A systematic review: osseous healing after mixing enamel matrix derivatives (EMD) or platelet-derived growth factor with graft material to aid in alveolar ridge preservation (ARP)
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Abstract
Alveolar ridge preservation (ARP) is a technique used after tooth extraction to preserve bone volume within the extracted sockets. It involves a minimally traumatic tooth extraction protocol followed by immediate grafting. This is crucial for preventing alveolar ridge resorption and minimizing the early bone loss associated with wound healing after extraction. This systematic review was conducted to assess the effect of adding Enamel matrix derivatives (EMD) or platelet-derived growth factor (PDGF) to graft material used for alveolar ridge preservation (ARP) as measured by assessing their effect on the osseous healing of extraction sockets.
Using a systematic search process guided by PICO and PRISMA, a research question was formulated, and four electronic databases, PubMed, Embase, Web of Science, and Cochrane, were searched for studies to answer the research question. The analysis was conducted by two independent reviewers, who were guided by defined inclusion and exclusion criteria.
The preliminary search, defined by PICO-derived mesh terms, resulted in a list of 292 publications. The titles and abstracts were further evaluated using the PRISMA checklist and defined inclusion and exclusion criteria, resulting in a refined list of 15 articles. A further full document review resulted in the exclusion of 11 more articles, leaving a final list of 4 articles. Analysis of these selected articles resulted in the following conclusion.
The lack of consistency in study designs and the individual investigator's criteria for data evaluation made it challenging to reach a definitive conclusion. The use of different bone graft and membrane materials introduced variables that raise the question of whether the additive effect on osseous quality is derived from PDGF, EMD, bone, or the membrane material.
Most available studies aimed to assess the impact of EMD or PDGF on either delayed ridge augmentation or intrabony periodontal defects, which added more variables to the equation, and we excluded them from our analysis. Further investigations and comparative human studies using randomized controlled clinical trial protocols are needed to confirm whether either EMD or PDGF has an additive effect on the socket graft quality of healing when added to a bone graft during Alveolar ridge preservation.
Description
2025