Use of Enamel Matrix Derivative in Combination with Bone Substitute for the Treatment of an Intrabony Defect: A Case Report

Abstract

Enamel matrix derivative (EMD) is a group of proteins involved in the development of cementum and may be used as a means of regenerating acellular extrinsic fiber cementum. EMD has been combined with different space-maintaining products, such as membranes or bone substitutes, in order to enhance the space available for periodontal regeneration. In this report we used EMD in combination with alloplastic graft biphasic calcium phosphate (BCP) as part of periodontal surgery in order to reduce an intrabony defect. Eighteen months after treatment, the clinical measurements demonstrated a 3 mm reduction in probing depth and a 3 mm gain in clinical attachment level without tooth mobility and bleeding upon probing. The increase in radiodensity of the radiographs suggested an increase in bone level after treatment. When defect morphology is appropriately evaluated, and the surgical procedure is carefully performed, the use of EMD in combination with BCP may help to improve clinical parameters and radiographic bone level; this thus could be an alternative treatment modality for intrabony defects.