ABSTRACT
The enamel matrix derivative [EMD] has been introduced in 1997 for the regeneration of intrabony periodontal defects. The aim of the present review is to study its clinical and histological efficacy. Material and methods: 33 clinical trials and 8 histological investigations on the efficacy of EMD in the treatment of intrabony defects have reviewed. A meta-analytic approach has been adopted in analyzing the clinical attachment gain and the gingival recession by weighing the outcomes of each study in relation to the number of treated defects. The weighted mean of the clinical attachment gain amounted to 3.1 mm for 403 compiled defects. Gingival recession amounted to 1 mm for 265 compiled defects. Bone fill of the original defect varied between 0.8 mm and 4.8 mm. Despite the overall efficacy of EMD, a significant variation in clinical outcomes was observed. Histologicaly, of 28 chronic human intrabony defects compiled, 54% presented regeneration, 24% new connective tissue attachment and 25% long junctional epithelium. Considering the variations observed in clinical and histological outcome, further randomized controlled clinical trial with adequate statistical power one needed in orcler to clarify the efficacy and the predictability of the EMD treatment