD and autogenous bone graft with EMD alone for the treatment of periodontal intrabony defects were included. Studies involving other graft materials were excluded. The requested follow-up was at least 6 months. There was no restriction on age or number of patients. Standard difference in means between test and control groups as well as relative forest plots were calculated for clinical attachment level gain (CALgain), probing depth reduction (PDred), and gingival recession increase (RECinc). Three RCTs reporting on 79 patients and 98 intrabony defects were selected for the analysis. Statistical heterogeneity was detected as significantly high in the analysis of PDred and RECinc (I2 = 85.28%, p = 0.001; I2 = 73.95%, p = 0.022, respectively), but not in the analysis of CALgain (I2 = 59.30%, p = 0.086). Standard difference in means (SDM) for CALgain between test and control groups amounted to −0.34 mm (95% CI −0.77 to 0.09; p = 0.12). SDM for PDred amounted to −0.43 mm (95% CI −0.86 to 0.01; p = 0.06). SDM for RECinc amounted to 0.12 mm (95% CI −0.30 to 0.55. p = 0.57). Within their limits, the obtained results indicate that the combination of enamel matrix derivative and autogenous bone graft may result in non-significant additional clinical improvements in terms of CALgain, PDred, and RECinc compared with those obtained with EMD alone. Several factors, including the surgical protocol used (e.g. supracrestal soft tissue preservation techniques) could have masked the potential additional benefit of the combined approach. Further well-designed randomized controlled trials, with well-defined selection criteria and operative protocols, are needed to draw more definite conclusions.

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Does enamel matrix derivative application provide additional clinical benefits in residual periodontal pockets associated with suprabony defects? A systematic review and meta-analysis of randomized clinical trials

Journal Of Clinical Periodontology ◽

10.1111/jcpe.12218 ◽

2014 ◽

Vol 41 (4) ◽

pp. 377-386 ◽

Cited By ~ 11

Author(s):

Filippo Graziani ◽

Stefano Gennai ◽

Silvia Cei ◽

Francesco Ducci ◽

Nicola Discepoli ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Enamel Matrix Derivative ◽

Enamel Matrix ◽

Clinical Benefits ◽

Matrix Derivative

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Enamel matrix derivative for replanted teeth in animal models: a systematic review and meta-analysis

Restorative Dentistry & Endodontics ◽

10.5395/rde.2013.38.4.194 ◽

2013 ◽

Vol 38 (4) ◽

pp. 194 ◽

Cited By ~ 8

Author(s):

Sahng G. Kim ◽

Steven I. Ryu

Keyword(s):

Systematic Review ◽

Animal Models ◽

Meta Analysis ◽

Enamel Matrix Derivative ◽

Enamel Matrix ◽

Matrix Derivative

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Lesões em áreas de furca: fatores etiológicos, diagnóstico e tratamento

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i6.5110 ◽

2020 ◽

Vol 9 (6) ◽

pp. 635-640

Author(s):

Ariana Larissa de Moura Rodrigues ◽

Ana Carolina de Sá Gomes Cruz Souza ◽

Jéssica Gomes Alcoforado de Melo ◽

Diego Moura Soares

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Meta Analysis ◽

Class Ii ◽

Periodontal Treatment ◽

Enamel Matrix Derivative ◽

Enamel Matrix ◽

Furcation Defects ◽

Furcation Involvement ◽

Matrix Derivative

As lesões de furca ocorrem quando a doença periodontal atinge a área de bifurcação dos dentes multirradiculares causando a destruição óssea e perda de inserção no espaço inter-radicular. Existem diversos fatores etiológicos que influenciam no aparecimento dessas lesões e até os dias de hoje o tratamento desse tipo de injúria ainda é um desafio na clínica odontológica. O objetivo deste artigo foi listar, através de uma revisão da literatura, os fatores que influenciam na etiologia da lesão de furca, bem como o seu diagnóstico, prognóstico e tratamento. Fatores como características morfológicas do dente e raiz e deficiência no controle do biofilme, que podem contribuir para o seu aparecimento. Além de diversos tipos de procedimentos e técnicas têm sido propostas para o tratamento das lesões de furca, seja mais ou menos conservadores. Descritores: Defeitos da Furca; Diagnóstico; Doenças Periodontais. 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Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24-month randomized clinical trial. J Clin Periodontol; 2010;37(12):1100-109. Hoffmann T, Richter S, Meyle J, Gonzales JR, Heinz B, Arjomand M et al. A randomized clinical multicentre trial comparing enamel matrix derivative and membrane treatment of buccal class II furcation involvement in mandibular molars. Part III: patient factors and treatment outcome. J Clin Periodontol. 2006;33(8):575-83.

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