Fakheran Omid, Fischer Kai R, Schmidlin Patrick R
Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, 81658 Isfahan, Iran.
Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine and Oral Health, Medical University of Graz, Graz 8010, Austria.
Dent J (Basel). 2023 Apr 10;11(4):100. doi: 10.3390/dj11040100.
To systematically assess the current evidence regarding the adjunctive application of enamel matrix derivatives (EMDs) during alveolar ridge preservation (ARP) following tooth extraction.
A comprehensive literature search was conducted in MEDLINE, Cochrane Library, PsycINFO, Web of Science, Google Scholar, and Scopus to identify relevant randomized controlled clinical trials (RCTs). The primary outcome parameters of this systematic review were histomorphometric and radiographic data; secondary outcomes were the feasibility of implant placement after ARP as well as patient-related outcomes such as postoperative discomfort.
The search identified 436 eligible articles published from 2011 to 2022, but only five were ultimately included for data extraction (146 patients). Given the substantial heterogeneity among the included studies, no meta-analysis could be performed. The authors' qualitative analysis showed marginally improved outcomes regarding an increased percentage of new bone formation after tooth extraction and a reduction in postoperative discomfort.
Given the potential value of EMDs in other fields of regenerative dentistry, more consideration should be given to EMDs as an adjunctive treatment option in ARP. However, more well-controlled randomized clinical trials are necessary to evaluate the exact potential and impacts of EMDs.
系统评估关于牙拔除后牙槽嵴保存（ARP）期间釉基质衍生物（EMD）辅助应用的现有证据。
在MEDLINE、Cochrane图书馆、PsycINFO、科学引文索引、谷歌学术和Scopus中进行全面的文献检索，以确定相关的随机对照临床试验（RCT）。该系统评价的主要结局参数为组织形态计量学和影像学数据；次要结局为ARP后种植体植入的可行性以及术后不适等患者相关结局。
检索确定了2011年至2022年发表的436篇符合条件的文章，但最终仅纳入5篇进行数据提取（146例患者）。鉴于纳入研究之间存在显著异质性，无法进行荟萃分析。作者的定性分析表明，拔牙后新骨形成百分比增加以及术后不适减轻方面的结局略有改善。
鉴于EMD在再生牙科其他领域的潜在价值，在ARP中应更多地考虑将EMD作为辅助治疗选择。然而，需要更多严格对照的随机临床试验来评估EMD的确切潜力和影响。
