Enamel matrix derivative (Emdogain) in the treatment of intrabony periodontal defects.

Heijl, Lars; Heden, Gunnar; Svärdström, G; Ostgren, A

doi:10.1111/j.1600-051x.1997.tb00253.x

Cited by 486 publications

(545 citation statements)

References 39 publications

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“…Previous clinical trials have shown mean PPD reductions ranging from 3.3 to 4.3 mm for the EMP group and from 2.2 to 3.7 mm for the control group at an interval of 8 to 12 months after treatment. 3,7,10,13,19 In the present study, no significant differences in PPD reduction were observed between the EMP (3.7 mm) and OFD (4.0 mm) groups after 6 months. However, our results disagree with those of previ- ous studies that reported a significantly greater PPD reduction for the EMP group.…”

Section: Discussionmentioning

confidence: 54%

“…However, our results disagree with those of previ- ous studies that reported a significantly greater PPD reduction for the EMP group. 3,7,10,13,19 Mean gain in relative attachment level was 2.7 mm for the EMP group and 1.8 mm for the OFD group 6 months after treatment. In previous clinical studies, the mean clinical attachment gain reported ranged from 1.7 to 4.2 mm for the EMP group and from 0.8 to 3.7 mm for the control group 8 to 12 months after treatment.…”

Section: Discussionmentioning

confidence: 98%

“…5,15 These positive results in animals 17 were later confirmed by histological findings in humans 15 and by clinical improvement observed in controlled clinical trials. 3,7,8,10,13,19 Thus, the purpose of this study was to compare the results of periodontal clinical parameters after treatment of intrabony defects with open flap debridement (OFP) combined or not with enamel matrix protein (EMP).…”

Section: Introductionmentioning

confidence: 99%

“…4 Enamel matrix protein (EMP) is derived from the developing tooth germ of fetal pigs and has recently been introduced as a treatment option for the regenerative therapy of periodontal defects. 6,7 Its use is based on the principle that EMP plays a crucial role in the development of the tooth, specifically of cementum. Histological studies in animals have shown that a new layer of cementum with inserting fibers and new alveolar bone were formed when EMP was applied to a debrided and conditioned root surface.…”

Section: Introductionmentioning

confidence: 99%

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Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study

et al. 2007

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241Effect of enamel matrix proteins on the treatment of intrabony defects . A splitmouth randomized controlled trial study O efeito da proteína da matriz do esmalte no tratamento de defeitos infra-ósseos. Um estudo clínico controlado randomizado boca-dividida Abstract: The objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2-or 3-wall intrabony defects with open flap debridement (OFD) combined or not with enamel matrix proteins (EMP). Thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (PPD) ≥ 5 mm. All individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. Each participant received the two treatment modalities: test sites were treated with OFD and EMP, and control sites received only OFD. After 6 months, a significant reduction was observed in PPD for the EMP group (from 6.42 ± 1.08 mm to 2.67 ± 1.15 mm) and for the OFD group (from 6.08 ± 1.00 mm to 2.00 ± 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). A significant gain in relative attachment level (RAL) was observed in both groups (EMP: from 13.42 ± 1.88 mm to 10.75 ± 2.26 mm, p < 0.001; OFD: from 12.42 ± 1.98 mm to 10.58 ± 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). Gingival recession (GR) was higher in the EMP group (from 1.08 ± 1.50 mm to 2.33 ± 1.43 mm; p = 0.0009) than in the OFD group (from 0.66 ± 1.15 mm to 1.16 ± 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). In conclusion, the results showed that OFD combined with EMP was not able to improve treatment of intrabony defects compared to OFD alone. Descriptors: Periodontics; Alveolar bone loss; Bone regeneration.Resumo: O objetivo deste estudo clínico controlado, randomizado, duplo-cego, tipo bocadividida foi comparar o efeito clínico do tratamento de defeitos infra-ósseos de 2 ou 3 paredes com retalho de espessura total (RET) associado ou não com a proteína da matriz do esmalte (PME). Treze voluntários com 1 par ou mais de defeitos infra-ósseos foram selecionados com profundidade clínica de sondagem (PCS) ≥ 5 mm. Todos receberam instruções de higiene bucal, raspagem e alisamento radicular. Cada participante recebeu os dois tipos de tratamento: o lado teste foi tratado com RET e PME, e o lado controle recebeu somente RET. Após 6 meses, foi observada uma redução significante na PCS para o grupo PME (de 6,42 ± 1,08 mm para 2,67 ± 1,15 mm) e para o grupo RET (de 6,08 ± 1,00 mm para 2,00 ± 0,95 mm) (p < 0,0001), mas não houve diferença significante entre os grupos (p = 0,13). Um ganho significante de nível clínico de inserção relativo (NCIR) foi observado em ambos os grupos (PME: de 13,42 ± 1,88 mm para 10,75 ± 2,26 mm, p < 0,001; RET: de 12,42 ± 1,98 mm para 10,58 ± 2,23 mm, p = 0,013), mas não houve diferença significante entre os grupos (p = 0,85). A retração gengival (RG) foi maior para o grupo PME (de 1,08 ± 1,50 mm para 2,33 ± 1,43 ...

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study

et al. 2007

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“…Since its introduction, EMD has demonstrated the ability to encourage periodontal regeneration in both animal studies and clinical trials 7,9,13,23) . Although clinical results are often dependent upon the dimension and morphology of the defect 6) , mean CAL gain (2.8 mm) observed for sites with regenerative therapy appeared to be comparable to that reported in our previous study 18) and others 13,20) .…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Surgical Periodontal Therapy: A Short-term Retrospective Study

Hayakawa

Fujinami

Ida

et al. 2012

Bull. Tokyo Dent. Coll.

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This study aimed to investigate retrospectively the outcome of surgical periodontal therapy. Periodontal surgeries implemented at General Dentistry, Tokyo Dental College Suidobashi Hospital during the period of April 2010 through March 2012 were subjected to data analysis. After initial periodontal therapy, 17 clinicians performed a total of 138 periodontal surgeries in 80 patients with moderate to advanced periodontitis (31 men and 49 women; mean age 54). Cases (sites) operated were as follows: open flap debridement=102, periodontal regenerative therapy=29 (17 for intrabony defects, 12 for furcation involvements) and periodontal plastic surgery=7. Enamel matrix derivative or bone graft was used for regenerative therapy. Clinical data were analyzed focusing on the comparison between open flap debridement and regenerative therapy. At 5 months after open flap debridement, mean reduction in probing depth (PD) and gain in clinical attachment level (CAL) was 3.9 mm (range 11.0-9.0) and 2.3 mm (range 11.0-9.0), respectively. The corresponding values with regenerative therapy were 4.0 mm (range 0-8.0) and 2.8 mm (11.0-6.0), respectively. At sites with initial PD≥8 mm, a significantly greater gain in CAL was obtained with the regenerative therapy than with flap surgery (mean CAL gain 4.3 mm vs. 2.9 mm, p<0.05). Periodontal surgery performed in our clinical setting demonstrated a favorable short-term outcome. Our data suggest the efficacy of regenerative therapy, in particular for the treatment of deep pockets.

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Early events associated with periodontal connective tissue attachment formation on titanium and hydroxyapatite surfaces

Craig

LeGeros

1999

J. Biomed. Mater. Res.

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Endosseous dental implants can support at least three types of biomaterial/connective tissue interfaces: osseointegration, fibro-osseous integration, and periodontal connective tissue attachment. Although a periodontal connective tissue attachment offers distinct advantages, only osseointegration and fibro-osseous integration are at present clinically achievable. Recent studies indicate a periodontal regeneration-competent cell population and an appropriate biomaterial substrate both are required for periodontal connective attachment formation on biomaterial surfaces. We therefore have developed an in vitro model to characterize the effects of various biomaterial substrates on the early events of periodontal connective tissue attachment formation. Primary cultures of periodontal ligament and gingival connective tissue cells were cultured on uncoated (control) and coated (titanium- and hydroxyapatite-coated) tissue culture plastic, and the level of cell proliferation, collagen, and noncollagen protein synthesis, alkaline phosphatase activity, and expression of a 42 kD cementum extracellular matrix protein were measured over 5, 7, and 9 days in culture. While all three substrates supported cell attachment, proliferation, and protein synthesis, only uncoated and titanium-coated tissue culture plastic supported expression of the cementum extracellular matrix protein after 9 days of culture. In addition, the levels of cell proliferation and collagen and noncollagen protein synthesis for cells grown on hydroxyapatite-coated surfaces lagged behind cells cultured on the control or titanium-coated surfaces at each of the three time points. These data suggest that biomaterial substrates markedly can influence the temporal sequence of extracellular matrix proteins associated with periodontal connective tissue attachment formation. In addition to surface composition (titanium versus hydroxyapatite), surface properties (e.g., topography) also may have an effect on periodontal connective tissue attachment formation. This model may be of use in designing biomaterials to support the formation of periodontal connective tissue attachment in vivo.

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Enamel matrix derivative (Emdogain) in the treatment of intrabony periodontal defects.

Cited by 486 publications

References 39 publications

Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study

Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study

Clinical Outcome of Surgical Periodontal Therapy: A Short-term Retrospective Study

Early events associated with periodontal connective tissue attachment formation on titanium and hydroxyapatite surfaces

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