Replantation of permanent incisors in children using Emdogain^®

Abstract

The aim of this study was to determine whether application of an enamel matrix protein derivative, Emdogain (Biora AB Malmo, Sweden) to the root surface of avulsed permanent incisors would improve postreplantation outcomes in a pediatric population. Between June 1999 and May 2002, 25 avulsed permanent maxillary incisors (22 centrals and three laterals) were treated with Emdogain and followed for up to 32 months, mean duration 20.6 months (range: 6.9-32.5 months). Mean patient age at the time of treatment was 12.0 years (range: 7.7-17.6 years) and mean extra-alveolar duration was 185 min (range: 100-300 min). At the end of their follow-up each of the replanted incisors demonstrated radiographic evidence of replacement root resorption and clinical evidence of ankylosis. None of the replanted teeth were affected by inflammatory root resorption and there was no evidence of infection. When compared with the control samples from Barrett and Kenny (Endod Dent Traumatol 1997;15:269-72.) and Andersson et al. (Endod Dent Traumatol 1989;5:38-47.) this sample treated with the Emdogain protocol demonstrated significantly less root resorption than either of the control samples (anova, P < 0.0001). Although the Emdogain protocol did not produce periodontal regeneration, it did eliminate inflammatory resorption and infection and led to significantly less root resorption compared with the two historical controls.

Amelogenins promote an alternatively activated macrophage phenotype in vitro

“…The large increase in AMAC-1 levels indicates macrophage activation towards a reparative phenotype. Clinically, amelogenin treatment (Emdogain ® ) also promotes tissue regeneration (Barrett et al, 2005;Fujishiro et al, 2008). Whether these beneficial effects can be attributed to the alternatively activated macrophages is discussed in the literature (Daley et al, 2010;Fujishiro et al, 2008).…”

National Athletic Trainers' Association Position Statement: Preventing and Managing Sport-Related Dental and Oral Injuries

“…The avulsed tooth must first be located and replantation attempted within 5 minutes. 29,46,111,112,120,122,123 To prevent additional trauma to the PDL, practitioners should refrain from handling the tooth by its root, as maintaining the viability of the PDL cells on the root surface is critical to a positive clinical outcome. Debris should never be brushed or scrubbed from the tooth, and the tooth should not be sterilized with boiling water or chemicals.…”

The effect of cathepsin K inhibitor surface treatment on delayed tooth replantation in dogs

“…4 Therefore, avulsed teeth should be treated with an agent that is able to inhibit the resorption after delayed replantation. 6 Enamel matrix derivative is also used to promote periodontal regeneration, and its ability to inhibit the resorption of avulsed teeth in animals and humans has been investigated, [7][8][9] in addition to the topical application of alendronate (a bisphosphonate widely used for the treatment of osteoporosis), which has been shown to inhibit root resorption in an animal model 6 Enamel matrix derivative is also used to promote periodontal regeneration, and its ability to inhibit the resorption of avulsed teeth in animals and humans has been investigated, [7][8][9] in addition to the topical application of alendronate (a bisphosphonate widely used for the treatment of osteoporosis), which has been shown to inhibit root resorption in an animal model …”