[The use of enamel matrix derivative in periodontal therapy]

Periodontal disease results in the loss of the attachment apparatus, i.e. the alveolar bone, the periodontal ligament and the cementum. In the last three decades, an increasing effort has been placed on seeking procedures and materials to promote the regeneration of these tissues. This article reviews published data concerning the enamel matrix derivative (EMD) as a regenerative mean. It encompasses in vitro and in vivo studies as well as human case reports, clinical comparative trials and histologic findings. According to the discussed studies it may be concluded that EMD possess comparable clinical abilities to initiate regeneration in previously diseased sites as guided tissue regeneration, or as the use of xenograft material. In contrast, the histologic findings are less promising regarding the amount of new bone formation. The controversy results concerning the benefit of the EMD as an additive to xenograft or alloplast materials should be attributed to the correct case selection, and particularly to the defect morphology. However, this latter statement needs further validation. Clinical examples of treatment utilizing EMD or in conjunction with allograft are presented.