The Effect of Emdogain Application on Non-Surgical Management of Peri-Implant Mucosal Inflammation (PIMI) and Its Cytokine Profile

Abstract

One of the ever-increasing complications related to dental implants, with controversy over how to control it, is peri-implant disease. The aim of this clinical trial was to evaluate the adjunctive use of enamel matrix derivatives (EMD) during non-surgical mechanical debridement inpatients with these lesions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF). Materials and methods: In the present double-blind clinical trial, 46 patients with peri-implant lesions with at least one functioning implant for more than a year were randomly divided into test and control groups. Two different therapeutic protocols, consisting of non-surgical mechanical debridement with and withoutthe use of EMD were considered for the two groups. Clinical parameters and sampling from PICF were carried out in the two groups before treatment and at 2-week and 3-month postoperative intervals. ELISA was used for the analysis of PICF samples in relation to IL-6 and IL-17 cytokines levels. Results: Finally, 21 and 20 subjects in the control and test groups, respectively, were statistically analyzed.After 3 months,no specific changes were observed in the control group in terms of BOP and PD; however, in the test group, use of EMD resulted in a significant decrease in BOB (from 75% to 25%) and PD (from 4.5 to 3 mm) (P<0.0001). After 3 months, the IL-6 and IL-17 PICF levels exhibited a significant decrease in the test group compared to the control group. Conclusion: The results showed that non-surgical mechanical debridement alone cannot be effective in the treatment of severe peri-implant mucositis and initial peri-implantitis, and use of EMD can be considered an adjunct to mechanical debridement in the non-surgical treatment of these lesions, although no complete recovery was achieved after 3 months