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Meta-Analysis
. 2009 Oct 7;2009(4):CD003875.
doi: 10.1002/14651858.CD003875.pub3.

Enamel matrix derivative (Emdogain(R)) for periodontal tissue regeneration in intrabony defects

Marco Esposito  1 , Maria Gabriella Grusovin, Nikolaos Papanikolaou, Paul Coulthard, Helen V Worthington
Affiliations
Meta-Analysis

Enamel matrix derivative (Emdogain(R)) for periodontal tissue regeneration in intrabony defects

Marco Esposito et al. Cochrane Database Syst Rev. .

Abstract

Background: Periodontitis is a chronic infective disease of the gums caused by bacteria present in dental plaque. This condition induces the breakdown of the tooth supporting apparatus until teeth are lost. Surgery may be indicated to arrest disease progression and regenerate lost tissues. Several surgical techniques have been developed to regenerate periodontal tissues including guided tissue regeneration (GTR), bone grafting (BG) and the use of enamel matrix derivative (EMD). EMD is an extract of enamel matrix and contains amelogenins of various molecular weights. Amelogenins are involved in the formation of enamel and periodontal attachment formation during tooth development.

Objectives: To test whether EMD is effective, and to compare EMD versus GTR, and various BG procedures for the treatment of intrabony defects.

Search strategy: We searched the Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE and EMBASE. Several journals were handsearched. No language restrictions were applied. Authors of randomised controlled trials (RCTs) identified, personal contacts and the manufacturer were contacted to identify unpublished trials. Most recent search: February 2009.

Selection criteria: RCTs on patients affected by periodontitis having intrabony defects of at least 3 mm treated with EMD compared with open flap debridement, GTR and various BG procedures with at least 1 year follow up. The outcome measures considered were: tooth loss, changes in probing attachment levels (PAL), pocket depths (PPD), gingival recessions (REC), bone levels from the bottom of the defects on intraoral radiographs, aesthetics and adverse events. The following time-points were to be evaluated: 1, 5 and 10 years.

Data collection and analysis: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two authors. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). It was decided not to investigate heterogeneity, but a sensitivity analysis for the risk of bias of the trials was performed.

Main results: Thirteen trials were included out of 35 potentially eligible trials. No included trial presented data after 5 years of follow up, therefore all data refer to the 1-year time point. A meta-analysis including nine trials showed that EMD treated sites displayed statistically significant PAL improvements (mean difference 1.1 mm, 95% CI 0.61 to 1.55) and PPD reduction (0.9 mm, 95% CI 0.44 to 1.31) when compared to placebo or control treated sites, though a high degree of heterogeneity was found. Significantly more sites had < 2 mm PAL gain in the control group, with RR 0.53 (95% CI 0.34 to 0.82). Approximately nine patients needed to be treated (NNT) to have one patient gaining 2 mm or more PAL over the control group, based on a prevalence in the control group of 25%. No differences in tooth loss or aesthetic appearance as judged by the patients were observed. When evaluating only trials at a low risk of bias in a sensitivity analysis (four trials), the effect size for PAL was 0.62 mm (95% CI 0.28 to 0.96), which was less than 1.1 mm for the overall result. Comparing EMD with GTR (five trials), GTR showed statistically significant more postoperative complications (three trials, RR 0.12, 95% CI 0.02 to 0.85) and more REC (0.4 mm 95% CI 0.15 to 0.66). The only trial comparing EMD with a bioactive ceramic filler found statistically significant more REC (-1.60 mm, 95% CI -2.74 to -0.46) at the EMG treated sites.

Authors' conclusions: One year after its application, EMD significantly improved PAL levels (1.1 mm) and PPD reduction (0.9 mm) when compared to a placebo or control, however, the high degree of heterogeneity observed among trials suggests that results have to be interpreted with great caution. In addition, a sensitivity analysis indicated that the overall treatment effect might be overestimated. The actual clinical advantages of using EMD are unknown. With the exception of significantly more postoperative complications in the GTR group, there was no evidence of clinically important differences between GTR and EMD. Bone substitutes may be associated with less REC than EMD.

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Conflict of interest statement

None known. Maria Gabriella Grusovin and Marco Esposito were authors of one of the included trials. However, they were not involved in the quality assessment of this trial.

Figures

1
1
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.1 PAL.
2
2
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.6 Aesthetics (continuous data).
3
3
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.7 Aesthetics (dichotomous data).
4
4
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.2 PAL < 2 mm.
5
5
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.3 PPD.
6
6
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.4 REC.
7
7
Forest plot of Comparison 1 Emdogain versus control: 1 year; Outcome 1.5 Marginal bone level.
8
8
Forest plot of Comparison 2 Emdogain versus GTR: 1 year; Outcome 2.1 PAL.
9
9
Forest plot of Comparison 2 Emdogain versus GTR: 1 year; Outcome 2.4 Postoperative complications.
10
10
Forest plot of Comparison 2 Emdogain versus GTR: 1 year; Outcome 2.2 PPD.
11
11
Forest plot of Comparison 2 Emdogain versus GTR: 1 year; Outcome 2.3 REC.
12
12
Forest plot of Comparison 2 Emdogain versus GTR: 1 year; Outcome 2.5 Marginal bone level.
13
13
Forest plot of Comparison 3 Emdogain versus bone graft; Outcome 3.1 PAL.
14
14
Forest plot of Comparison 3 Emdogain versus bone graft; Outcome 3.2 PPD.
15
15
Forest plot of Comparison 3 Emdogain versus bone graft; Outcome 3.3 REC.
1.1
1.1. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 1 PAL.
1.2
1.2. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 2 PAL < 2 mm.
1.3
1.3. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 3 PPD.
1.4
1.4. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 4 REC.
1.5
1.5. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 5 Marginal bone level.
1.6
1.6. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 6 Aesthetics (continuous data).
1.7
1.7. Analysis
Comparison 1 Emdogain versus control: 1 year, Outcome 7 Aesthetics (dichotomous data).
2.1
2.1. Analysis
Comparison 2 Emdogain versus GTR: 1 year, Outcome 1 PAL.
2.2
2.2. Analysis
Comparison 2 Emdogain versus GTR: 1 year, Outcome 2 PPD.
2.3
2.3. Analysis
Comparison 2 Emdogain versus GTR: 1 year, Outcome 3 REC.
2.4
2.4. Analysis
Comparison 2 Emdogain versus GTR: 1 year, Outcome 4 Postoperative complications.
2.5
2.5. Analysis
Comparison 2 Emdogain versus GTR: 1 year, Outcome 5 Marginal bone level.
3.1
3.1. Analysis
Comparison 3 Emdogain versus bone graft, Outcome 1 PAL.
3.2
3.2. Analysis
Comparison 3 Emdogain versus bone graft, Outcome 2 PPD.
3.3
3.3. Analysis
Comparison 3 Emdogain versus bone graft, Outcome 3 REC.
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References

References to studies included in this review

Crea 2008 {published and unpublished data}
    1. Crea A, Dassatti L, Hoffmann O, Zafiropoulos GG, Deli G. Treatment of intrabony defects using guided tissue regeneration or enamel matrix derivative: a 3‐year prospective randomized clinical study. Journal of Periodontology 2008;79(12):2281‐9. - PubMed
Francetti 2004 {published and unpublished data}
    1. Francetti L, Fabbro M, Basso M, Testori R, Weinstein R. Enamel matrix proteins in the treatment of intra‐bony defects. A prospective 24‐month clinical trial. Journal of Clinical Periodontology 2004;31(1):52‐9. - PubMed
Grusovin 2009 {published and unpublished data}
    1. Grusovin MG, Esposito M. The efficacy of enamel matrix derivates (Emdogain) for the treatment of infrabony defects. A placebo‐controlled randomised clinical trial. European Journal of Oral Implantology 2009;2:43‐54. - PubMed
Heijl 1997 {published and unpublished data}
    1. Heijl L, Heden G, Svardstrom G, Ostgren A. EMDOGAIN in the treatment of intrabony periodontal defects. Journal of Dental Research 1997;76 (Special Abstract Issue 1):292. - PubMed
    1. Heijl L, Heden G, Svardstrom G, Ostgren A. Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. Journal of Clinical Periodontology 1997;24(9 Pt 2):705‐14. - PubMed
Leknes 2009 {published data only (unpublished sought but not used)}
    1. Leknes KN, Andersen KM, Boe OE, Skavland RJ, Albandar JM. Enamel matrix derivative versus bioactive ceramic filler in the treatment of intrabony defects: 12‐month results. Journal of Periodontology 2009;80(2):219‐27. - PubMed
Okuda 2000 {published and unpublished data}
    1. Okuda K, Miyazaki A, Momose M, Murata M, Yokoyama S, Yonezawa Y. Enamel matrix derivative (EMD) in the treatment of human intrabony periodontal osseous defects. Journal of Periodontology 2000;71:1913. - PubMed
    1. Okuda K, Momose M, Miyazaki A, Murata M, Yokoyama S, Yonezawa Y, et al. Enamel matrix derivative in the treatment of human intrabony osseous defects. Journal of Periodontology 2000;71(12):1821‐8. - PubMed
Pontoriero 1999 {published and unpublished data}
    1. Pontoriero R, Wennstrom J, Lindhe J. The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study. Journal of Clinical Periodontology 1999;26(12):833‐40. - PubMed
Rösing 2005 {published and unpublished data}
    1. Rösing CK, Aass AM, Mavropoulos A, Gjermo P. Clinical and radiographic effects of enamel matrix derivative in the treatment of intrabony periodontal defects: a 12‐month longitudinal placebo‐controlled clinical trial in adult periodontitis patients. Journal of Periodontology 2005;76(1):129‐33. - PubMed
Sanz 2004 {published data only}
    1. Sanz M, Tonetti M, Zabalegui I, Blanco J, Rebelo H, Sicilia A, et al. Treatment of infrabony defects with enamel matrix proteins. A multicentre practice‐based study. Conference Proceedings of the Pan European Federation of the International Association for Dental Research. Newcastle: Pattinson and Sons, 2002:Abstract No 164.
    1. Sanz M, Tonetti MS, Zabalegui I, Sicilia A, Blanco J, Rebelo H, et al. Treatment of intrabony defects with enamel matrix proteins or barrier membranes. Results from a multicentre practice‐based clinical trial. Journal of Periodontology 2004;75:726‐33. - PubMed
Silvestri 2000 {published and unpublished data}
    1. Silvestri M, Ricci G, Rasperini G, Sartori S, Cattaneo V. Comparison of treatments of infrabony defects with enamel matrix derivative, guided tissue regeneration with a nonresorbable membrane and Widman modified flap. A pilot study. Journal of Clinical Periodontology 2000;27(8):603‐10. - PubMed
Silvestri 2003 {published and unpublished data}
    1. Silvestri M, Sartori S, Rasperini G, Ricci G, Rota C, Cattaneo V. Comparison of infrabony defects treated with enamel matrix derivative versus guided tissue regeneration with a non‐resorbable membrane. Journal of Clinical Periodontology 2003;30(5):386‐93. - PubMed
    1. Silvestri M, Sartori S, Rasperini G, Ricci G, Rota C, Cattaneo V. The treatment of infrabony defects. Clinical/statistical comparison in cases treated with enamel matrix derivative (Emdogain) versus GTR procedure and Widman modified flap. Journal of Clinical Periodontoloy 2001;27 (Supplement 1 July):60.
    1. Silvestri M, Sartori S, Rasperini G, Ricci G, Rota C, Cattaneo V. Treatment of infrabony defects with enamel matrix derivative (EMD) or non‐resorbable membrane: a randomized controlled multicenter clinical trial. Journal of Periodontology 2002;73:1402.
Tonetti 2002 {published and unpublished data}
    1. Tonetti MS, Fourmousis I, Suvan J, Cortellini P, Brägger U, Lang NP. Healing, post‐operative morbidity and patient perception of outcomes following regenerative therapy of intrabony defects. Journal of Clinical Periodontology 2004;31(12):1092‐8. - PubMed
    1. Tonetti MS, Lang NP, Cortellini P, Suvan, JE, Adriaens P, Dubravec D, et al. Enamel matrix proteins in the regenerative therapy of deep intrabony defects. Journal of Clinical Periodontology 2002;29(4):317‐25. - PubMed
Zucchelli 2002 {published and unpublished data}
    1. Zucchelli G, Bernardi F, Montebugnoli L, De M. Enamel matrix proteins and guided tissue regeneration with titanium‐reinforced expanded polytetrafluoroethylene membranes in the treatment of infrabony defects: a comparative controlled clinical trial. Journal of Periodontology 2002;73(1):3‐12. - PubMed

References to studies excluded from this review

Bokan 2006 {published data only}
    1. Bokan I, Bill JS, Schlagenhauf U. Primary flap closure combined with Emdogain alone or Emdogain and Cerasorb in the treatment of intra‐bony defects. Journal of Clinical Periodontology 2006;33:885‐93. - PubMed
Chambrone 2007 {published data only}
    1. Chambrone D, Pasin IM, Conde MC, Panutti C, Carneiro S, Lima LA. Effect of enamel matrix proteins on the treatment of intrabony defects: a split‐mouth randomized controlled trial study. Brazilian Oral Research 2007;21(3):241‐6. - PubMed
Doertbudak 2000 {published data only}
    1. Doertbudak O, Durstberger G, Bernhart T, Haas R. Treatment of periodontal defects with an enamel matrix derivative (Emdogain). Journal of Clinical Periodontology 2000;27 (Supplement 1 July):61.
Eger 1998 {published data only}
    1. Eger T, Muller H‐P. Periodontal regeneration in vertical bone defects with resorbable barriers and enamel‐matrix proteins [Parodontale regeneration in vertikalen knochendefecten mit resorbierbaren membranen und schmelz‐matrix‐proteinen]. Deutsche Zahnrztliche Zeitschrift 1998;53:590‐4.
Francetti 2005 {published data only (unpublished sought but not used)}
    1. Francetti L. A multicenter study to evaluate the clinical eligibility to periodontal treatment with enamel matrix derivative. Preliminary data. Journal of Clinical Periodontology 2000;27 (Supplement 1 July):60.
    1. Francetti L, Trombelli L, Lombardo G, Guida L, Cafiero C, Roccuzzo M, et al. Evaluation of efficacy of enamel matrix derivative in the treatment of intrabony defects: a 24‐month multicenter study. International Journal of Periodontics and Restorative Dentistry 2005;25:461‐73. - PubMed
Froum 2001 {published data only (unpublished sought but not used)}
    1. Froum SJ, Weinberg MA, Rosenberg E, Tarnow D. A comparative study utilizing open flap debridement with and without enamel matrix derivative in the treatment of periodontal intrabony defects: a 12‐month re‐entry study. Journal of Periodontology 2001;72(1):25‐34. - PubMed
Ghaffar 2001 {published data only}
    1. Ghaffar KA, Hosny MM, Garrett S. Enamel matrix proteins and bioresorbable membranes in the treatment of early onset periodontitis. Journal of Dental Education 2001;80 (January 2001 Special Issue AADR Abstracts):82.
Hagenaars 2004 {published and unpublished data}
    1. Hagenaars S, Louwerse PH, Timmerman MF, Velden U, Weijden GA. Soft‐tissue wound healing following periodontal surgery and Emdogain application. Journal of Clinical Periodontology 2004;31(10):850‐6. - PubMed
Lombardo 2000 {published data only}
    1. Lombardo G, Bernini R, Urbani G. Treatment of intrabony periodontal defects using enamel matrix derivative (EMDOGAIN). Journal of Clinical Periodontology 2000;27 (Supplement 1 July):61.
Martinez 2001 {published data only}
    1. Martinez GA, Rodriguez F, Sanz M. Efficacy of enamel matrix proteins derivate (EMDOGAIN) in intra‐osseous defects. Journal of Dental Research 2001;80:1213.
Martu 2000a {published data only}
    1. Martu S, Burlui V, Mocanu C, Forna N. Periodontal regeneration with enamel derivate proteins (Emdogain) ‐ clinical evaluation. Revista Medico‐Chirurgicala a Societatii de Medici si Naturalisti din Iasi 2000;104(4):147‐51. - PubMed
Martu 2000b {published data only}
    1. Martu S, Burlui V, Forna N, Mocanu C. Preliminary account on the use of enamel matrix derivate (Emdogain) in intra‐osseous defects. Journal of Clinical Periodontology 2000;27 (Supplement 1 July):61.
Minabe 2002 {published data only}
    1. Minabe M, Kodama T, Kogou T, Takeuchi K, Fushimi H, Sugiyama T, et al. A comparative study of combined treatment with a collagen membrane and enamel matrix proteins for the regeneration of intraosseous defects. The International Journal of Periodontics and Restorative Dentistry 2002;22(6):595‐605. - PubMed
Mombelli 2005 {published data only}
    1. Mombelli A, Brochut P, Plagnat D, Casagni F, Giannopoulou C. Enamel matrix proteins and systemic antibiotics as adjuncts to non‐surgical periodontal treatment: clinical effects. Journal of Clinical Periodontology 2005;32(3):225‐30. - PubMed
Ozcelik 2007 {published data only (unpublished sought but not used)}
    1. Ozcelik O, Haytac MC, Seydaoglu G. Immediate post‐operative effects of different periodontal treatment modalities on oral health‐related quality of life: a randomized clinical trial. Journal of Clinical Periodontology 2007;34:788‐96. - PubMed
Parashis 2004 {published data only}
    1. Parashis A, Andronikaki‐Faldami A, Tsiklakis K. Clinical and radiographic comparison of three regenerative procedures in the treatment of intrabony defects. International Journal of Periodontics and Restorative Dentistry 2004;24(1):81‐90. - PubMed
    1. Parashis A, Andronikaki‐Faldami A, Tsiklakis K. Comparison of three regenerative procedures in the treatment of intrabony defects: a clinical & radiographic study. Journal of Clinical Periodontology 2000;27 (Supplement 1 July):29.
Sculean 1999 {published data only}
    1. Sculean A, Donos N, Windisch P, Brecx M, Gera I, Reich E, et al. Healing of human intrabony defects following treatment with enamel matrix proteins or guided tissue regeneration. Journal of Periodontal Research 1999;34(6):310‐22. - PubMed
Sculean 2001a {published and unpublished data}
    1. Sculean A, Donos N, Blaes A, Lauermann M, Reich E, Brecx M. Comparison of enamel matrix proteins and bioabsorbable membranes in the treatment of intrabony periodontal defects. A split‐mouth study. Journal of Periodontology 1999;70(3):255‐62. - PubMed
    1. Sculean A, Donos N, Blaes A, Reich E, Brecx M. Enamel matrix proteins (Emdogain) and guided tissue regeneration in the treatment of intrabony periodontal defects. A split‐mouth clinical study. Journal of Dental Research 1998;77 (June Special Abstract Issue B):924.
    1. Sculean A, Donos N, Blaes A, Reich E, Brecx M. Enamel matrix proteins and GTR in the treatment of intrabony defects. Three year results of a split‐mouth study. Journal of Clinical Periodontology 2000;27 (Supplement 1 July):62.
    1. Sculean A, Donos N, Miliauskaite A, Arweiler N, Brecx M. Treatment of intrabony defects with enamel matrix proteins or bioabsorbable membranes. A 4‐year follow‐up split‐mouth study. Journal of Periodontology 2001;72(12):1695‐701. - PubMed
    1. Sculean A, Schwarz, F, Miliauskaite A, Kiss A, Arweiler N, Becker J, et al. Treatment of intrabony defects with an enamel matrix protein derivative or bioabsorbable membrane: an 8‐year follow‐up split‐mouth study. Journal of Periodontology 2006;77:1879‐86. - PubMed
Sculean 2001b {published and unpublished data}
    1. Sculean A, Donos N, Schwarz F, Becker J, Brecx M, Arweiler NB. Five‐year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. Journal of Clinical Periodontology 2004;31(7):545‐9. - PubMed
    1. Sculean A, Kiss A, Miliauskaite A, Schwarz F, Arweiler NB, Hannig M. Ten‐year results following treatment of intra‐bony defects with enamel matrix proteins and guided tissue regeneration. Journal of Clinical Periodontology 2008;35:817‐24. - PubMed
    1. Sculean A, Windisch P, Blaes A, Gera I, Brecx M, Donos N. Treatment of intrabony defects with enamel matrix proteins and GTR. Journal of dental Research 2000;79 (Special Abstract Issue 1):171.
    1. Sculean A, Windisch P, Chiantella GC, Donos N, Brecx M, Reich E. Treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. A prospective controlled clinical study. Journal of Clinical Periodontology 2001;28(5):397‐403. - PubMed
Vandana 2004 {published data only}
    1. Vandana KL, Shah K, Prakash S. Clinical and radiographic evaluation of Emdogain as a regenerative material in the treatment of interproximal vertical defects in chronic and aggressive periodontitis patients. The International Journal of Periodontics and Restorative Dentistry 2004;24(2):185‐91. - PubMed
Wachtel 2003 {published data only}
    1. Wachtel H, Schenk G, Böhm S, Weng D, Zuhr O, Hürzeler MB. Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects: a controlled clinical study. Journal of Clinical Periodontology 2003;30(6):496‐504. - PubMed
Windisch 2002 {published data only}
    1. Windisch P, Sculean A, Klein F, Toth V, Gera I, Reich E, et al. Comparison of clinical, radiographic, and histometric measurements following treatment with guided tissue regeneration or enamel matrix proteins in human periodontal defects. Journal of Periodontology 2002;73(4):409‐17. - PubMed

Additional references

Arweiler 2002
    1. Arweiler NB, Auschill TM, Donos N, Sculean A. Antibacterial effect of an enamel matrix protein derivative on in vivo dental biofilm vitality. Clinical Oral Investigations 2002;6(4):205‐9. - PubMed
Bosshardt 2005
    1. Bosshardt DD, Sculean A, Windisch P, Pjetursson BE, Lang NP. Effects of enamel matrix proteins on tissue formation along the roots of human teeth. Journal of Periodontal Research 2005;40(2):158‐67. - PubMed
Bowers 1989a
    1. Bowers GM, Chadroff B, Carnevale R, Mellonig J, Corio R, Emerson J, et al. Histologic evaluation of new attachment apparatus formation in humans. Part I. Journal of Periodontology 1989;60(12):664‐74. - PubMed
Bowers 1989b
    1. Bowers GM, Chadroff B, Carnevale R, Mellonig J, Corio R, Emerson J, et al. Histologic evaluation of new attachment apparatus formation in humans. Part II. Journal of Periodontology 1989;60(12):675‐82. - PubMed
Bratthall 2001
    1. Bratthall G, Lindberg P, Havemose‐Poulsen A, Holmstrup P, Bay L, Soderholm G, et al. Comparison of ready‐to‐use Emdogain‐gel and Emdogain in patients with chronic adult periodontitis. A multicenter clinical trial. Journal of Clinical Periodontology 2001;28(10):923‐9. - PubMed
Brookes 1995
    1. Brookes SJ, Robinson C, Kirkham J, Bonass WA. Biochemistry and molecular biology of amelogenin proteins of developing dental enamel. Archives of Oral Biology 1995;40(1):1‐14. - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140‐9. - PubMed
Filippi 2001
    1. Filippi A, Pohl Y, Arx T. Treatment of replacement resorption with Emdogain. Preliminary results after 10 months. Dental Traumatology 2001;17(3):134‐8. - PubMed
Filippi 2002
    1. Filippi A, Pohl Y, Arx T. Treatment of resorption with Emdogain. A prospective clinical study. Dental Traumatology 2002;18(3):138‐43. - PubMed
Follmann 1992
    1. Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. Journal of Clinical Epidemiology 1992;45:769‐73. - PubMed
Froum 2004
    1. Froum S, Weinberg M, Novak J, Mailhot J, Mellonig J, Dyke T, et al. A multicenter study evaluating the sensitization potential of enamel matrix derivative after treatment of two infrabony defects. Journal of Periodontology 2004;75(7):1001‐8. - PubMed
Giannobile 2003
    1. Giannobile WV, Somerman MJ. Growth and amelogenin‐like factors in periodontal wound healing. A systematic review. Annals of Periodontology 2003;8(1):193‐204. - PubMed
Hammarström 1997a
    1. Hammarström L. Enamel matrix, cementum development and regeneration. Journal of Clinical Periodontology 1997;24(9 Pt 2):658‐68. - PubMed
Hammarström 1997b
    1. Hammarström L, Heijl L, Gestrelius S. Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins. Journal of Clinical Periodontology 1997;24(9 Pt 2):669‐77. - PubMed
Heard 2000
    1. Heard RH, Mellonig JT, Brunsvold MA, Lasho DJ, Meffert RM, Cochran DL. Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative in the treatment of intrabony periodontal defects. Journal of Periodontology 2000;71(11):1715‐21. - PubMed
Higgins 2008
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from: www.cochrane‐handbook.org.
Kalpidis 2002
    1. Kalpidis CD, Ruben MP. Treatment of intrabony periodontal defects with enamel matrix derivative: a literature review. Journal of Periodontology 2002;73(1):1360‐76. - PubMed
Mariotti 2003
    1. Mariotti A. Efficacy of chemical root surface modifiers in the treatment of periodontal disease. Annals of Periodontology 2003;8(1):205‐26. - PubMed
Needleman 2006
    1. Needleman IG, Worthington HV, Giedrys‐Leeper E, Tucker R. Guided tissue regeneration for periodontal infra‐bony defects. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD001724] - DOI - PubMed
Reynolds 2003
    1. Reynolds MA, Aichelmann‐Reidy ME, Branch‐Mays GL, Gunsolley JC. The efficacy of bone replacement grafts in the treatment of periodontal osseous defects. A systematic review. Annals of Periodontology 2003;8(1):227‐65. - PubMed
Schjøtt 2005
    1. Schjøtt M, Andreasen JO. Emdogain does not prevent progressive root resorption after replantation of avulsed teeth: a clinical study. Dental Traumatology 2005;21(1):46‐50. - PubMed
Sculean 2001c
    1. Sculean A, Auschill TM, Donos N, Brecx M, Arweiler NB. Effect of an enamel matrix protein derivative (Emdogain) on ex vivo dental plaque vitality. Journal of Clinical Periodontology 2001;28(11):1074‐8. - PubMed
Sculean 2001d
    1. Sculean A, Blaes A, Arweiler N, Reich E, Donos N, Brecx M. The effect of postsurgical antibiotics on the healing of intrabony defects following treatment with enamel matrix proteins. Journal of Periodontology 2001;72(2):190‐5. - PubMed
Sculean 2006
    1. Sculean A, Berakdar M, Willershausen B, Arweiler NB, Becker J, Schwarz F. Effect of EDTA root conditioning on the healing of intrabony defects treated with an enamel matrix protein derivative. Journal of Periodontology 2006;77:1167‐72. - PubMed
Spahr 2002
    1. Spahr A, Lyngstadaas SP, Boeckh C, Andersson C, Podbielski A, Haller B. Effect of the enamel matrix derivative Emdogain on the growth of periodontal pathogens in vitro. Journal of Clinical Periodontology 2002;29(1):62‐72. - PubMed
St George 2006
    1. George G, Darbar U, Thomas G. Inflammatory external root resorption following surgical treatment for intra‐bony defects: a report of two cases involving Emdogain and a review of the literature. Journal of Clinical Periodontology 2006;33:449‐54. - PubMed
Trombelli 2002
    1. Trombelli L, Heitz‐Mayfield LJ, Needleman I, Moles D, Scabbia A. A systematic review of graft materials and biological agents for periodontal intraosseous defects. Journal of Clinical Periodontology 2002;29 Suppl 3:117‐35. - PubMed
Venezia 2004
    1. Venezia E, Goldstein M, Boyan BD, Schwartz Z. The use of enamel matrix derivative in the treatment of periodontal defects: a literature review and meta‐analysis. Critical Reviews in Oral Biology and Medicine 2004;15(6):382‐402. - PubMed
Wennström 2002
    1. Wennström JL, Lindhe J. Some effects of enamel matrix proteins on wound healing in the dento‐gingival region. Journal of Clinical Periodontology 2002;29(1):9‐14. - PubMed
Zetterström 1997
    1. Zetterström O, Andersson C, Eriksson L, Fredriksson A, Friskopp J, Heden G, et al. Clinical safety of enamel matrix derivative (EMDOGAIN) in the treatment of periodontal defects. Journal of Clinical Periodontology 1997;24(9 Pt 2):697‐704. - PubMed

References to other published versions of this review

Esposito 2003
    1. Esposito M, Coulthard P, Worthington HV. Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD003875] - DOI - PubMed
Esposito 2004
    1. Esposito M, Coulthard P, Thomsen P, Worthington HV. Enamel matrix derivative for periodontal tissue regeneration in treatment of intrabony defects: a Cochrane systematic review. Journal of Dental Education 2004;68(8):834‐44. - PubMed
Esposito 2005
    1. Esposito M, Grusovin MG, Coulthard P, Worthington HV. Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects. Cochrane Database of Systematic Reviews 2005, Issue 4. [DOI: 10.1002/14651858.CD003875.pub2] - DOI - PubMed

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