Emdogain – can it help even without surgery …?
PD Dr. Kristina Bertl, PhD MSc MBA
Emdogain is a product that consists of enamel matrix proteins and is obtained from porcine tooth germs. It has been successfully used in periodontal surgery for more than 20 years and, with the right indication and application, it can be used to achieve outstanding results including at least partial regeneration of periodontal defects. In recent years, however, the discussion as to whether or not Emdogain can be used in non-surgical periodontal therapy has come up time and again. Yet this idea is somewhat controversial as Emdogain cannot be used, for example, in exactly the same way in non-surgical periodontal therapy as is recommended strictly for surgical application.
A research group from Switzerland recently summarized the literature available thus far on this subject in a systematic review (Roccuzzo et al. 2022). The review included all randomized controlled clinical studies with at least a three-month follow-up period. The authors were able to identify a total of six studies on this topic, and four studies could be statistically summarized and assessed in a meta analysis.
The results of the individual studies and the statistical analyses led the authors to the following conclusions:
- Based on the results of the randomized controlled clinical studies available thus far, there is no statistically and clinically relevant benefit provided by the additional application of Emdogain during non-surgical periodontal therapy.
- The studies included also showed significant heterogeneity, which, for us, means that the results should be treated with even greater caution.
From our perspective, this means that no clear conclusions can be drawn on this subject at this point and that we should wait for the results of future studies. Another question also worthy of consideration for the future is whether use for any individual residual pocket probing depths in periodontal maintenance therapy is more expedient than ‘generalized’ application during the first and second phase of non-surgical periodontal therapy.
- Roccuzzo A, Imber JC, Stähli A, Kloukos D, Salvi GE, Sculean A. Enamel matrix derivative as adjunctive to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig. 2022 Jun;26(6):4263-4280. doi: 10.1007/s00784-022-04474-1.