title: Effects of enamel matrix derivative on non-surgical management of peri-implant mucositis: a double-blind randomized clinical trial.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Atabak
authors.initials: A
authors.lastname: Kashefimehr
authors.affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.|Faculty of Dentistry, University of Toronto, Toronto, Canada.|Department of Dentistry, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Reza
authors.initials: R
authors.lastname: Pourabbas
authors.affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Masumeh
authors.initials: M
authors.lastname: Faramarzi
authors.affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Dr.alizarandi@gmail.com.|Department of Periodontics, Tabriz, Islamic Republic of Iran. Dr.alizarandi@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Zarandi
authors.affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Abouzar
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Faculty of Dentistry, University of Toronto, Toronto, Canada.|Department of Dentistry, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Howard C
authors.initials: HC
authors.lastname: Tenenbaum
authors.affiliation: Faculty of Dentistry, University of Toronto, Toronto, Canada.|Department of Dentistry, Mount Sinai Hospital, Toronto, Canada.|Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Amir
authors.initials: A
authors.lastname: Azarpazhooh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000378:metabolism; D003646:Debridement; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000188:drug therapy*; D057873:Peri-Implantitis / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins
keywords: Cytokines; Debridement; Dental implants; ELISA; IL-17; IL-6; Peri-implantitis