Effect of enamel matrix derivative on alveolar ridge preservation in the posterior maxilla: A randomized controlled clinical trial

Background: EMD has been considered to exert positive effects on wound healing, postoperative discomfort, and bone regeneration. Purpose: The aim of this randomized controlled clinical trial was to investigate and compare (a) horizontal and vertical bone dimensional changes, (b) early postoperative discomfort and soft tissue wound healing outcomes, and (c) treatment modalities for implant placement, following posterior maxillary alveolar ridge preservation (ARP) with and without adjunctive use of EMD. Methods: Twenty-eight participants were randomly assigned to three groups: extraction sockets filled with bovine bone mineral and membrane with EMD (test group 1, n = 10) and without EMD (test group 2, n = 10) and spontaneous healing (control group, n = 8). Alveolar bone dimensional changes were measured using cone-beam computed tomography 5 months after ARP, and postoperative pain and wound healing outcomes were also evaluated. Results: There were no significant differences in horizontal or vertical bone dimensional changes between test groups 1 (horizontal width changes at 1 mm apically below the alveolar ridge crest [HW]: −1.44 ± 0.54 mm) and 2 (HW: −1.42 ± 0.26 mm), but the changes at HW (−2.36 ± 1.03 mm) in the control group were significantly greater than those in test groups 1 and 2 (P <.05). Early postoperative discomfort and soft tissue wound healing outcomes were not significantly different between the two test groups. Furthermore, unlike the control group, both the test groups 1 and 2 were implanted without sinus floor elevation using the lateral approach. Conclusion: Within the limitations of this study, EMD failed to provide additional benefits in ARP in the posterior maxilla.