CLINICAL AND RADIOGRAPHIC ASSESSMENT OF IMMEDIATELY PLACED DENTAL IMPLANTS WITH ENAMEL MATRIX DERIVATIVE (EMDOGAIN): A SPLIT MOUTH RANDOMIZED CONTROLLED CLINICAL TRIAL

Introduction: The osseointegration of immediately placed implants remain challenging prerequisites to successful implant integration. Enamel matrix protein derivative (EMD) is composed of growth factors extracted from piglet teeth, which has shown to have regenerative capacity. Several studies have suggested that EMD improves the regeneration of bone. However, its effect around immediately placed implants has not been fully investigated.Aim: determine the effect of EMD on osseointegration and healing potential.Methods: Twelve patients with hopeless bilateral maxillary anterior teeth who need dental implant rehabilitation were recruited, without the need for bone augmentation. After atraumatic tooth extraction, immediate implants were installed; one side received an implant with an 0.15 mm EMD injected into the osteotomy site, while the contralateral side received an implant without EMD. Stability of implants at immediately postoperative, 2 and 6 months were measured, radiographic changes at the bone implant contact were assessed; by taking cone beam computed tomography image at postoperative and at 6 months, besides assessing wound healing at 4 and 15 days using the wound evaluation scale.Results: The application of EMD into the implant bed showed comparable results to immediately placed implants without EMD, in terms of secondary stability, and bone changes. There was a significant difference between the two groups regarding wound healing at 4 days favoring the application of EMD, however, the difference was insignificant at 15 days.Conclusion: EMD is equally beneficial in enhancing implant stability, marginal bone level, and bone density, and has shown an enhanced potential to wound healing.