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Enamel matrix derivative promotes new bone formation in xenograft assisted maxillary anterior ridge preservation—A randomized controlled clinical trial
Author(s) -
Mercado Faustino,
Vaquette Cedryck,
Hamlet Stephen,
Ivanovski Sašo
Publication year - 2021
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.13742
Subject(s) - enamel matrix derivative , buccal administration , dentistry , alveolar ridge , ridge , medicine , dental alveolus , extraction (chemistry) , nuclear medicine , implant , chemistry , surgery , paleontology , regeneration (biology) , chromatography , biology , microbiology and biotechnology
Objectives To compare the effectiveness of deproteinized bovine bone mineral with 10% collagen alone (DBBMC) or with enamel matrix derivative (DBBMC‐EMD) in ridge preservation. Methods 42 maxillary anterior teeth were extracted and received either a DBBMC (control) or DBBMC‐EMD (test) treatment protocol. CBCT taken before and 4 months after the extraction procedure was used to measure changes in alveolar ridge width (RW), buccal bone height (BH) and palatal bone height (PH). Bone cores were harvested during implant osteotomy preparation, and the samples processed histomorphometrically to assess the fraction of new bone (%NB), residual graft (%RG) and soft tissue matrix (%STM). Results Overall, both treatment groups showed significant reductions in mean RW from baseline to 4 months after extraction, but no significant change in either mean BH or PH over this time. When CBCT measurements were analysed according to the initial thickness of the buccal wall (BT < 1 mm vs. BT ≥ 1 mm), significant reductions in all ridge dimensions (RW, BH and PH) were noted in the <1 mm BT group. Histomorphometrically, the DBBMC‐EMD test group showed significantly increased new bone formation (%NB): (control = 16.5 ± 6.9% cf.; test = 45.1 ± 8.8%) with less residual graft (%RG): (control = 36.8 ± 8.8% cf.; test = 20.3 ± 7.2%) compared to the DBBMC control group. Conclusions Both DBBMC alone and DBBMC‐EMD treated sites 4 months after extraction lost RW but showed no significant change in BH or PH. Irrespective of treatment, maxillary anterior teeth with thick initial buccal walls (≥1 mm) exhibited less alveolar ridge reduction 4 months after treatment. The addition of EMD to DBBMC resulted in more new bone formation in the test group.