The Use of Enamel Matrix Derivative in Combination with a Synthetic Bone Graft in the Treatment of Periodontitis: A Case Report

D. Gillam
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Abstract

It has been recognised that periodontal disease in susceptible individuals may lead to the gradual loss of the tooth supportive apparatus. Therefore, the objective of periodontal treatment is not only the arrestment of the progression of periodontitis but additionally to aid in the reconstruction of lost structures such as bone, cementum and periodontal ligament using regenerative procedures and techniques such as Guided tissue regeneration (GTR) with and without the use of bone grafting materials [1,2]. Over the last three decades there has been a major development of novel materials for the treatment of periodontal disease, particularly regarding the treatment of infra bony defects. For example, stem cells, conductive scaffolds, platelet-rich plasma, Bone Morphogenetic Proteins (BMPs), cell binding peptides, fibroblast growth factors and Enamel matrix proteins (EMD) as well as bone replacement products such as autograft, xenograft, allograft and alloplastic grafts [2]. Several investigators have, however reported on the efficacy of EMD compared to the other biomaterials in combination with regenerative procedures [3-6]. According to Fernandes et al. [6] there are considerable benefits in combining both EMD and a bone ceramic as there is potential to create a synergetic effect of both these materials.
牙釉质基质衍生物联合人工骨移植治疗牙周炎1例
人们已经认识到,牙周病易感个体可能导致牙齿支持装置的逐渐丧失。因此,牙周治疗的目标不仅是阻止牙周炎的进展,而且还需要使用再生程序和技术,如使用或不使用植骨材料的引导组织再生(GTR),帮助重建丢失的结构,如骨、牙骨质和牙周韧带[1,2]。在过去的三十年里,治疗牙周病的新材料有了很大的发展,特别是在治疗骨下缺损方面。例如,干细胞、导电支架、富血小板血浆、骨形态发生蛋白(BMPs)、细胞结合肽、成纤维细胞生长因子和搪瓷基质蛋白(EMD)以及骨替代产品,如自体移植物、异种移植物、同种异体移植物和同种异体移植物[2]。然而,一些研究人员报道了EMD与其他生物材料结合再生手术的疗效[3-6]。Fernandes等人认为[6]结合EMD和骨陶瓷有相当大的好处,因为这两种材料有可能产生协同效应。
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