Enamel Matrix Proteins In The Treatment Of Intrabony Defects: A Systematic Review

ObjectiveThe aim of the present study was to evaluate clinically treatment effect of enamel matrix proteins(EMPs), guided tissue redeneration(GTR)(control), combination of EMPs and GTR on intrabony defects, and to provide basis for the choice of the treatment plan.MethodsThe selected studies were pooled from seven major electronic databases (CBM,CNKI,PubMed,EBSCO,OVID,Science Direct,Springerlink) from 1997 to 2008 for randomized controlled trial (RCT) with at least 6 months of follow-up. Several English journals were handsearched.In addition, a meta-analysis is presented regarding the clinical results during regeneration with EMPs or GTR. We searched 440 studies at first but only eleven studies that met inclusion criteria were entered into the meta-analysis. Outcome measures were:probing depth (PD) reduction, clinical attachment level (CAL) gain, and gingival recession (GR). The titles and abstracts of all reports identified were scanned independently by two reviewers. All studies meeting the inclusion criteria then underwent validity assessment by Jadad score calculation, data extraction was performed by the table of Review Manager software 4.2 (Revman 4.2), and used Revman 4.2 to analyze the outcome measures. For continuous outcomes, weighted mean differences and 95 percent confidence intervals were used to summarize the data for each group.Results1.EMPs (EMD) versus GTREleven trials provided data for this comparison between EMPs (EMD) and GTR.The meta-analysis showed that the baseline between two groups are comparative, but there was no statistical significant difference in PD reduction,CAL gain and GR were observed between the two groups after the treatment of 6 months.2.Combination of EMPs (EMD) and GTRversus GTRThree trials provided data for this comparison between EMPs (EMD)+GTR and GTR. The meta-analysis showed that the baseline between two groups are comparative, but there was no statistical significant difference in PD reduction,CAL gain and GR were observed between the two groups after the treatment of 6 months.Conclusions1.here was no evidence of important difference beteen EMPs and GTR in PD reduction, CAL gain and GR. EMPs can gain the similar clinical effects as GTR when treated with intrabony defects.2.here was no evidence of important difference beteen EMPs+GTR and GTR in PD reduction, CAL gain and GR. the combination of EMPs and GTRcan not improve clinical effects when compare to GTR alone.