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Effects of enamel matrix derivative on non-surgical management of peri-implant mucositis: a double-blind randomized clinical trial

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Abstract

Background

Peri-implant diseases have been recognized as being among the ever-increasing complications related to dental implants. The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) to mechanical debridement (MD) in patients with these conditions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF).

Methods

In the present double-blind clinical trial, 46 patients with peri-implant mucositis (PM) were randomly divided into control and test groups. Two different therapeutic protocols, consisting of non-surgical MD alone (control group) and MD with the application of EMD (test group), were considered for the two groups. Clinical parameters [bleeding on probing (BOP) and probing depth (PD)] and sampling from PICF were carried out before treatment and 3 months postoperatively. The levels of IL-6 and IL-17 cytokines in PICF were evaluated by enzyme-linked immunosorbent (ELISA).

Results

Three-month post-interventional assay revealed significant improvements in BOP and PD in the test group in comparison to the control group (P < 0.0001). Relative to control, IL-6 and IL-17 levels were reduced significantly (p < 0.05) in the test group compared to the control group.

Conclusion

Application of EMD can be considered an adjunct to MD in the non-surgical treatment of PM. However, complete recovery was not observed using either treatment approach showing that management of implant-associated disease is still a significant clinical problem.

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Notes

  1. Top Dent Lifco Dental AB, Enko¨ping, Sweden

  2. Piezon ® 250, EMS Electro Medical Systems SA, Nyon, Switzerland

  3. Air-Flow Master ®, Perio Powder ®; EMS Electro Medical Systems SA, Nyon, Switzerland

  4. Laboratorios KIN, S.A., ,Barcelona, Spain

  5. Emdogain ® Straumann, Basel, Switzerland

  6. Laboratorios KIN, S.A., ,Barcelona, Spain

  7. 12 UNC color coded probe, Hu-Friedy Mfg. Co., LLC.Chicago, IL

  8. Insight Dental Films, Eastman Kodak Company, Rochester, NY, USA

  9. Periopaper ® Oraflow, Plainview, NY, USA

  10. Eppendorf ® AG, Hamburg, Germany

  11. PBS, Invitrogen, USA

  12. Sigma-Aldrich, Saint Louis, MO, USA

  13. MABTECH AB, R&D Systems, Büro Deutschland, Germany

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Authors and Affiliations

  1. Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Atabak Kashefimehr, Reza Pourabbas, Masumeh Faramarzi, Ali Zarandi & Abouzar Moradi

  2. Faculty of Dentistry, University of Toronto, Toronto, Canada

    Reza Pourabbas, Howard C. Tenenbaum & Amir Azarpazhooh

  3. Department of Dentistry, Mount Sinai Hospital, Toronto, Canada

    Reza Pourabbas, Howard C. Tenenbaum & Amir Azarpazhooh

  4. Department of Periodontics, Tabriz, Islamic Republic of Iran

    Ali Zarandi

  5. Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada

    Amir Azarpazhooh

Authors
  1. Atabak Kashefimehr
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  2. Reza Pourabbas
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  3. Masumeh Faramarzi
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  4. Ali Zarandi
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  5. Abouzar Moradi
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Correspondence to Ali Zarandi.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

The work was supported by the Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Ethical approval

The study was approved by the Research Ethics Committee of Tabriz University of Medical Sciences (No. 9278) and registered with the local World Health Organization Registry Network (IRCT2013060113543N1).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kashefimehr, A., Pourabbas, R., Faramarzi, M. et al. Effects of enamel matrix derivative on non-surgical management of peri-implant mucositis: a double-blind randomized clinical trial. Clin Oral Invest 21, 2379–2388 (2017). https://doi.org/10.1007/s00784-016-2033-7

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