Enamel matrix derivative in liquid form as adjunct to natural bovine bone grafting at buccal bone dehiscence defects at implant sites: An experimental study in beagle dogs

Abstract

Objectives To evaluate the effect of enamel matrix derivative in liquid form (EMD‐liquid) as adjunct to grafting with natural bovine bone (NBB), on new bone formation and osseointegration in buccal dehiscence defects at dental implants. Material and methods In six beagles, 3 months after extraction of the mandibular premolars and first molars. Three titanium implants (3.3 Ø × 8.0 mm) were inserted, and dehiscence‐type defects (mesiodistal width 3 mm × 5 mm depth) were created on their buccal aspect. The defects were randomly assigned to one of the following three treatment groups: Group 1: NBB, Group 2: NBB/EMD‐L, Group 3: Control. All sites were covered with a collagen membrane. Histomorphometric measurements were performed after 3 months of healing. Results New bone area, bone‐to‐implant contact (BIC), and first BIC (fBIC) in the NBB and NBB/EMD‐L groups were significantly greater than in the control group (p < .05). Further, f‐BIC was at a significantly more coronal position in the NBB + EMD‐liquid group (0.4 ± 0.1 mm) compared with the NBB group (1.2 ± 0.2 mm). Conclusions Natural bovine bone grafting enhances bone regeneration and osseointegration at implants with buccal bone dehiscences compared with no grafting, and adjunct use of EMD‐liquid appears to further enhance bone formation and osseointegration.

Effect of enamel matrix derivative on alveolar ridge preservation in the posterior maxilla: A randomized controlled clinical trial

“…In an in vivo study, EMD with bone graft materials, applied to an artificial circumferential bone defect around an implant, showed no significant difference with bone graft alone or without graft 31 . However, in another study, EMD liquid combined with the natural bovine bone, applied in an implant dehiscence defect, showed significant benefits in terms of bone‐to‐implant contact 32 …”

“…In an in vitro study, Miron et al 33 found that EMD in a liquid type carrier with bone grafting materials showed higher absorption of amelogenin than the gel type counterpart if used with bone grafting materials. Several pre‐clinical studies evaluating bone formation capability of EMD in a liquid type carrier showed significantly greater new bone formation and less soft/connective tissue infiltration 32‐34 . These variations in EMD carrier may result in improvement of efficacy of EMD for the ARP procedure, but further research, including in vivo and clinical studies are required.…”

The Applications of Enamel Matrix Derivative in Implant Dentistry: A Narrative Review

“…Nine studies examine the behavior of EMD in the presence of titanium surfaces in animal models ( Table 2 ) [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Improved bone regeneration using bone anabolic drug conjugates (C3 and C6) with deproteinized bovine bone mineral as a carrier in rat mandibular defects

“…31 The presence or the ability to recruit osteoblast precursors and growth factors to the grafting site is another requirement for bone regeneration. 14 The osteoblast precursors can be provided by the recipient bed via the native bone and/or the graft materials (cancellous or autogenic grafts). 32 During the early phase of bone regeneration, bone resorption and formation throughout the graft material dominates.…”

“…7,8 It has been demonstrated that DBBM possesses osteoconductive properties, but lacks osteoinductive properties. 3 To overcome this limitation, several studies investigated combining the inorganic bovine bone with barrier membranes, 9 autogenous bone 10 as well as biological and synthetic growth factors and molecules (e.g., platelet concentrates, 11 fibrin glue, 12 strontium, 13 enamel matrix derivatives 14 and bone morphogenic proteins (BMPs). 15 BMPs are amongst the most extensively studied growth factors for promoting bone formation.…”