Enamel matrix derivative and bone healing after guided bone regeneration in dehiscence-type defects around implants. A histomorphometric study in dogs.
BACKGROUND
The goal of this investigation was to histometrically evaluate the effect of enamel matrix derivative (EMD) on bone healing after guided bone regeneration (GBR) in dehiscence-type osseous defects around dental implants; i.e., in the absence of periodontal ligament cells.


METHODS
Six mongrel dogs were used. The second, third, and fourth mandibular premolars (p2, p3, and p4) and first molars (ml) were extracted. After 3 months, 2 implant osteotomies were prepared in each side of the mandible, dehiscence-type defects were created on the buccal aspect of each implant osteotomy (3.5 mm x 5.0 mm), and titanium implants were placed (3.75 mm x 8.5 mm). The surgically-created defects were randomly assigned to one of the treatments: EMD, GBR, EMD+GBR, or control. After 2 months, 4 additional defects were created and treated. The animals were sacrificed 3 months after the placement of the first implants, thus allowing the healing periods of 1 and 3 months. Undecalcified sections were obtained for the histometric evaluation including the percentage of bone-to-implant contact and new bone area on the implant threads related to the defect.


RESULTS
No statistically significant differences were observed among the groups in the evaluated parameters after 1 month of healing. After 3 months, no statistically significant differences were observed among the groups for the percentage of bone-to-implant contact. The values for the new bone area were: 55.5+/-11.8, 53.8+/-16.3, 62.1+/-18.4, and 36.9+/-25.1 for EMD, GBR, EMD+GBR, and control, respectively. The difference between EMD+GBR and control was statistically significant (P <0.05).


CONCLUSIONS
Within the limits of this study, it can be concluded that EMD may positively influence bone healing after GBR around titanium implants. EMD alone, however, had no statistically significant effect.
Casati
Marcio Z
MZ
Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, UNICAMP, São Paulo, Brazil.
Sallum
Enilson A
EA
Nociti
Francisco H
FH
Caffesse
Raul G
RG
Sallum
Antonio Wilson
AW
D016301:Alveolar Bone Loss / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D000818:Animals; D001861:Bone Regeneration / Q000187:drug effects*; D003746:Dental Enamel Proteins / Q000494:pharmacology* / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects; D004285:Dogs; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal; D016348:Osseointegration / Q000187:drug effects; D011897:Random Allocation
D003746:Dental Enamel Proteins; D015921:Dental Implants; C109069:enamel matrix proteins