Evaluation of the Effectiveness of Enamel Matrix Derivative, Bone Grafts, and Membrane in the Treatment of Mandibular Class II Furcation Defects

Jaiswal, Ritika; Deo, Vikas

doi:10.11607/prd.1428

Cited by 30 publications

(57 citation statements)

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“…Thirty‐four articles were excluded after full‐text review (Table 3). 10‐12,16,30‐59 A final selection of 150 articles was made, of which six were systematic reviews, 2,60‐64 109 were clinical trials, 53,65‐172 27 were case series, 173‐199 and eight were case reports 200‐207 . No cohort studies were identified.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 24 clinical trials 149‐172 and 13 case series 185‐197 were non‐classifiable, as defined in Materials and Methods (Tables 4 and 5). Of the 85 remaining clinical trials, 53,65‐148 eight reported outcomes after applying regenerative therapy on maxillary facial/interproximal Class II furcation defects, 76,87,92,100,105,140,148,208 68 on mandibular facial/lingual Class II furcation defects, 65‐68,70‐72,75,77,78,80‐85,87‐90,93‐99,101‐104,106,107,110‐112,114‐122,124‐139,141‐147 one on maxillary Class III furcation defects, 91 nine on mandibular Class III furcation defects, 69,73,74,77,86,108,109,113,123 and one on maxillary premolars presenting Class I and Class II furcation defects 79 . Of the 14 selected case series, two reported on the treatment of maxillary facial/interproximal Class II furcation defects, 177,180 11 on mandibular facial/lingual Class II furcation defects, 173‐176,178‐184 and two on mandibular Class III furcation defects 198,199 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…A total of 68 articles reporting clinical trials aimed at assessing the effectiveness of regenerative therapies in the treatment of mandibular facial or lingual Class II furcation defects were identified (see http://www.joponline.org/doi/suppl/10.1902/jop.2015.130677/suppl_file/130677_suptab4.pdf in online Journal of Periodontology ) 65‐68,70‐72,75,77,78,79‐85,87‐90,93‐99,101‐104,106,107,110‐112,114‐122,124‐139,141‐147 . Thirty‐seven studies compared a non‐regenerative surgical intervention consisting of OFD or CPF (control) with at least one regenerative approach (test) 65‐68,70,71,75,77,78,83,85,87,89,93,94,102,103,107,112,118,120‐122,126,128,129,132‐134,137,138,141‐143,145‐147 . Of these 37 studies, 17 included at least one test group consisting of OFD or CPF plus a barrier membrane alone, 67,68,70,71,78,85,87,89,93,94,107,118,120,122,129,142,145 eight had at least one test group consisting of OFD or CPF + bone graft alone, 65,66,77,103,126,132,133,147 six included at least one test group consisting of OFD or CPF + bone graft in combination with a membrane, 112,129,132,138,143,147 four included at least one test group consisting of OFD or CPF in combination with a bioactive agent alone, 133,135,141,146 and six had at least one test group consisting of OFD or CPF + other regenerative therapies encompassing a variety of grafting materials and chemotherapeutics 75,94,102,121,128,129 .…”

Section: Resultsmentioning

confidence: 99%

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Periodontal Regeneration – Furcation Defects: A Systematic Review From the AAP Regeneration Workshop

Ávila‐Ortiz

Buitrago

Reddy

2015

Journal of Periodontology

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Background: The aim of this review is to present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy to provide clinical guidelines for the therapeutic management of furcation defects and to identify priorities for future research that may advance the understanding of periodontal regenerative medicine.Methods: A comprehensive search based on predetermined eligibility criteria was conducted to identify human original studies and systematic reviews on the topic of periodontal regeneration of furcation defects. Two reviewers independently screened the title and abstract of the entries yielded from the initial search. Subsequently, both reviewers read the full-text version of potentially eligible studies, made a final article selection, and extracted the data of the selected studies considering specific clinical scenarios. The clinical scenarios contemplated in this review included the following: 1) facial and interproximal Class I defects in maxillary molars; 2) facial and lingual Class I defects in mandibular molars; 3) facial and interproximal Class II furcation defects in maxillary molars; 4) facial and lingual Class II furcation defects in mandibular molars; 5) Class III furcation defects in maxillary molars; 6) Class III furcation defects in mandibular molars; and 7) Class I, II, or III furcation defects in maxillary premolars. Endpoints of interest included different clinical, radiographic, microbiologic, histologic, and patient-reported outcomes.Results: The initial search yielded a total of 1,500 entries. The final selection consisted of 150 articles, of which six were systematic reviews, 109 were clinical trials, 27 were case series, and eight were case reports. A summary of the main findings of previously published systematic reviews and the available evidence relative to the indication of regenerative approaches for the treatment of furcation defects compared with conventional surgical therapy are presented. Given the marked methodologic heterogeneity and the wide variety of materials and techniques applied in the selected clinical trials, the conduction of a meta-analysis was not viable.Conclusions: On the basis of the reviewed evidence, the following conclusions can be drawn. 1) Periodontal regeneration has been demonstrated histologically and clinically for the treatment of maxillary facial or interproximal and mandibular facial or lingual Class II furcation defects. 2) Although periodontal regeneration has been demonstrated histologically for the treatment of mandibular Class III defects, the evidence is limited to one case report. 3) Evidence supporting regenerative therapy in maxillary Class III furcation defects in maxillary molars is limited to clinical case reports. 4) In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although most Class I furcation defects may be successfully treated with non-regen...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Periodontal Regeneration – Furcation Defects: A Systematic Review From the AAP Regeneration Workshop

Ávila‐Ortiz

Buitrago

Reddy

2015

Journal of Periodontology

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“…The in vivo effects of EMD on ossification remain unclear. Some groups reported enhanced bone induction in vivo in both animals and humans (Hammarstrom et al, 1997; Boyan et al, 2000; Jaiswal and Deo, 2013) while others showed no effect of EMD on the formation of mineralized bone (Schneider et al, 2011). Yagi showed that EMD inhibits RANKL expression, resulting in inhibited osteoclast formation, the cells that are responsible for bone resorption (Yagi et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Enamel Matrix Derivative has No Effect on the Chondrogenic Differentiation of Mesenchymal Stem Cells

Groeneveldt

Knuth

Witte-Bouma

et al. 2014

Front. Bioeng. Biotechnol.

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Background: Treatment of large bone defects due to trauma, tumor resection, or congenital abnormalities is challenging. Bone tissue engineering using mesenchymal stem cells (MSCs) represents a promising treatment option. However, the quantity and quality of engineered bone tissue are not sufficient to fill large bone defects. The aim of this study was to determine if the addition of enamel matrix derivative (EMD) improves in vitro chondrogenic priming of MSCs to ultimately improve in vivo MSC mediated endochondral bone formation.Methods: MSCs were chondrogenically differentiated in 2.0 × 105 cell pellets in medium supplemented with TGFβ3 in the absence or presence of 1, 10, or 100 μg/mL EMD. Samples were analyzed for gene expression of RUNX2, Col II, Col X, and Sox9. Protein and glycoaminoglycan (GAG) production were also investigated via DMB assays, histology, and immunohistochemistry. Osteogenic and adipogenic differentiation capacity were also assessed.Results: The addition of EMD did not negatively affect chondrogenic differentiation of adult human MSCs. EMD did not appear to alter GAG production or expression of chondrogenic genes. Osteogenic and adipogenic differentiation were also unaffected though a trend toward decreased adipogenic gene expression was observed.Conclusion: EMD does not affect chondrogenic differentiation of adult human MSCs. As such the use of EMD in combination with chondrogenically primed MSCs for periodontal bone tissue repair is unlikely to have negative effects on MSC differentiation.

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Regenerative Therapy of Furcations in Human Clinical Studies

Jepsen

2018

Diagnosis and Treatment of Furcation‐Involved Teeth

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Evaluation of the Effectiveness of Enamel Matrix Derivative, Bone Grafts, and Membrane in the Treatment of Mandibular Class II Furcation Defects

Cited by 30 publications

References 0 publications

Periodontal Regeneration – Furcation Defects: A Systematic Review From the AAP Regeneration Workshop

Periodontal Regeneration – Furcation Defects: A Systematic Review From the AAP Regeneration Workshop

Enamel Matrix Derivative has No Effect on the Chondrogenic Differentiation of Mesenchymal Stem Cells

Regenerative Therapy of Furcations in Human Clinical Studies

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