São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, Brazil.
Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
J Periodontal Res. 2021 Dec;56(6):1213-1222. doi: 10.1111/jre.12934. Epub 2021 Sep 19.
This study was conducted to evaluate the clinical, immunologic, and patient-centered outcomes of enamel matrix protein derivative (EMD) on excisional wounds in palatal mucosa.
Forty-four patients in need of ridge preservation were randomly allocated into two groups: control group (n = 22): open palatal wound after free gingival graft (FGG) harvest and EMD group (n = 22): open palatal wound after FGG harvest that received 0.3 ml of EMD. Clinical and patient-centered parameters were analyzed for 3 months post-treatment. Wound fluid levels of inflammatory markers were assessed 3 and 7 days postoperatively.
No significant inter-group difference was observed in remaining wound area and re-epithelialization. EMD and control groups achieved wound closure and re-epithelialization 30 days postoperatively (p < .001), without inter-group differences. Similarly, number of analgesics and Oral Health Impact Profile scores did not present significant inter-group differences (p > .05). EMD appeared to selectively modulate wound fluid levels of monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, matrix metallopeptidase 9, and tissue inhibitor of metalloproteinases-2.
Within the limits of the present study, it can be concluded that EMD application to excisional palatal wounds using the investigated protocol does not provide clinical healing benefits, despite an apparent modulation of selected inflammatory markers.
本研究旨在评估釉基质蛋白衍生物(EMD)对腭黏膜切开伤口的临床、免疫和患者为中心的疗效。
44 名需要进行牙槽嵴保存的患者被随机分为两组:对照组(n=22):游离龈瓣移植(FGG)后切开的腭部伤口;EMD 组(n=22):FGG 后切开的腭部伤口,给予 0.3ml 的 EMD。治疗后 3 个月分析临床和患者为中心的参数。术后 3 天和 7 天评估伤口液中炎症标志物的水平。
两组间剩余伤口面积和上皮再形成无显著差异。EMD 组和对照组均在术后 30 天达到伤口闭合和上皮再形成(p<.001),两组间无差异。同样,镇痛药的使用次数和口腔健康影响程度评分(OHIP)也无显著差异(p>.05)。EMD 似乎选择性地调节了伤口液中单核细胞趋化蛋白-1、巨噬细胞炎症蛋白-1α、基质金属蛋白酶 9 和金属蛋白酶组织抑制剂 2 的水平。
在本研究的范围内,可以得出结论,尽管对选定的炎症标志物有明显的调节作用,但使用所研究的方案将 EMD 应用于切开的腭部伤口并不会提供临床愈合益处。