Enamel matrix derivative (EMD) has recently been introduced as a new modality in regenerative periodontal therapy. This case report demonstrates a combined approach in topical application of EMD gel (Emdogain®) and autogenous bone grafts for treatment of intrabony defects and furcation involvement defects in a patient with chronic periodontitis. The seven-month post-surgery clinical and radiographic results were presented. The combined application of EMD gel with autogenous bone grafts in intrabony osseous defects resulted in clinically significant gain of attachment on diseased root surfaces and bone fill on radiographs. Further controlled clinical studies are required to confirm the long-term effectiveness of the combination of EMD gel and autogenous bone grafts in treatment of various osseous defects in subjects with chronic periodontitis.
TakataT, KatauchiK, MiyauchiM, OgawaI, AkagawaY, NikaiH.Periodontal tissue regeneration on the surface of synthetic hydroxy-apatite implanted into root surface. J Periodontol1995;66:125–30.
5.
RegisterAA, BurdickFA.Accelerated reattachment with cementogenesis to dentin, demineralized in situ. II. Defect repair. J Periodontol1976;47:497–505.
6.
KarringT, NymanS, GottlowJ, LaurellL.Development of the biological concept of guided tissue regeneration—animal and human studies. Periodontol 20001993;1:26–35.
7.
GiannobileWV.Periodontal tissue engineering by growth factors. Bone1996;19(1 Suppl):23S–37S.
8.
BowersG, FeltonF, MiddletonC, GlynnD, SharpS, MellonigJ, . Histologic comparison of regeneration in human intrabony defects when osteogenin is combined with demineralized freeze-dried bone allograft and with purified bovine collagen. J Periodontol1991;62:690–702.
9.
McClainPK, SchallhornRG.Long-term assessment of combined osseous composite grafting, root conditioning, and guided tissue regeneration. Int J Periodontics Restorative Dent1993;13:9–27.
10.
GuilleminMR, MellonigJT, BrunsvoldMA.Healing in periodontal defects treated by decalcified freeze-dried bone allografts in combination with ePTFE membranes (I). Clinical and scanning electron microscope analysis. J Clin Periodontol1993;20:528–36.
11.
WallaceSC, GellinRG, MillerMC, MishkinDJ.Guided tissue regeneration with and without decalcified freeze-dried bone in mandibular Class II furcation invasions. J Periodontol1994;65:244–54.
12.
HammarstromL.Enamel matrix, cementum development and regeneration. J Clin Periodontol1997;24:658–68.
13.
GestreliusS, AnderssonC, JohanssonAC, PerssonE, BrodinA, RydhagL, . Formulation of enamel matrix derivative for surface coating. Kinetics and cell colonization. J Clin Periodontol1997;24:678–84.
14.
HeijlL, HedenG, SvardstromG, OstgrenA.Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. J Clin Periodontol1997;24:705–14.
15.
ZetterstromO, AnderssonC, ErikssonL, FredrikssonA, FriskoppJ, HedenG, . Clinical safety of enamel matrix derivative (EMDOGAIN) in the treatment of periodontal defects. J Clin Periodontol1997;24:697–704.
16.
SculeanA, DonosN, BlaesA, LauermannM, ReichE, BrecxM.Comparison of enamel matrix proteins and bioabsorbable membranes in the treatment of intrabony periodontal defects. A split-mouth study. J Periodontol1999;70:255–62.
17.
OkudaK, MomoseM, MiyazakiA, MurataM, YokoyamaS, YonezawaY, . Enamel matrix derivative in the treatment of human intrabony osseous defects. J Periodontol2000;71:1821–8.
18.
MellonigJT.Enamel matrix derivative for periodontal reconstructive surgery: technique and clinical and histologic case report. Int J Periodontics Restorative Dent1999;19:8–19.
19.
SculeanA, ChiantellaGC, WindischP, DonosN.Clinical and histologic evaluation of human intrabony defects treated with an enamel matrix protein derivative (Emdogain). Int J Periodontics Restorative Dent2000;20:374–81.
20.
LekovicV, CamargoPM, WeinlaenderM, NedicM, AleksicZ, KenneyEB.A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans. J Periodontol2000;71:1110–6.
21.
WenzelA, WarrerK, KarringT.Digital subtraction radiography in assessing bone changes in periodontal defects following guided tissue regeneration. J Clin Periodontol1992;19:208–13.
22.
BlumenthalN, SteinbergJ.The use of collagen membrane barriers in conjunction with combined demineralized bone-collagen gel implants in human infrabony defects. J Periodontol1990;61:319–27.
