Clinical Outcomes of Enamel Matrix Derivate Used in Surgical and Non-Surgical Treatment of Peri-Implantitis: A Systematic Review of Clinical Studies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
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- Participants: patient diagnosed with peri-implantitis or peri-implant mucositis;
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- Interventions: surgical treatment of peri-implantitis or peri-implant mucositis using enamel matrix derivate;
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- Comparison: non-surgical treatment of peri-implantitis or peri-implant mucositis using enamel matrix derivate;
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- Outcome: changes in periodontal parameters recorded: probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and radiographic bone level (RBL);
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- Study design: clinical trials; prospective, retrospective studies; cohort studies, case-control studies; and case series.
2.2. Search Process
2.3. Data Extraction
2.4. Risk of Bias Assessment
2.5. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.2.1. Description of the Included Studies
3.2.2. Characteristics of Studies Included
Non-Surgical Treatment
Surgical Treatment
Author. Year. Country | Study Type | Participant’s Characteristics | Type of Intervention | Periodontal Parameters | Follow-up | Outcomes |
---|---|---|---|---|---|---|
Non-surgical treatment | ||||||
Faramarzi. 2015. Iran [19] | Double-blind, three arm parallel RCT | MSM: n = 23 EMD: n = 20 Control: n = 21 Diagnosis: peri-implant mucositis (n = NA) | Mechanical debridement + MSM Mechanical debridement + EMD Mechanical debridement alone | PD BOP | 2 weeks 3 months | PD reduction BOP reduction |
Kashefimehr. 2017. Iran [20] | Double-blind RCT | Test: n = 20 Control: n = 21 Diagnosis: peri-implant mucositis (n = NA) | Test: mechanical debridement + EMD Control: mechanical debridement alone | PD BOP | 3 months | PD reduction BOP reduction |
Surgical treatment | ||||||
Froum. 2012. USA [24] | Prospective cohort | n = 38 Diagnosis: peri-implantitis (n = 51) | OFD with surface decontamination + EMD + PDGF + an organic bovine/mineralized freeze-dried bone + SCTG/collagen matrix | PD BOP RBL | 3 to 7.5 years | PD reduction BOP reduction Bone-level gain |
Froum. 2015. USA [23] | Prospective cohort | n = 100 Diagnosis: peri-implantitis (n = 170) | OFD with surface decontamination + EMD + PDGF + an organic bovine/mineralized freeze-dried bone + SCTG/collagen matrix | PD BOP RBL | 2 to 10 years | PD reduction BOP reduction Bone level gain |
Isehed. 2016. Sweden [22] | Double-blind RCT | Test: n = 15 Control: n = 14 Diagnosis: peri-implantitis (n = 29) | Test: OFD + EMD Control: OFD alone | PD BOP RBL | 3, 6, 12 months | PD reduction BOP reduction Bone level gain |
Isehed. 2018. Sweden [21] | RCT | Test: n = 13 Control: n = 12 Diagnosis: peri-implantitis (n = 25) | Test: OFD + EMD Control: OFD alone | BOP RBL | 1 year 3 years 5 years | BOP reduction Bone level gain |
Mercado. 2018. Australia [25] | Prospective cohort | n = 30 Diagnosis: peri-implantitis (n = 30) | OFD + EMD + deproteinized bovine bone mineral with 10% collagen + doxycycline +/− CTG | PD BOP RBL | 1, 2, 3 years | PD reduction BOP reduction Bone level reduction |
Pilenza. 2022. Switzerland [26] | Retrospective case series | n = 11 Diagnosis: peri-implantitis (n = 20) | OFD + EMD + hydroxyapatite + collagen membrane | PPD BOP RBL | 1 year | PPD reduction |
3.3. Risk of Bias Assessment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Adequate Sequence Generation | Allocation Concealment | Blinding of Participants and Personnel | Blinding of Outcome Assessment | Incomplete Outcome Data Addressed | Selective Outcome Reporting | Other Bias | Estimated Potential ROB |
---|---|---|---|---|---|---|---|---|
Faramarzi [19] | Low | Unclear | Low | Low | Unclear | Low | Low | Unclear |
Kashefimehr [20] | Unclear | High | High | Unclear | Unclear | Low | Low | High |
Isehed [21] | High | Low | Low | Low | Low | Low | Low | High |
Isehed [22] | High | Low | Low | Low | Low | Low | Low | High |
Author | Confounding | Selection of Participants | Classification of Interventions | Deviations from Intended Interventions | Missing Data | Measurements of Outcome | Selection of the Reported Result | Estimated Potential ROB |
---|---|---|---|---|---|---|---|---|
Froum [21] | Moderate | Critical | Moderate | Low | Low | Low | Moderate | Critical |
Froum [22] | Moderate | Moderate | Moderate | Low | Low | Low | Moderate | Moderate |
Mercado [25] | Low | Low | Low | Low | Low | Low | Low | Low |
Pilenza [26] | Low | Low | Low | Low | Low | Low | Low | Low |
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Moldovan, R.; Mester, A.; Piciu, A.; Bran, S.; Onisor, F. Clinical Outcomes of Enamel Matrix Derivate Used in Surgical and Non-Surgical Treatment of Peri-Implantitis: A Systematic Review of Clinical Studies. Medicina 2022, 58, 1819. https://doi.org/10.3390/medicina58121819
Moldovan R, Mester A, Piciu A, Bran S, Onisor F. Clinical Outcomes of Enamel Matrix Derivate Used in Surgical and Non-Surgical Treatment of Peri-Implantitis: A Systematic Review of Clinical Studies. Medicina. 2022; 58(12):1819. https://doi.org/10.3390/medicina58121819
Chicago/Turabian StyleMoldovan, Raluca, Alexandru Mester, Andra Piciu, Simion Bran, and Florin Onisor. 2022. "Clinical Outcomes of Enamel Matrix Derivate Used in Surgical and Non-Surgical Treatment of Peri-Implantitis: A Systematic Review of Clinical Studies" Medicina 58, no. 12: 1819. https://doi.org/10.3390/medicina58121819