Comparative Analysis of Enamel Matrix Proteins in Dental Development and Regenerative Applications: A Systematic Review and Meta-analysis

Authors

  • Kahaf Mujtaba School of Biochemistry, Free University of Berlin, Germany.
  • Ashar Hussain Isra University, Hyderabad, Pakistan.
  • Irum Naz Shahida Islam Dental College, Lodhran Pakistan.
  • Suman Shoro Dow Dental College, DUHS, Karachi.
  • Falak Murad Shah Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan.
  • Ehsan Ul Haq Free University of Berlin, Germany. https://orcid.org/0009-0005-2392-2360

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/095

Keywords:

Dental Enamel Proteins, Enamel Matrix Proteins, Guided Tissue Regeneration, Periodontal, Wound Healing

Abstract

Background: Dental development, together with regenerative dentistry, depends heavily on three main enamel matrix proteins, including amelogenin, enamelin, and ameloblastin.
The purpose of this systematic review and meta-analysis was to examine the effectiveness of enamel matrix derivative (EMD) proteins as a factor in periodontal regenerative therapy, specifically in terms of their effects on probing pocket depth (PPD) and clinical attachment level (CAL), in patients with chronic periodontitis who received these proteins.

Methods: The literature search across databases was conducted up to June 2024. There were six randomized control trials (RCTs). The extraction of data was carried out independently, and the Cochrane Risk of Bias tool was utilized to measure the quality. The inverse variance method of meta-analysis was done with a random-effects model. Standardized mean difference (SMDs) at 95% confidence interval (CI) was calculated.

Results: For PPD, the pooled SMD was 0.11 (95% CI: -0.20 to 0.42), with no statistically significant difference observed between the experimental and control groups. No major heterogeneity was noticed. In the case of CAL, there was no statistically significant difference as the pooled SMD was 0.06 (95% CI: -0.60 to 0.71). However, heterogeneity was substantial (I² = 84%, p < 0.01), reflecting inconsistent findings across studies.

Discussion: There is no statistically significant benefit of EMD in comparison with traditional therapies in the enhancement of PPD or CAL. Although the results for PPD seem reliable, the high heterogeneity in CAL outcomes limits the transferability of findings.

Author Biographies

  • Kahaf Mujtaba, School of Biochemistry, Free University of Berlin, Germany.

    Department of  Biochemistry, 

  • Ashar Hussain, Isra University, Hyderabad, Pakistan.

    Department of Science of Dental Materials,

  • Irum Naz, Shahida Islam Dental College, Lodhran Pakistan.

    Department of Oral Biology ,

  • Suman Shoro, Dow Dental College, DUHS, Karachi.

    Department of Forensic Odontology


  • Falak Murad Shah, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan.

    Department of Forensic Odontology,

  • Ehsan Ul Haq, Free University of Berlin, Germany.

    School of Biochemistry,

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2025-09-29

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1.
Mujtaba K, Hussain A, Naz I, Shoro S, Shah FM, Haq EU. Comparative Analysis of Enamel Matrix Proteins in Dental Development and Regenerative Applications: A Systematic Review and Meta-analysis. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 4];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/3768

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