Enamel matrix derivative promotes new bone formation in xenograft assisted maxillary anterior ridge preservation-A randomized controlled clinical trial.

Abstract

To compare the effectiveness of deproteinized bovine bone mineral with 10% collagen alone (DBBMC) or with enamel matrix derivative (DBBMC-EMD) in ridge preservation. 42 maxillary anterior teeth were extracted and received either a DBBMC (control) or DBBMC-EMD (test) treatment protocol. CBCT taken before and 4months after the extraction procedure was used to measure changes in alveolar ridge width (RW), buccal bone height (BH) and palatal bone height (PH). Bone cores were harvested during implant osteotomy preparation, and the samples processed histomorphometrically to assess the fraction of new bone (%NB), residual graft (%RG) and soft tissue matrix (%STM). Overall, both treatment groups showed significant reductions in mean RW from baseline to 4months after extraction, but no significant change in either mean BH or PH over this time. When CBCT measurements were analysed according to the initial thickness of the buccal wall (BT<1mm vs. BT≥1mm), significant reductions in all ridge dimensions (RW, BH and PH) were noted in the <1mm BT group. Histomorphometrically, the DBBMC-EMD test group showed significantly increased new bone formation (%NB): (control=16.5±6.9% cf.; test=45.1±8.8%) with less residual graft (%RG): (control=36.8±8.8% cf.; test=20.3±7.2%) compared to the DBBMC control group. Both DBBMC alone and DBBMC-EMD treated sites 4months after extraction lost RW but showed no significant change in BH or PH. Irrespective of treatment, maxillary anterior teeth with thick initial buccal walls (≥1mm) exhibited less alveolar ridge reduction 4months after treatment. The addition of EMD to DBBMC resulted in more new bone formation in the test group.