Table 3.
Studies evaluating the use of EMD at implant sites in humans.
| Authors | Year | Study Type | Population | Methods | Results |
|---|---|---|---|---|---|
| Cangini and Cornelini [29] | 2005 | Clinical report | 32 implants in 32 patients, mean age 45 years (age range 21–60 years), 10 smokers | Implant placement immediately after tooth extraction, filling of the remaining bone defect with EMD or bioresorbable collagen membrane; final prosthetic restoration at 6 months; clinical evaluation at 12 months | Membrane led to lower PD and better position of the soft tissue margin around the implant shoulder |
| Froum et al. [30] | 2012 | Case series | 51 implants in 38 patiens, age range 29–81 years | Treatment of peri-implantitis through surface decontamination, + EMD, + PDGF + anorganic bovine bone or mineralized freeze-dried bone, + coverage with a collagen membrane or a subepithelial connective tissue graft; follow-up at 3 to 7.5 years | Mean PD reduction of 5.4 and 5.1 mm in mesial/distal defects and buccal/lingual defects, respectively; mean bone level gain of 3.75 and 3.0 mm |
| Froum et al. [31] | 2015 | Case series | 170 implants in 100 patients | As reported by Froum et al. 2012; follow-up at 2–10 years. Surgical procedures were repeated twice in 18 implants and three times in 10 implants | Survival rate 98.8%, mean PD reduction 5.10 mm, mean bone level gain 1.77 mm, mean soft tissue marginal gain 0.52 mm |
| Guimaraes et al. [32] | 2015 | Clinical study | Five patients, without periodontal disease, diabetes, not smoking | Split mouth design: Placement of at least one implant in each side of the maxilla, one side with EMD adjunct; second-stage surgery at 14 days with biopsies; histologic and immunohistochemical analysis | Increased number of blood vessels in EMD-treated sites |
| Faramarzi et al. [33] | 2016 | Double-blind RCT | 64 patients, not smoking | Non-surgical treatment of peri-implant mucositis alone, +EMD or +MSM; clinical evaluation and microbial analysis of peri-implant crevicular fluid at 2 weeks and 3 months | Significant decrease in P. gingivalis levels, PD and BOP for both EMD and MSM groups |
| Isehed et al. [34] | 2016 | Double-blind RCT | 26 patients | Surgical treatment of peri-implantitis alone or +EMD; clinical, radiographic, and microbiologic evaluation of PICF at 3, 6, and 12 months | EMD led to significantly higher marginal bone levels at 12 months and was associated to a Gram+/aerobic microbial flora |
| Kashefimehr et al. [35] | 2017 | Double-blind RCT | 46 patients, not smoking | Non-surgical treatment of peri-implant mucositis alone or +EMD, clinical and microbiologic evaluation of PICF at 3 months | Significant improvements in BOP and PD, decrease in IL-6 and IL-7 levels in PICF |
| Isehed et al. [36] | 2018 | RCT | 25 patients, 18 screened at 3 years, 14 at 5 years | Surgical treatment of peri-implantitis alone or +EMD; clinical and radiographic evaluation at 3 and 5 years | EMD was positively associated with implant survival at 5-year follow-up |
| Esberg et al. [37] | 2019 | RCT | 25 patients, 25 implants | Surgical treatment of peri-implantitis alone or +EMD; evaluation of PICF proteomic profile at 3, 6, and 12 months; analysis of its correlation with EMD adjunct, PD, implant survival up to 5 years | Two main clusters were identified, with different proteomic profiles. One was related to implant loss and higher protein concentration and diversity; the other one was related to implant survival at 5 years and EMD treatment |
| Cardaropoli et al. [38] | 2019 | Clinical study | 20 patients | Placement of immediate post-extraction anterior maxillary single-tooth implant + xenograft, application of EMD and placement of immediately loaded screwed restoration; evaluation of soft tissue contour at 12 months | No difference in soft tissue contour between pretreatment and 12-month follow-up |
| Cardaropoli et al. [39] | 2019 | Clinical study | 20 patients | As reported by Cardaropoli et al. 2019; definitive ceramic crown at 3 months; radiographic and CBCT evaluation at 12 months | No difference in marginal bone levels and horizontal width of bone crest between pretreatment and 12-month follow-up |
BOP: Bleeding on probing; EMD: Enamel matrix derivative; F: Female; M: Male; MSM: Micro-spherical minocycline; PD: Probing depth; PICF: Peri-implant crevicular fluid; RCT: Randomized clinical trial.