The Outcomes of Enamel Matrix Derivative on Periodontal Regeneration under Diabetic Conditions

Abstract

Background and Objectives: Enamel matrix derivative (EMD) is a biomaterial used for periodontal regenerative therapy due to its properties of stimulating cementum development and bone synthesis. Diabetes is a chronic condition that affects healing and predisposes to infection. The aim of this review was to evaluate the current studies available on the application and results of EMD for periodontal regenerative therapy under diabetic conditions. Materials and Methods: Five databases (PubMed, ResearchGate, Scopus, Web of Science and Google Scholar) were searched for relevant articles, using specific keywords in different combinations. The inclusion criteria were clinical trials, case reports, case studies, and animal studies published in English, where periodontal treatment for bone defects includes EMD, and it is performed under diabetic conditions. Results: Of the 310 articles resulted in search, five studies published between 2012 and 2020 met the inclusion criteria and were selected for the current review. In human studies, the use of EMD in infrabony defects showed favorable results at follow-up. In animal studies, periodontal regeneration was reduced in diabetic rats. Conclusions: EMD might promote bone healing when used under diabetic conditions for the regenerative periodontal therapy. Due to limited number of studies, more data are required to sustain the effects of EMD therapy in diabetic settings.

A Systematic Analysis of the Available Human Clinical Studies of Dental Implant Failure in Patients with Inflammatory Bowel Disease

“…Furthermore, the lack of nutrition in people suffering from IBD and the occurrence of autoimmune inflammatory processes at the site of bone and implant junction, along with other processes in various parts of the organism, may lead to insufficient osseous formation around the implant [ 6 , 7 ]. The risk of failure and the poor implant prognosis of patients with IBD is commonly acknowledged by medical specialists, knowing that other systemic disorders also have the capacity to induce the same undesirable consequences [ 7 , 8 , 9 ]. Another aspect that should be taken into account is the peri-implant bone loss.…”

Canonical Wnt/β‐catenin signaling has positive effects on osteogenesis, but can have negative effects on cementogenesis

“…8,9 By applying regenerative therapeutic approaches, cementum can be restored by stimulation of cementogenesis, 10,11 even though, current therapeutic strategies are limited and outcomes unpredictable. 4,12,13 During formation of cellular cementum, a portion of cementoblasts is embedded in the cementoid matrix and become cementocytes. A significant barrier to improved therapies for cementum regeneration is that the cementocyte remains poorly understood.…”

“…Therefore, the integrity of cellular cementum protects the tooth root from resorption and is fundamental in maintaining occlusal relationships and its function in tooth support 8,9 . By applying regenerative therapeutic approaches, cementum can be restored by stimulation of cementogenesis, 10,11 even though, current therapeutic strategies are limited and outcomes unpredictable 4,12,13 …”