Effects of enamel matrix derivative on non-surgical management
of peri-implant mucositis: a double-blind randomized clinical trial
Howard C. Tenenbaum
Received: 2 March 2016 / Accepted: 8 December 2016 /Published online: 30 December 2016
Springer-Verlag Berlin Heidelberg 2016
Background Peri-implant diseases have been recognized as
being among the ever-increasing complications related to den-
tal implants. The aim of this study was to evaluate the adjunc-
tive use of enamel matrix derivative (EMD) to mechanical
debridement (MD) in patients with these conditions in terms
of clinical parameters and cytokine levels of peri-implant cre-
vicular fluid (PICF).
Methods In the present double-blind clinical trial, 46 patients
with peri-implant mucositis (PM) were randomly divided into
control and test groups. Two different therapeutic protocols,
consisting of non-surgical MD alone (control group) and MD
with the application of EMD (test group), were considered for
the two groups. Clinical parameters [bleeding on probing
(BOP) and probing depth (PD)] and sampling from PICF were
carried out before treatment and 3 months postoperatively.
The levels of IL-6 and IL-17 cytokines in PICF were evaluat-
ed by enzyme-linked immunosorbent (ELISA).
Results Three-month post-interventional assay revealed sig-
nificant improvements in BOP and PD in the test group in
comparison to the control group (P < 0.0001). Relative to
control, IL-6 and IL-17 levels were reduced significantly
(p < 0.05) in the test group compared to the control group.
Conclusion Application of EMD can be considered an ad-
junct to MD in the non-surgical treatment of PM. However,
complete recovery was not observed using either treatment
approach showing that management of implant-associated
disease is still a significant clinical problem.
Electronic supplementary material The online version of this article
(doi:10.1007/s00784-016-2033-7) contains supplementary material,
which is available to authorized users.
* Ali Zarandi
Howard C. Tenenbaum
Dental and Periodontal Research Center, Tabriz University of
Medical Sciences, Tabriz, Iran
Faculty of Dentistry, University of Toronto, Toronto, Canada
Department of Dentistry, Mount Sinai Hospital, Toronto, Canada
Department of Periodontics, Tabriz, Islamic Republic of Iran
Institute of Health Policy, Management and Evaluation, Faculty of
Medicine, University of Toronto, Toronto, Canada
Clin Oral Invest (2017) 21:2379–2388