Saving Teeth With Periodontal Regeneration: Emdogain & Allograft
The goal of regenerative periodontal therapy is the reconstitution of the lost periodontal structures (i.e. the new formation of root cementum, periodontal ligament and alveolar bone). Results from basic research have pointed to the important role of the enamel matrix protein derivative (EMD) in the periodontal wound healing. Histological results from animal and human studies have shown that treatment with EMD promotes periodontal regeneration.
Video: Full (Edited) Surgical Protocol Including Preparation, Scaling & Root Planning, Emdogain, Allograft & Closing Suturing
Moreover, clinical studies have indicated that treatment with EMD positively influences periodontal wound healing in humans. Surgical periodontal treatment of deep infrabony defects with EMD and allograft promotes periodontal regeneration.
The patient, 27 years old, healthy and non smoker, came to my clinic for a second opinion. She had been told she needs to extract tooth 31.
In the clinical examination: tooth 31 presented mobility grade 2 and probing depth up to 8mm with Bleeding On Probing (BOP). The other teeth from 32 until 42 were 6-7mm with BOP . The XR presented tooth 31 with infrabony defect at the distal side.
Diagnosis : Localised periodontitis.
Tooth 31 can be saved and must be saved. Extraction in this area could cause permanent bone loss and gingival loss which can harm the adjacent teeth. Periodontal regeneration with EMD and allograft were the treatment of choice. The following steps were taken:
- Before the surgical treatment tooth 31 was splinted to the adjacent teeth for stabilisation.
- A simplified papilla preservation flap was designed from 33 – 43.
- Scaling and root planing and excavated inflamed granulation tissue.
- Prep gel – left for 2 minutes, washed and dried.
- Allograft and Emdogain mixed together (left for 5 minutes)
- EMD on the root surfaces and Allograft placed at the IBD.
- Sutured with 60/11mm nylon sutures material.
Ten days after surgery: sutures were removed. Note: No probing for six months.
Surgical periodontal therapy of deep infrabony defects with EMD may lead to significantly higher improvements of the clinical parameters than open flap debridement alone. The combination of EMD and some types of bone grafts/bone substitutes may result in certain improvements in the soft and hard tissue parameters compared to treatment with EMD alone. This treatment of periodontal regeneration with EMD and Allograft has long term success and can save teeth.
Dr Meizi’s final words:
“Try to save teeth before extracting them”.
To talk to Dr Meizi about a saving teeth or periodontal regeneration use the contact form or whatsapp directly [chat]
