Histologic Evaluation of Periodontal Healing in Humans Following Regenerative Therapy With Enamel Matrix Derivative. A 10‐Case Series

Yukna, Raymond A.; Mellonig, James T.

doi:10.1902/jop.2000.71.5.752

Cited by 223 publications

(236 citation statements)

References 15 publications

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“…In addition, evaluation of 10 intrabony defects in eight patients treated with EMD revealed histologic evidence of regeneration in only 3 specimens (Yukna and Mellonig, 2000). The healing of the rest of the specimens was characterized by new attachment (connective tissue/adhesion only), or by long junctional epithelium.…”

Section: (6):382-402 (2004)mentioning

confidence: 99%

See 1 more Smart Citation

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

Venezia

Goldstein

Boyan

et al. 2004

Critical Reviews in Oral Biology & Medicine

158

110

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Background-Periodontal disease results in the loss of the attachment apparatus. In the last three decades, an increasing effort has been placed on seeking procedures and materials to promote the regeneration of this tissue. The aim of this paper is to evaluate the effect of enamel matrix derivative (EMD) during regenerative procedures. In addition, a meta-analysis is presented regarding the clinical results during regeneration with EMD, to gain evidence as to what can be accomplished following treatment of intrabony defects with EMD in terms of probing depth reduction, clinical attachment level gain, defect fill (using re-entry studies), and radiographic parameters. Methods-The review includes in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findings. In addition, a meta-analysis is presented regarding the regenerative clinical results. For this purpose, we used 28 studies-including 955 intrabony defects treated with EMD that presented baseline and final data on probing depth, clinical attachment level (CAL) gain, or bone gain-to calculate weighted mean changes in the different parameters. The selected studies were pooled from the MEDLINE database at the end of May, 2003. Results-The meta-analysis of intrabony defects treated with EMD resulted in a mean initial probing depth of 7.94 ± 0.05 mm that was reduced to 3.63 ± 0.04 mm (p = 0.000). The mean clinical attachment level changed from 9.4 ± 0.06 mm to 5.82 ± 0.07 mm (p = 0.000). These results were significantly better than the results obtained for either open-flap debridement (OFD) or guided tissue regeneration (GTR). In contrast, histologically, GTR is more predictable than EMD in terms of bone and cementum formation. No advantage was found for combining EMD and GTR. Xenograft, or EMD and xenograft, yielded inferior results compared with EMD alone, but a limited number of studies evaluated this issue. Promising results were noted for the combination of allograft materials and EMD. Conclusions-EMD seems to be safe, was able to regenerate lost periodontal tissues in previously diseased sites based on clinical parameters, and was better than OFD or GTR. Its combination with allograft materials may be of additional benefit but still needs to be further investigated.Key words. Enamel matrix derivative, Emdogain ® , meta-analysis, periodontal regeneration. States Food and Drug Administration (FDA).In 1997, an alternative approach for periodontal regeneration was introduced that was based on embryonic tooth formation (Hammarström, 1997;Heijl et al., 1997). This approach uses an extract of embryonic enamel matrix, termed 'enamel matrix derivative' (EMD), thought to induce mesenchymal cells to mimic the processes that take place during the development of the nascent root and periodontal tissues. The present analysis reviews the data on the effect of EMD as a regenerative promoter. It encompasses in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findin...

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Section: (6):382-402 (2004)mentioning

confidence: 99%

“…One study could not demonstrate any relationship between the baseline attachment loss and the clinical attachment gain (Silvestri et al, 2000). In addition, there was no relationship between defect depth and histologic results (Yukna and Mellonig, 2000).( II.6.2.6 …”

mentioning

confidence: 99%

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

Venezia

Goldstein

Boyan

et al. 2004

Critical Reviews in Oral Biology & Medicine

158

110

View full text Add to dashboard Cite

show abstract

“…New alveolar bone had regenerated on 65% of the initial bone height. In another study Yukna and Mellonig [68] treated 10 intrabony periodontal defects in 8 patients with EMD. Histological analysis 6 months later showed complete periodontal regeneration (i.e.…”

Section: Human Histological Studiesmentioning

confidence: 99%

The Application of an Enamel Matrix Protein Derivative (Emdogain®) in Regenerative Periodontal Therapy: A Review

et al. 2007

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Regenerative periodontal therapy aims at reconstitution of the lost periodontal structures such as new formation of root cementum, periodontal ligament and alveolar bone. Findings from basic research indicate that enamel matrix protein derivative (EMD) has a key role in periodontal wound healing. Histological results from animal and human studies have shown that treatment with EMD promotes periodontal regeneration. Moreover, clinical studies have indicated that treatment with EMD positively influences periodontal wound healing in humans. This review aims to present an overview of evidence-based clinical indications for regenerative therapy with EMD.

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“…One of the indications for the use of EMDPs is for the management of infrabony periodontal defects (IPD). The use of EMDP in such defects has been histologically evaluated in animals (19,20) and in humans (8,15,21,22) with promising results regarding periodontal regeneration, and their clinical results have been shown to be significantly better than those of their comparative controls (14,15,(23)(24)(25)(26)(27)(28)(29).…”

Section: Introductionmentioning

confidence: 99%

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

Zanatta

Souza²,

Pinto

et al. 2013

Braz. Dent. J.

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Previous systematic reviews have demonstrated better results with enamel matrix derivative proteins (EMDP) as compared with open flap debridement (OFD) for the management of infrabony periodontal defects (IPD). The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies. Cochrane Central Register of Controlled Trials, Medline/PubMed, Lilacs, Embase and Web of Science electronic databases were searched up to August 2013 for randomized clinical trials.Eligible outcomes were changes in probing depth (PD), clinical attachment level (CAL),gingival recession (GR) and bone changes (BC). Studies with follow-up of 12 months showed differences of 0.97 mm (CI95% 0.52 -1.43) and 1.19 mm (CI95% 0.77 -1.60) for PD and CAL, respectively, favorable for EMDP. Studies with follow-up ≥ 24 months presented advantages of 1.11 mm (CI95% 0.74 -1.48) for CAL and 0.83 mm (CI95% 0.19 -1.48) for PD,with use of EMDP. Considering the quality of studies, those with low risk of bias showed lower difference between groups, presenting 0.8 mm (CI95% 0.24-1.36) for CAL, favorable for EMDP and without differences for PS (0.51 mm, CI95% -0.21 -1.23). In conclusion, follow-up time (< or > 2 years) and the risk of bias influence the results of treatment with EMDP in IPD.

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Histologic Evaluation of Periodontal Healing in Humans Following Regenerative Therapy With Enamel Matrix Derivative. A 10‐Case Series

Abstract: The results of this study fulfill the proof of principle that use of EMD can result in periodontal regeneration on previously diseased root surfaces in humans, but on an inconsistent basis.

Cited by 223 publications

References 15 publications

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

The Application of an Enamel Matrix Protein Derivative (Emdogain®) in Regenerative Periodontal Therapy: A Review

Do the Clinical Effects of Enamel Matrix Derivatives in Infrabony Defects Decrease Overtime? A Systematic Review and Meta-Analysis

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