scholarly journals Two-stage approach for class II mandibular furcation defect with insufficient keratinized mucosa: a case report with 3 years’ follow-up

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110445
Author(s):  
Hiroyuki Saida ◽  
Shunsuke Fukuba ◽  
Takahiko Shiba ◽  
Keiji Komatsu ◽  
Takanori Iwata ◽  
...  
Keyword(s):  
Case Report ◽  
Periodontal Regeneration ◽  
Gingival Recession ◽  
Enamel Matrix Derivative ◽  
Enamel Matrix ◽  
Two Stage ◽  
Probing Depth ◽  
Keratinized Mucosa ◽  
Depth Reduction ◽  
Matrix Derivative

Periodontal regenerative treatment is useful for intrabony defects and furcation involvement, but is difficult when there is insufficient keratinized mucosa to cover and maintain the regenerative material, particularly in the mandibular molar region. We report the case of a 27-year-old woman who underwent a two-stage surgical approach for a class II furcation defect with gingival recession and insufficient keratinized mucosal width (KMW) and vestibular depth at the mandibular left first molar. We first improved the KMW and keratinized mucosal thickness using an epithelial embossed connective tissue graft with enamel matrix derivative, and then focused on periodontal regeneration at the furcation defect using an enamel matrix derivative and a bovine-derived xenograft. Probing depth reduction, clinical attachment gain, horizontal probing depth reduction, KMW gain, and gingival recession reduction were observed 3 years postoperatively. This case report suggests that this novel staged approach may be effective for treating furcation defects with insufficient keratinized mucosa, thus providing useful insights into periodontal regeneration therapy.

scholarly journals Single flap approach with or without enamel matrix derivative in the treatment of severe supraosseous defects: a retrospective study

2021 ◽  
Author(s):  
Anna Simonelli ◽  
Luigi Minenna ◽  
Leonardo Trombelli ◽  
Roberto Farina
Keyword(s):  
Clinical Effectiveness ◽  
Gingival Recession ◽  
Enamel Matrix Derivative ◽  
Enamel Matrix ◽  
Clinical Attachment Level ◽  
Post Surgery ◽  
Probing Depth ◽  
Deep Pockets ◽  
Attachment Level ◽  
Matrix Derivative

Abstract Aim To comparatively evaluate the clinical effectiveness of the single flap approach (SFA) with and without enamel matrix derivative (EMD) in the treatment of supraosseous defects (SDs) associated with deep pockets. Materials and methods Twenty patients, each contributing one SD associated with a deep (≥ 6 mm) pocket and treated with buccal SFA either alone (SFA group; n = 10) or in combination with EMD (SFA+EMD group; n =10), were retrospectively selected. Clinical parameters (probing depth, PD; clinical attachment level, CAL; gingival recession, REC) had been assessed at pre-surgery and 12 months post-surgery. Results Complete wound closure was observed in 70% and 80% of defects treated with SFA and SFA+EMD, respectively. Treatments resulted in a significant PD reduction of 3.1±1.0 mm (p=0.005). In SFA+EMD group, 100% of closed pockets was obtained, while 90% of closed pockets was observed in SFA group. Both treatments resulted in a significant CAL gain of 2.1±0.9 mm and 1.9±1.7 mm in SFA and SFA+EMD group, respectively (p= 0.465). In both groups, REC significantly increased 1.0±1.1 mm in SFA group and 1.1±1.1 mm in SFA+EMD group (p= 0.722). Conclusions Within their limits, the findings of present study suggest that SFA may represent a valuable option for the surgical treatment of SDs associated with deep pockets. EMD did not result in a significant clinical benefit to the procedure. Clinical relevance SFA may represent a valuable option in obtaining pocket closure when treating SDs associated with deep residual pockets.

Function of Amelogenins in Periodontal Regeneration Induced by Enamel Matrix Derivative

2011 ◽  
Vol 53 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Yorimasa Ogata ◽  
Hideki Takai ◽  
Youhei Nakayama ◽  
Makoto Fukae
Keyword(s):  
Periodontal Regeneration ◽  
Enamel Matrix Derivative ◽  
Enamel Matrix ◽  
Matrix Derivative

scholarly journals Low Frequency Electromagnetic Fields Might Increase the Effect of Enamel Matrix Derivative on Periodontal Tissues

2021 ◽  
Vol 11 (22) ◽  
pp. 10758
Author(s):  
Stefano Guizzardi ◽  
Giuseppe Pedrazzi ◽  
Carlo Galli
Keyword(s):  
Electromagnetic Fields ◽  
Primary Cilia ◽  
Periodontal Regeneration ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Enamel Matrix Derivative ◽  
Enamel Matrix ◽  
Periodontal Tissues ◽  
Osteoblast Activity ◽  
Matrix Derivative

Periodontal regeneration is a complex goal, which is commonly pursued with a combination of surgical techniques, biomaterials, and bioactive compounds. One such compound is enamel matrix derivative (EMD), a medical substance that is extracted from porcine tooth germs and which contains several protein fractions with BMP- and TGF-β-like action. Activation of TGF-β signaling is required for EMD activity on cells and tissues, and a growing body of evidence indicates that EMD largely relies on this pathway. As low frequency electromagnetic fields (EMFs) have long been investigated as a tool to promote bone formation and osteoblast activity, and because recent studies have reported that the effects of EMFs on cells require primary cilia, by modulating the presence of membrane-bound receptors (e.g., for BMP) or signal mediators, it can be hypothesized that the application of EMFs may increase cell sensitivity to EMD: as TGFBR receptors have also been identified on primary cilia, EMFs could make cells more responsive to EMD by inducing the display of a higher number of receptors on the cellular membrane.

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