Clinical Application of Enamel Matrix Derivative for Periodontal Regeneration and Treatment of Peri-Implantitis

Book excerpt: One of the goals of periodontal therapy is to regenerate lost supporting structures that have been destroyed by periodontal disease. Treatment procedures including various bone grafts, guided tissue regeneration, use of enamel matrix derivative, or combinations of the aforementioned have been suggested as regenerative periodontal therapies to achieve this goal. Enamel matrix derivative is composed of a number of proteins, 90% of which are amelogenins, and these proteins are thought to induce the formation of periodontal attachment during tooth formation. Previous reports have shown that enamel matrix derivative was able to improve clinical attachment level and reduce probing depth. The results of previous controlled clinical trials have shown that using enamel matrix derivative in combination with bovine porous bone mineral may enhance the regenerative outcome with regard to the clinical attachment level gain compared with using the enamel matrix derivative alone. In this chapter, an extensive review of the role of enamel matrix derivate will be performed using in vitro and in vivo studies. Clinical implications of the enamel matrix derivative will also be discussed.