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

Matarasso, M; Iorio-Siciliano, V; Blasi, A; Ramaglia, L; Salvi, Giovanni Edoardo; Sculean, Anton (2015). Enamel matrix derivative and bone grafts for periodontal regeneration of intrabony defects. A systematic review and meta-analysis. Clinical oral investigations, 19(7), pp. 1581-1593. Springer 10.1007/s00784-015-1491-7

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OBJECTIVE The aim of the present systematic review and meta-analysis was 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. Mean PD reduction measured 4.22 ± 1.20 mm (median 4.10; 95 % CI 3.96-4.24) at sites treated with EMD and bone graft and yielded 4.12 ± 1.07 mm (median 4.00; 95 % CI 3.88-4.12) at sites treated with EMD alone. Mean REC increase amounted to 0.76 ± 0.42 mm (median 0.63; 95 % CI 0.58-0.68) at sites treated with EMD and bone graft and to 0.91 ± 0.26 mm (median 0.90; 95 % CI 0.87-0.93) at sites treated with EMD alone. CONCLUSIONS Within their limits, the present results indicate that the combination of EMD and bone grafts may result in additional clinical improvements in terms of CAL gain and PD reduction compared with those obtained with EMD alone. The potential influence of the chosen graft material or of the surgical procedure (i.e., flap design) on the clinical outcomes is unclear. CLINICAL RELEVANCE The present findings support the use of EMD and bone grafts for the treatment of intrabony periodontal defects.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology

UniBE Contributor:

Salvi, Giovanni Edoardo and Sculean, Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-6981

Publisher:

Springer

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

15 Feb 2016 14:02

Last Modified:

09 Sep 2017 18:00

Publisher DOI:

10.1007/s00784-015-1491-7

PubMed ID:

26008887

Uncontrolled Keywords:

Intrabony defect, Periodontal disease, Enamel matrix derivative, Bone graft, Periodontal pocket, Periodontal regeneration

BORIS DOI:

10.7892/boris.75559

URI:

https://boris.unibe.ch/id/eprint/75559

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