Regenerative Periodontal Endoscopy (RPE) – Periodontal endoscopy and Emdogain
Non-surgical periodontal bone fill is finally possible thanks to a new biological technology called Emdogain, by Straumann. But what is Emdogain and how does it work? The following post will help clarify what Emdogain is and also help the reader to understand the tremendous benefits of endoscope assisted regeneration using this natural protein.
IMPORTANT: Emdogain is used non surgically at PerioPeak Innovations with an innovative technique and protocol utilizing a periodontal endoscope, soft tissue laser, micro-piezo ultrasonics, and enzyme inhibitors. Emdogain is typically used only during some type of flap periodontal surgery procedure. However, a recent study demonstrates histological bone regeneration with Emdogain used in a non surgical periodontal therapy approach.
So what exactly is Emdogain?
Emdogain contains Enamel Matrix Protiens, or Bioactive Molecules, called amelogenin proteins, which are harvested from the developing teeth of pigs. What are enamel matrix proteins and how do they help humans to regenerate periodontal tissues and bone? The answer is in the unique biology of tooth development. When teeth are still developing, we can extract these “bioactive molecules” and use them in humans for the stimulation of adult stem cells to promote regeneration in periodontal defects created by chronic or acute infections of the gums. The body responds by growing new cementum, ligament, and bone (osteogenesis) in areas where periodontal disease has damaged these important supporting structures. The damage of periodontal disease can be repaired and reversed with Emdogain.
The Mechanism of Emdogain:
Attachment – the mesenchymal cells attach to the root surface covered by Emdogain.
Proliferation and Growth -the cells start to produce cementum. Cementum is the key tissue in periodontal regeneration. The recreation of alveolar bone starts from the root cementum.
Alveolar Bone – the process of mineralization starts a certain distance from the root and alveolar bone (periodontal bone around the teeth) is formed.
Note: Efficient piezo microscopic root debridement (proper root preparation) and laser soft tissue curettage are guided by the use of a periodontal endoscope with 48X magnification.
View non-surgical bone restoration cases using endoscope assisted RPE techniques instead of surgery.
The DV2 Dental Endoscope with 48X Magnification is used to definitively access and clean all root surfaces prior to the placement of Emdogain with this non surgical technique.
Summary of the Clinical Benefits of Emdogain:
James T. Mellonig,* Pilar Valderrama,* Holly J. Gregory,* and David L. Cochran* (read entire paper)
EMD stimulates fibroblast proliferation, the growth of periodontal ligament (PDL) cells, osteogenesis, and the proliferation and differentiation of osteoblasts; it also prolongs osteoblast growth and enhances trabecular bone regeneration, promotes osteoprotegerin production, and enhances osteopontin expression and transforming growth factor-beta1 production. EMD stimulates bone sialoprotein, signal transduction of bone morphogenetic protein, release of vascular endothelial growth factor, and angiogenesis. EMD also has anti-inflammatory properties. It limits the release of proinflammatory cytokines, modulates tumor necrosis factor-alpha and prostaglandin, and inhibits caspase activation. EMD has a negative effect on the growth of periodontal pathogens and might be useful as an antiadhesive agent for breast cancer cells.
The history of Emdogain:
- 1995 CE Certification
- 1996 FDA approval- 1997 introduction into the US market.
- Since 1989 produced in Malmo Sweden
- 2004 completion of integration by Straumann.
There are numerous studies involving the safety, efficacy, and statistical clinical significance with Emdogain. Over one million people have been treated successfully with Emdogain. Go to www.straumann.com for more information.