Effects of Enamel Matrix Derivative on Non-surgical Management of Peri-implant Mucositis: a Double-blind Randomized Clinical Trial

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2017 Jan 1

PMID 28039545

Citations 9

Authors

Atabak Kashefimehr

Reza Pourabbas

Masumeh Faramarzi

Ali Zarandi

Abouzar Moradi

Howard C Tenenbaum

Amir Azarpazhooh

Affiliations

Soon will be listed here.

Abstract

Background: Peri-implant diseases have been recognized as being among the ever-increasing complications related to dental implants. The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) to mechanical debridement (MD) in patients with these conditions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF).

Methods: In the present double-blind clinical trial, 46 patients with peri-implant mucositis (PM) were randomly divided into control and test groups. Two different therapeutic protocols, consisting of non-surgical MD alone (control group) and MD with the application of EMD (test group), were considered for the two groups. Clinical parameters [bleeding on probing (BOP) and probing depth (PD)] and sampling from PICF were carried out before treatment and 3 months postoperatively. The levels of IL-6 and IL-17 cytokines in PICF were evaluated by enzyme-linked immunosorbent (ELISA).

Results: Three-month post-interventional assay revealed significant improvements in BOP and PD in the test group in comparison to the control group (P < 0.0001). Relative to control, IL-6 and IL-17 levels were reduced significantly (p < 0.05) in the test group compared to the control group.

Conclusion: Application of EMD can be considered an adjunct to MD in the non-surgical treatment of PM. However, complete recovery was not observed using either treatment approach showing that management of implant-associated disease is still a significant clinical problem.

Citing Articles

The Effect of Peri-Implant Therapy on the Expression of Th17-Related Cytokines in Patients with Peri-Implant Mucositis and Peri-Implantitis: A Prospective Longitudinal Study.

Goncalves L, Neves G, da Silva A, Telles D, Figueredo C, Lourenco E J Clin Med. 2025; 14(2).

PMID: 39860346 PMC: 11766395. DOI: 10.3390/jcm14020340.

Peri-Implantitis.

Ting M, Suzuki J Dent J (Basel). 2024; 12(8).

PMID: 39195095 PMC: 11352821. DOI: 10.3390/dj12080251.

Local Oxygen-Based Therapy (bluem) for Treatment of Peri-Implant Disease: Clinical Case Presentation and Review of Literature about Conventional Local Adjunct Therapies.

Shaheen M, Abas I, Basudan A, Alghamdi H Medicina (Kaunas). 2024; 60(3).

PMID: 38541173 PMC: 10972400. DOI: 10.3390/medicina60030447.

Novel Flowchart Guiding the Non-Surgical and Surgical Management of Peri-Implant Complications: A Narrative Review.

Shiba T, Komatsu K, Takeuchi Y, Koyanagi T, Taniguchi Y, Takagi T Bioengineering (Basel). 2024; 11(2).

PMID: 38391604 PMC: 10885994. DOI: 10.3390/bioengineering11020118.

Enamel Matrix Derivative (EMD) as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review.

Abu-Taa M, Marzouka D Cureus. 2023; 15(8):e43530.

PMID: 37719602 PMC: 10500965. DOI: 10.7759/cureus.43530.

References

Irshad M, Scheres N, Anssari Moin D, Crielaard W, Loos B, Wismeijer D . Cytokine and matrix metalloproteinase expression in fibroblasts from peri-implantitis lesions in response to viable Porphyromonas gingivalis. J Periodontal Res. 2013; 48(5):647-56. DOI: 10.1111/jre.12051. View

Lang N, Berglundh T . Periimplant diseases: where are we now?--Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011; 38 Suppl 11:178-81. DOI: 10.1111/j.1600-051X.2010.01674.x. View

Zeza B, Pilloni A . Peri-implant mucositis treatments in humans: a systematic review. Ann Stomatol (Roma). 2013; 3(3-4):83-9. PMC: 3555467. View

Koop R, Merheb J, Quirynen M . Periodontal regeneration with enamel matrix derivative in reconstructive periodontal therapy: a systematic review. J Periodontol. 2011; 83(6):707-20. DOI: 10.1902/jop.2011.110266. View

Kemoun P, Gronthos S, Snead M, Rue J, Courtois B, Vaysse F . The role of cell surface markers and enamel matrix derivatives on human periodontal ligament mesenchymal progenitor responses in vitro. Biomaterials. 2011; 32(30):7375-88. PMC: 4441221. DOI: 10.1016/j.biomaterials.2011.06.043. View

Weishaupt P, Bernimoulin J, Trackman P, Hagewald S . Stimulation of osteoblasts with Emdogain increases the expression of specific mineralization markers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(2):304-8. DOI: 10.1016/j.tripleo.2008.02.033. View

Froum S, Froum S, Rosen P . Successful management of peri-implantitis with a regenerative approach: a consecutive series of 51 treated implants with 3- to 7.5-year follow-up. Int J Periodontics Restorative Dent. 2012; 32(1):11-20. View

Kadkhodazadeh M, Baghani Z, Ebadian A, Youssefi N, Mehdizadeh A, Azimi N . IL-17 gene polymorphism is associated with chronic periodontitis and peri-implantitis in Iranian patients: a cross-sectional study. Immunol Invest. 2013; 42(2):156-63. DOI: 10.3109/08820139.2012.746697. View

Schwarz F, Sculean A, Rothamel D, Schwenzer K, Georg T, Becker J . Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: a pilot study. Clin Oral Implants Res. 2005; 16(1):44-52. DOI: 10.1111/j.1600-0501.2004.01051.x. View

10.

Spahr A, Lyngstadaas S, Boeckh C, Andersson C, Podbielski A, Haller B . Effect of the enamel matrix derivative Emdogain on the growth of periodontal pathogens in vitro. J Clin Periodontol. 2002; 29(1):62-72. DOI: 10.1034/j.1600-051x.2002.290110.x. View

11.

Bosshardt D . Biological mediators and periodontal regeneration: a review of enamel matrix proteins at the cellular and molecular levels. J Clin Periodontol. 2008; 35(8 Suppl):87-105. DOI: 10.1111/j.1600-051X.2008.01264.x. View

12.

Esposito M, Grusovin M, Coulthard P, Worthington H . The efficacy of interventions to treat peri-implantitis: a Cochrane systematic review of randomised controlled clinical trials. Eur J Oral Implantol. 2010; 9 Suppl 1(2):111-25. View

13.

Meffert R . Periodontitis vs. peri-implantitis: the same disease? The same treatment?. Crit Rev Oral Biol Med. 1996; 7(3):278-91. DOI: 10.1177/10454411960070030501. View

14.

Gutierrez M, Mellonig J, Cochran D . Evaluation of enamel matrix derivative as an adjunct to non-surgical periodontal therapy. J Clin Periodontol. 2003; 30(8):739-45. DOI: 10.1034/j.1600-051x.2003.00374.x. View

15.

van Winkelhoff A . Antibiotics in the treatment of peri-implantitis. Eur J Oral Implantol. 2012; 5 Suppl:S43-50. View

16.

Brito C, Tenenbaum H, Wong B, Schmitt C, Nogueira-Filho G . Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature. J Biomed Mater Res B Appl Biomater. 2013; 102(3):643-50. DOI: 10.1002/jbm.b.33042. View

17.

Esposito M, Grusovin M, Worthington H . Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012; 5 Suppl:S21-41. View

18.

Renvert S, Persson G . Periodontitis as a potential risk factor for peri-implantitis. J Clin Periodontol. 2009; 36 Suppl 10:9-14. DOI: 10.1111/j.1600-051X.2009.01416.x. View

19.

Heitz-Mayfield L . Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol. 2008; 35(8 Suppl):292-304. DOI: 10.1111/j.1600-051X.2008.01275.x. View

20.

Wada Y, Mizuno M, Tamura M . Enamel matrix derivative neutralized the effect of lipopolysaccharide on osteoprotegerin and receptor activator of nuclear factor kappa B ligand expression of osteoblasts. Arch Oral Biol. 2009; 54(4):306-12. DOI: 10.1016/j.archoralbio.2009.01.004. View