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

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.