Endoscope Assisted Bone Regeneration with Emdogain
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, precision micro-piezo ultrasonics, and enzyme inhibitor medication. 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.
What 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 (thorough root detoxification) is guided by the use of
a periodontal endoscope with 48X magnification.
View RPE non-surgical bone regeneration cases using endoscope assisted RPE techniques instead of surgery.
The Perioscopy Unit with 48X magnification is incorporated
to definitively access and detoxify all root surfaces prior to the
placement of Emdogain with this technique.
Summary of the Clinical Benefits of Emdogain:
Clinical and Histologic Evaluation of Non-Surgical
Periodontal Therapy With Enamel Matrix
Derivative: A Report of Four Cases
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:
– 1988 Biora founded by Professor Lars Hammerstrom, Stockholm Sweden.
– 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.