Periodontal regeneration with enamel matrix derivative in the management of generalized aggressive periodontitis: A case report with 11-year follow-up and literature review

Abstract

Objectives: Aggressive periodontitis (AgP) represents an uncommon but rapidly advanced inflammatory process, which involves the destruction of periodontal tissues. This study aimed to report a case of generalized AgP (GAgP), where the treatment approach consists of the utilization of the full-mouth disinfection protocol (FMDP) in conjunction with flap curettage and regenerative appliance of enamel matrix derivatives (EMDs). The associated literature was also reviewed. Materials and Methods: A 19-year-old female patient was diagnosed with GAgP. The treatment was initiated with FMDP and administration of antibiotics. Afterward, open flap debridement was performed, and EMD was selected as the regenerative material for the reconstruction of the periodontal defects. Over an 11-year period and during all the phases of the treatment, the outcomes were regularly evaluated with clinical measurements and radiographic controls. Results: The 11-year results demonstrated no recurrence of disease, and the patient's periodontal health exhibited evident improvement. Overall, the pocket depths presented satisfactory reduction while the clinical attachment loss (CAL) was improved. Both our limited experience and available literature data revealed that the use of EMD in AgP treatment contributes to bone fill of the intrabony defects as well as regeneration of the destructed periodontal apparatus. Conclusions: Although the outcomes of this treatment approach have not been widely evaluated, it seems that the use of EMD may be an effective means of periodontal regeneration in patients with GAgP. Additional prospective studies with adequate number of GAgP patients are essential to thoroughly assess the effectiveness of this approach.

Effects of Enamel Matrix Derivative on Cell Spheroids Made of Stem Cells Obtained from the Gingiva on Osteogenic Differentiation

“…A bone substitute and enamel matrix derivative were used to repair the buccal plate extraction socket [ 28 ]. Additionally, it was hypothesized that using an enamel matrix derivative could help patients whose inflammatory processes were fast progressing and causing the degeneration of periodontal tissue [ 29 ]. Additionally, severe intrabony flaws linked with the palatal radicular groove were successfully treated without endodontic therapy or retreatment by applying an enamel matrix derivative [ 30 ].…”

Baricitinib alleviates lipopolysaccharide‑induced human periodontal ligament stem cell injury and promotes osteogenic differentiation by inhibiting JAK/STAT signaling

“…A number of studies have demonstrated that periodontitis is associated with the initiation or progression of various systemic diseases, such as cardiovascular and chronic kidney disease and diabetes (6)(7)(8). Although progress has been achieved in the treatment of periodontitis, including skin flap curettage, scaling and root planting, the effects of the aforementioned therapies only control the development of this condition (9)(10)(11). Therefore, it is of clinical importance to investigate promising therapeutic agents for periodontitis to improve oral health and avert the development of systemic disease.…”

Hyperoside ameliorates periodontitis in rats by promoting osteogenic differentiation of BMSCs via activation of the NF‐κB pathway

“…In recent years, with the development of regenerative medicine and tissue engineering technology, the focus of periodontitis treatment has shifted from the control of soft tissue inflammation to the control of pathological bone loss, so as to achieve periodontal tissue regeneration [6][7][8]. At present, a variety of regeneration methods have been proposed to treat periodontitis, including guided tissue regeneration, application of platelet-rich plasma, enamel matrix derivative and so on [9][10][11]. However, most of these treatment methods have shown variable and unpredictable clinical results.…”