The Use of Enamel Matrix Derivative in Two-Stage Guided Bone Regeneration Procedures

Frequently, clinicians are confronted with situations that require the regeneration of a deficient alveolar ridge before implant placement. This is often the result of the extraction of hopelessly compromised teeth. Enamel matrix derivative (EMD) has been used successfully in the treatment of periodontal disease, including guided tissue regeneration, and the treatment of mucogingival defects. Although the exact mechanism of action is not clearly understood, there may in fact be more uses for this product. This case series reviews a proposed mechanism of action of EMD and depicts its effective use in guided bone regeneration (GBR).

Three cases requiring GBR were treated with a mixture of human freeze-dried bone and EMD. The teeth were extracted, sockets were thoroughly debrided, and the defects were filled with the EMD-saturated allograft. Dental implants were placed after 10 to 16 weeks of hard and soft tissue maturation.

The use of a freeze-dried bone allograft saturated with EMD can be used successfully in GBR. Three cases demonstrate both horizontal and vertical bone regeneration with successful implant placement.