Enamel matrix derivative,
does it really help with Increased marginal bone level 12 months after regenerative surgery for peri-implantitis?
research showsThe grade is D. In a 29-person randomized trial, only 25 were included in the 12-month bone-level analysis. Median change was +0.9 mm with adjunctive Emdogain versus -0.1 mm with surgery alone, but the between-group primary-endpoint test had p=0.295. A positive signal appeared only in exploratory multivariable modeling, and one small completer analysis gives D with 30 points.
ads claimClaiming that the product regenerated 1 mm of bone hides the uncertainty. The +0.9 versus -0.1 mm medians must be presented with the failed primary between-group test and the 25-person analysis.
Useful facts when choosing a product
- Emdogain is an enamel-matrix-protein-derived gel; 0.3 mL was applied to the implant defect in this trial.
- Both groups received flap surgery, implant-surface cleaning, and the same supportive care.
- Emdogain was the intervention material; free manufacturer supply was not reported in the article.
What the research actually shows
Twenty-nine patients were assigned to adjunctive Emdogain, 15, or surgery alone, 14. The article states, ‘The examiners of the clinical and radiology registrations were blinded,’ and the surgeon remained unaware until Emdogain application. Only the 25 patients completing the full 12 months remained in the primary bone-level analysis. Three EMD participants discontinued, including two treated with systemic antibiotics for severe reinfection at three months; one control implant was lost at 12 months. The study was self-funded by authors and the Centre for Research & Development and Public Dental Health Region Gävleborg; Renvert reported an ITI Foundation grant during the study. Emdogain was the trial intervention, but the article did not report free supply from Straumann, and outside company relationships were not counted as trial funding. The two avoidable limitations were a total sample below 200 and completer-only analysis of 25 of 29.
Why this is classified as D (30)
The prespecified radiographic surrogate primary comparison was null, and one 29-person trial with a 25-person completer analysis gives D with 30 points.
Counterpoint. D is not precise refutation of possible bone gain. The small trial reported no confidence interval, so a larger randomized trial is needed.
Rejudgment record. Cross-check applied — Centers the null univariate prespecified radiographic bone-level result while accounting for the 29-person sample, 25-person completer analysis, and nonprofit funding
| Endpoint | S | Surrogate marker - laboratory or imaging measures |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E0 | Null |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Increased marginal bone level at 12 months | D | Medians differed, but the prespecified between-group test had p=0.295. |
| Improved implant survival | ? | The original trial was not powered for survival, and long-term follow-up involved the same small cohort. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Assessor-blinded randomized trial of surgery plus Emdogain versus surgery alone | 13 | Self-funded by authors, the Centre for Research & Development, and Public Dental Health Region Gävleborg, with an ITI Foundation grant; free supply by Straumann was not reported | Change in radiographic marginal bone level at 12 months | Median +0.9 mm versus -0.1 mm, between-group p=0.295; a positive EMD association appeared only in exploratory multivariable modeling | Null prespecified imaging primary endpoint in a small completer analysis |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-18).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-18 · Corrections: none
Cite this verdict
[Chamgap] Enamel matrix derivative x bone level after regenerative peri-implantitis surgery — Evidence Grade D·30. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/enamel-matrix-derivative-peri-implantitis-regenerative-surgery-bone-level/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.