The Effect Of Enamel Matrix Derivative Alone Versus In Combination With Alloplastc Materials To Treat Intrabony Defects:a Meta-analysis

Objective: This meta-analysis aims to compare the effect of the application of enamel matrix derivative(EMD)used alone with that in combination with alloplastic materials in the treatment of periodontal intrabony defects.Methods: Relevant studies were retrieved from Pub Med,the Cochrane Library and EMBase through November 2015.The main clinical outcomes were pocket probing depth(PPD)reduction,clinical attachment level(CAL)gain,gingival recession(REC)increase and defect fill gain.Two separate meta-analyses were performed according to the length of follow-up.9 articles were included.Results: The results demonstrated that in the short-term follow-up group(not more than one year),in terms of PPD reduction(P<0.05),gain of defect fill(P<0.05)and REC increase(P<0.05),the application of an EMD combined with alloplastic materials provided advantages compared to EMD used alone;for CAL gain(P=0.17),no significant differences were observed.In the long-term follow-up group(more than one year),no significant differences in terms of REC increase(P=0.05)were found between the groups,but combined therapy exhibited an advantage in terms of PPD reduction(P<0.05),CAL gain(P<0.05)and gain of defect fill(P<0.05).Conclusion: Within the limits,the meta-analysis indicated that the additional benefit of combined therapy in the treatment of periodontal intrabony defects compared with an EMD used alone cannot be completely proven.