Najeeb Shariq, Khurshid Zohaib, Sohail Zafar Muhammad, Zohaib Sana, Siddiqui Fahad
Restorative Dental Sciences, Al-Farabi Colleges, Saudi Arabia.
School of Metallurgy and Materials, University of Birmingham, Edgbaston, Birmingham, UK.
Iran Endod J. 2017 Summer;12(3):269-275. doi: 10.22037/iej.v12i3.12036.
Vital pulp therapy (VPT) aims to preserve the health and maintain life of the tooth pulp which has been compromised by caries, trauma or restorative procedures. Recently, enamel matrix derivative (EMD) has been introduced as a material for vital pulp therapy. The aim of this review is to critically analyze and summarize the available literature on EMD for VPT.
Online databases (PubMED/MEDLINE, Google Scholar, ISI Web of Science, and Wiley-Online) were searched by using the following keywords in various combinations: and for studies indexed from January 1949 to April 2016. We used an English-limited search in for the missing grey literature. All studies fulfilling the selection criteria were carefully reviewed for the focused question: "Does using EMD in VPT, compared with other materials, result in better clinical, radiographic and histological outcomes?".
The primary search resulted in 18 articles of which, 14 articles (including 6 animal studies and 6 clinical trials and 2 case reports) met the inclusion criteria for this review and hence were included. The number of teeth tested in the animal studies ranged from 8 to 144 including pigs, rats and dogs teeth. A number of studies used EMD in the experimental group in comparison with calcium hydroxide, propylene glycol alginate (PGA) and MTA as a control. The observation period ranged from 1 to 2 months and 4 out of 6 animal trials reported more favorable outcomes with EMD while two studies reported comparable outcomes.
Although EMD has potential for various applications in endodontics, studies conducted to date have failed to demonstrate any significant advantage of EMD over conventional VPT materials. Additionally, the 5-year and 10-year survival rate of EMD-treated teeth is not yet known. Hence, studies with a longer follow-up periods are required to deduce the long-term viability of teeth treated with EMD.
活髓治疗（VPT）旨在保存因龋齿、外伤或修复操作而受损的牙髓的健康并维持其活力。最近，釉基质衍生物（EMD）已被引入作为活髓治疗的一种材料。本综述的目的是批判性地分析和总结关于EMD用于VPT的现有文献。
通过在在线数据库（PubMed/MEDLINE、谷歌学术、ISI Web of Science和Wiley Online）中以各种组合使用以下关键词，检索1949年1月至2016年4月索引的研究。我们在谷歌学术中使用英文限制搜索以查找缺失的灰色文献。对所有符合选择标准的研究进行仔细审查，以回答重点问题：“与其他材料相比，在VPT中使用EMD是否能产生更好的临床、影像学和组织学结果？”
初步检索得到18篇文章，其中14篇文章（包括6项动物研究、6项临床试验和2篇病例报告）符合本综述的纳入标准，因此被纳入。动物研究中测试的牙齿数量从8颗到144颗不等，包括猪、大鼠和狗的牙齿。一些研究在实验组中使用EMD，并与氢氧化钙、海藻酸丙二醇酯（PGA）和MTA作为对照。观察期从1个月到2个月不等，6项动物试验中有4项报告使用EMD有更有利的结果，而两项研究报告结果相当。
尽管EMD在牙髓病学中有各种潜在应用，但迄今为止进行的研究未能证明EMD比传统VPT材料有任何显著优势。此外，EMD治疗牙齿的5年和10年生存率尚不清楚。因此，需要进行随访期更长的研究，以推断用EMD治疗牙齿的长期生存能力。
