Clinical effect of enamel matrix derivative(EMD) in the treatment of periodontal intrabony defects

골내 결손부에서 법랑기질 유도체의 임상적 효과

  • Lee, Kyung-Jin (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Kim, Min-Jung (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Yun, Jeong-Ho (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Jung, Ui-Won (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Kim, Chang-Sung (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Choi, Seong-Ho (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Cho, Kyoo-Sung (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Chai, Jung-Kiu (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University) ;
  • Kim, Chong-Kwan (Department of Periodontology, Research institute for Periodontal Regeneration, College of Dentistry, Brain Korea 21 Project for Medical Science, Yonsei University)
  • 이경진 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 김민중 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 윤정호 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 정의원 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 김창성 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 최성호 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 조규성 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 채중규 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단) ;
  • 김종관 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소, BK21 의과학 사업단)
  • Published : 2004.09.30

Abstract

tachment level was changed from $8.67{\pm}1.72mm$ to $7.00{\pm}1.60mm$ (control); from $8.93{\pm}2.23mm$ to $6.00{\pm}1.92mm$ (test); and bone probing depth was decreased from $10.20{\pm}1.90mm$ to $9.07{\pm}1.95mm$ (control); from $10.14{\pm}2.14mm$ to $7.43{\pm}2.06mm$ (test). This study indicates that treatment of periodontal intrabony defects with EMD is clinically superior to treatment without EMD (OFD alone) in every parameter evaluated. Within the limits of this study, the application of EMD in intrabony defects resulted in clinically significant gain of clinical attachment level and decrease of bone probing depth. And further controlled clinical studies are required to confirm the effectiveness of the EMD in the treatment of various osseous defects.

Keywords

References

  1. Zander HA, Polson AM, Heijl LC: Goals of peri-odontal therapy. J periodontol 47:261-6, 1976
  2. Garrett S: Periodontal regeneration around nat-ural teeth. Ann Periodontol 1: 662-66, 1996
  3. Hirooka H: The biologic concept for the use of enamel matrix protein : True periodontal regen-eration. Quintessence Int 29: 621-30, 1998
  4. Pearson GE, Rosen S, Deporter DA: Preliminary observations on the usefulness of a decalcified, freeze-dried cancellous bone allograft material in periodontal surgery. J Periodontol 52: 55-9, 1981
  5. Quintero G, Mellonig JT, Gambill VM, Pelleu GB Jr: A six-month clinical evaluation of decalcified freeze-dried bone allografts in periodontal osseous defects. J Periodontol 53: 726-30, 1982
  6. Barnett JD, Mellonig JT, Gray JL, Towle HJ: Comparison of freeze-dried bone allograft and porous hydroxylapatite in human periodontal defects. J. Periodontol 60 : 231-7, 1989
  7. Gottlow J, Nyman S, Lindhe J, Karring T, Wennstrom J: New attachment formation in the human periodontium by guided tissue regenera-tion. Case reports. J Clin Periodontol 13: 604-16, 1986
  8. Nyman S, Gottlow J, Karring T, Lindhe J: The regenerative potential of the periodontal liga-ment. An experimental study in the monkey. J Clin Periodontol 9: 257-65, 1982a
  9. Gestrelius S, Andersson C, Lidstrom D, Hammarstrom L, Somerman M: In vitro studies on periodontal ligament cells and enamel matrix derivative. J Clin Periodontol 24: 685-92, 1997b
  10. Hammarstrom L: Enamel matrix, cementum development and regeneration. J Clin Periodontol 24: 658-68, 1997
  11. Zetterstrom O, Andersson C, Eriksson L: Clinical safety of enamel matrix derivative(Emdogain) in the treatment of periodontal defects. J Clin Periodontol 24:697-704, 1997
  12. Owens PD: Ultrastructure of Hertwig's epithelial root sheath during early root development in premolar teeth in dogs. Arch Oral Biol 23: 91-104, 1978
  13. Cho MI, Lin WL, Garant PR: Occurrence of epidermal growth factor-binding sites during differ-entiation of cementoblasts and periodontal liga-ment fibroblasts of the young rat: a light and electron microscopic radioautographic study. Anat Rec 231: 14-24, 1991
  14. Slavkin He: Towards a cellular and molecular understanding of periodontics. : Cementogenesis revisited. J Periodontal 47: 249-55, 1976
  15. Kollar EJ, Baird GR: Tissue interactions in embryonic mouse tooth germs. I. Reorganization of the dental epithelium during tooth-germ reconstruction. J Embryol Exp Morphol 24: 159-71, 1970a
  16. Kollar EJ, Baird GR: Tissue interactions in embryonic mouse tooth germs. II. The inductive role of the dental papilla. J Embryol Exp Morphol 24: 173-86, 1970b
  17. Thesleff I, Hurmerinta K: Tissue interactions in tooth development. Differentiation 18: 75-88, 1981
  18. Thesleff I, Partanen AM, Vainio S: Epithelial-mes-enchymal interactions in tooth morphogenesis : the roles of extracellular matrix, growth factors, and cell surface receptors. J Craniofac Genet Dev Biol 11: 229-37, 1991
  19. Gestrelius S, Andersson C, Johansson AC, Persson E, Brodin A, Rydhag L, Hammarstrom L: Formulation of enamel matrix derivative for sur-face coating. Kinetics and cell colonization. J Clin Periodontol 24: 678-84, 1997a
  20. Hammarstrom L, Heijl L, Gestrelius S: Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins. J Clin Periodontol 24: 669-77, 1997
  21. 오제익, 최성호, 이승원, 조규성, 김종관, 채중규: 성견의 1면 골결손부에서 법량기질 유도체가 치주조직 치유에 미치는 영향. 대한치주과학회지 27:767-82, 1997
  22. Wikesjo UM, Nilveus R: Periodontal repair in dogs: effect of wound stabilization on healing. J Periodontol 61:719-24, 1990
  23. 최성호, 김창성, 서종진, 김현영, 김정혜, 조규성, 김종관. 성견 1면 치조골 결손부에서 $Emdogain^{\circledR}$과 Emdogain 및 특수 제조된 Calcium Sulfate Paste 혼합물이 치주조직 치유에 미치는 영향. 대한치주과학회지 30: 539-53, 2000
  24. 김종관: 성견 1면 치조골 결손부에서 특수제조된 calcium sulfate paste가 치주조직 치유에 미치는영향. 대한치주과학회지 29: 153-71, 1999
  25. 서혜연, 최성호, 문익상, 조규성, 김종관, 채중규: 성견의 1면 골내낭에 calcium sulfate 이식이 치주조직 치유에 미치는 영향. 대한치주과학회지 27: 363-77, 1997
  26. Silness J, Loe H: Periodontal disease in pregnan-cy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22: 121-35, 1964
  27. Nyman S, Lindhe J, Karring T, Rylander H: New attachment following surgical treatment of human periodontal disease. J Clin Periodontol 9: 290-6, 1982b
  28. Matsuda N, Lin WL, Kumar NM, Cho MI, Genco RJ: Mitogenic, chemotactic, and synthetic responses of rat periodontal ligament fibroblastic cells to polypeptide growth factors in vitro. J Periodontol 63: 515-25, 1992
  29. Heijl L: Periodontal regeneration with enamel matrix derivative in one human experimental defect. A case report. J Clin Periodontol 24: 693-6, 1997
  30. Heijl L, Heden G, Svardstrom G, Ostgren A: Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. J Clin Periodontol 24: 705-14, 1997
  31. Pontoriero R, Wennstrom J, Lindhe J: The use of barrier membranes and enamel matrix proteins in the treatment of angular hone defects. A prospective controlled clinical study. J Clin Periodontol 26: 833-40, 1999
  32. Heden G, Wennstrom J, Lindhe J: Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects. A series of case reports. J Clin Periodontol 26: 855-60, 1999
  33. Heden G: A Case Report Study of 72 Consecutive Emdogain-Treated Intrabony Periodontal Defects: Clinical and Radiographic Findings After 1 Year. Int J Periodontics Restorative Dent 20: 127-139, 2000
  34. Froum SJ, Weinberg MA, Rosenberg E, TarnowD: A comparative study utilizing open flap debridement with and without enamel matrix derivative in the treatment of periodontal intra-bony defects: a 12-month re-entry study. J Periodontol 72: 25-34, 2001
  35. Esposito M, Coulthard P, Worthinton HV: Enamel matrix derivative (Emdogain) for peri-odontal tissue regeneration in intrabony defects. Cochrane Database Syst Rev 2: CD003875, 2003
  36. Sculean A, Donos N, Miliauskaite A, Arweiler N, Brecx M: Treatment of intrabony defects with enamel matrix proteins or bioabsorbable mem-branes. A 4-year follow-up split-mouth study. J Periodontol 72: 1695-701, 2001
  37. Silvestri M, Ricci G, Rasperini G, Sartori S, Cattaneo V: Comparison of treatment of infrabony defects with enamel matrix derivative, guided tissue regeneration with a nonresorbable membrane and Widman modified flap. J Clin Periodontol 27: 603-10, 2000
  38. Giannobile WV, Somerman MJ: Growth and amelogenin-like factors in periodontal wound healing. A systematic review. Ann Periodontol 8: 193-204, 2003
  39. Westfelt E, Bragd L, Socransky SS, Haffajee AD, Nyman S, LindheJ Improved periodontal condi-tions following therapy. J Clin Periodontol 12: 283-93, 1985
  40. Mombelli A, Lehmann B, Tonetti M, Lang NP: Clinical response to local delivery of tetracycline in relation to overall and local periodontal condi-tions. J Clin Periodontol 24: 470-477, 1997
  41. Okuda K, Momose M, Miyazaki A, Murata M, Yokoyama S, Yonezawa Y, Wolff LF, Yoshie H: Enamel Matrix Derivative in the Treatment of Human Intrabony Osseous Defects. J Periodontol 71: 1821-28, 2000