title: The use of enamel matrix derivative alone versus in combination with bone grafts to treat patients with periodontal intrabony defects: a meta-analysis.
abstract: BACKGROUND
  The authors performed a meta-analysis to compare the clinical outcomes of enamel matrix derivative (EMD) used in combination with various bone grafts with EMD alone in patients with intrabony defects.
  
  
  METHODS
  The authors retrieved relevant studies through Sept. 30, 2011, from MEDLINE, PubMed, Embase and Cochrane Central Register of Controlled Trials. The main clinical outcomes were probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, gingival recession (REC) increase and defect fill gain. The authors performed two separate meta-analyses, according to the length of follow-up. They also conducted subgroup analyses regarding the study designs and surgical procedures used.
  
  
  RESULTS
  The authors included 11 studies in their meta-analysis. At six to eight months' follow-up, pooled estimates showed that there was no significant difference regarding PPD reduction (P = .62) and CAL gain (P = .23) among the treatment groups, but there was a significant difference regarding defect fill gain and REC increase. At 12 months' follow-up, pooled estimates revealed no significant differences regarding PPD reduction (P = .29), CAL gain (P = .15) and REC increase (P = .30) between the groups, but the authors still detected a significant difference for defect fill gain.
  
  
  CONCLUSIONS
  In trials with a short-term follow-up, the combination therapies yielded better clinical outcomes regarding defect fill gain and REC increase compared with EMD alone, whereas most clinical outcomes were not significantly different between the two groups in the long run. The additional benefits from using combination therapies to promote periodontal tissue regeneration need to be confirmed.
authors.affiliation: State Key Laboratory of Oral Diseases and Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Wenyang
authors.initials: W
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D003746:Dental Enamel Proteins; C109069:enamel matrix proteins