Periodontal Intrabony Defects and the Treatment with Enamel Matrix Derivative

The intrabony defects are considered the main consequence of periodontal disease, presenting itself as a challenge to the clinician. These represent locations that, if untreated, are at an increased risk for disease progression. Although resection surgery has been used a treatment option to their elimination, the treatment of choice is periodontal regeneration .

Reports of guided tissue regeneration (GTR) as a periodontal procedure appeared more than 20 years ago. The rationale behind this therapy is to achieve regeneration of tooth supporting structures, or cementum, periodontal ligament and alveolar bone. This is different from conventional periodontal surgery that achieves healing by repair. Another way to approach periodontal regeneration is to mimic the process that occurs during development of periodontal tissues.

After the discovery of the presence of a layer of enamel matrix between the peripheral dentin and cementum underdevelopment, along with the ability of this protein to induce the formation of acellularcementum, periodontal ligament, and alveolar bone, provided the fundamental concept for use tissue derivatives of enamel matrix in periodontal regenerative therapies. The results of several clinical studies indicated that topical application on the root surface of the enamel matrix proteins commercially available (EMD, Straumann, Basel, Switzerland) during access flap surgery promoted clinically significant gains in clinical attachment and bone formation in intrabony defects.  Read more......