*Corresponding Author: Melak Tlili, Department of Periodontology, Faculty of Dental Medicine of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.

Received: September 15, 2026; Published: October 16, 2026

Objectives: The aim of this umbrella review was to evaluate whether the combination of enamel matrix derivatives (EMD) with bone grafts provides additional clinical benefits compared with the use of EMD alone in the treatment of periodontal intrabony defects.

Materials and Methods: An umbrella review was conducted according to PRIOR and PRISMA 2020 recommendations. A comprehensive search was performed in PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, and Mendeley Search for systematic reviews published between 2009 and 2025. Reviews comparing EMD alone versus EMD combined with bone grafts in human intrabony periodontal defects were included. Methodological quality was assessed using AMSTAR 2, and risk of bias was evaluated using the ROBIS tool.

Results: Six systematic reviews, with or without meta-analysis, were included. Overall, the findings suggested a slight advantage for the combination therapy (EMD + bone graft), particularly regarding clinical attachment level gain and probing pocket depth reduction. However, the observed differences were quantitatively modest and heterogeneous across studies. Methodological appraisal revealed very low overall confidence and a high risk of bias in most included reviews.

Conclusions: The adjunctive use of bone grafts with EMD may provide limited additional clinical benefits compared with EMD alone in periodontal intrabony defects. Nevertheless, the current evidence remains methodologically weak, requiring cautious interpretation.

Clinical Relevance: Although EMD combined with bone grafts may enhance regenerative outcomes in some clinical situations, the magnitude of benefit appears limited, and treatment decisions should be individualized according to defect morphology and clinical context.

Keywords: Enamel Matrix Derivatives; Bone Grafting; Periodontal Regeneration; Intrabony Defects; Periodontitis; Umbrella Review

References

Citation

Citation: Melak Tlili., et al. “Treatment Tactics for Patients with Concomitant Cranio-Maxillofacial Trauma". Acta Scientific Dental Sciences 10.11 (2026): 05-10.

Copyright

Copyright: © 2026 Likhanova MA., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.