EMDOGAIN SS PART1

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EMDOGAIN applications: Guided tissue regeneration & other indicationsPart 1 : 

EMDOGAIN applications: Guided tissue regeneration & other indicationsPart 1 “The Reganato Lecture Series” Sponsored by Woodlake Family Dental of Naperville, IL Anthony J Reganato, DDS, MS Private Practice Periodontist West Suburbs-Chicago, IL

Benefits of Emdogain in your Practice : 

Benefits of Emdogain in your Practice General Practitioners who don’t perform surgery in their practice: Alternative to gingival grafting and GTR techniques; higher case acceptance; lower cost compared to other materials; minimal treatment time compared to other techniques; minimally invasive procedure with enhanced wound healing for your patients; however, requires coordination with your surgeon General Practitioners who perform surgery in their practice: Ease of use, alternative therapeutic option, enhanced wound healing of surgical procedures Specialists: Enhanced armamentarium, enhanced wound healing with GTR/GBR/gingival grafting procedures; lower cost compared to BMP, PDGF materials, ease of use compared to PRP

Emdogain Advantages : 

Emdogain Advantages Improved outcome and esthetics Straumann® Emdogain regenerates periodontal tissue1 and significantly improves the outcome of surgical treatment alone: Almost doubles the "highly improved"Clinical Attachment Level (CAL) gain (>4 mm) compared to open flap debridement (OFD) alone2 Tripled average percent of defect fill from 23% for surgical procedure alone to 74%3 Increases root coverage compared to coronally advanced flap (CAF) alone4,5 or connective tissue graft6 1 Hamarström J Clin Periodontol 1997; 24; 658 and 6692 Tonetti et al. J Clin Periodontology 2002; 29: 317-3253 Froum, J Periodontol. 2001; 72: 25 4 Castellanos et al. J Periodontol. 2006; 77: 7-145 Cueva et al. J Periodontol. 2004; 75: 949-9566 McGuire, Nunn, J Periodontol 2003; 74: 1110-11257 Sculean et al. Int J Periodontics Restorative Dent. 2007; 27: 2218 Heden et al. J Periodontol 2006; 77: 295-3019 Sanz et al J. Periodontol, 2004, 726-73310 Jepsen, Meyle et al. J Periodontol. 2004; 75: 115011 Wennstrom et al J Clin Periodontol. 2002, 29: 9-14

Emdogain Advantages : 

Emdogain Advantages Long term effectiveness – sustained results Straumann® Emdogain demonstrates long term clinical benefits: Clinical success maintained over at least 9 years7 Continued improvement of clinical attachment level gain and recession reduction beyond 12 months was shown in a 5 year study8 1 Hamarström J Clin Periodontol 1997; 24; 658 and 6692 Tonetti et al. J Clin Periodontology 2002; 29: 317-3253 Froum, J Periodontol. 2001; 72: 25 4 Castellanos et al. J Periodontol. 2006; 77: 7-145 Cueva et al. J Periodontol. 2004; 75: 949-9566 McGuire, Nunn, J Periodontol 2003; 74: 1110-11257 Sculean et al. Int J Periodontics Restorative Dent. 2007; 27: 2218 Heden et al. J Periodontol 2006; 77: 295-3019 Sanz et al J. Periodontol, 2004, 726-73310 Jepsen, Meyle et al. J Periodontol. 2004; 75: 115011 Wennstrom et al J Clin Periodontol. 2002, 29: 9-14

Emdogain Advantages : 

Emdogain Advantages Reduced complications – Improved satisfaction Regenerative therapy with Straumann® Emdogain exhibits fewer complications than alternative methods: Lower complication rate (dehiscences); 6% vs. almost 100% for guided tissue regeneration (GTR)9 Fewer patients with swelling; 56% vs. 94% for GTR10 Less patient pain; 38% had pain one-week post-op compared to 88% for GTR10 and 5% with pain vs. 45% when comparing CAF and CTG respectively6 Moreover, clinicians have reported enhanced wound healing through Straumann® Emdogain.6,11 1 Hamarström J Clin Periodontol 1997; 24; 658 and 6692 Tonetti et al. J Clin Periodontology 2002; 29: 317-3253 Froum, J Periodontol. 2001; 72: 25 4 Castellanos et al. J Periodontol. 2006; 77: 7-145 Cueva et al. J Periodontol. 2004; 75: 949-9566 McGuire, Nunn, J Periodontol 2003; 74: 1110-11257 Sculean et al. Int J Periodontics Restorative Dent. 2007; 27: 2218 Heden et al. J Periodontol 2006; 77: 295-3019 Sanz et al J. Periodontol, 2004, 726-73310 Jepsen, Meyle et al. J Periodontol. 2004; 75: 115011 Wennstrom et al J Clin Periodontol. 2002, 29: 9-14

Possible Indications : 

Possible Indications Root coverage NOTE: keratinized tissue should be present; may not be the best option for MGDs in the absence of keratinized tissue GTR: infrabony defects, class II furcation defects NOTE: may not be as predictable with class III furcation defects but may improve longevity Enhanced wound healing through cellular proliferation and differentiation May enhance wound healing and root coverage with CTG, FGG, tissue allografts May enhance wound healing and GBR outcomes with bone autografts, allografts, xenografts, and alloplasts

Straumann Website : 

Straumann Website Root coverage

Straumann Case Report : 

Straumann Case Report Root coverage

Straumann Case Report : 

Straumann Case Report Root coverage

Straumann Website : 

Straumann Website Infrabony Defect

Emdogain Without Membrane:Rationale : 

Emdogain Without Membrane:Rationale The biological explanation for the use of EMD without the use of a membrane may be derived from their role in tooth development, whereby the secretion of these proteins onto the developing root surface precedes the formation of tooth attachment A similar action occurs when these proteins are placed on a root surface that has lost bone and attachment from periodontal disease; when applied to the root surface during surgery, these proteins assemble into an insoluble matrix layer that promotes the attachment of mesenchymal cells These cells produce new matrix components and growth factors that participate in the region of tooth attachment Emdogain also inhibits epithelial cell growth that could interfere with proper tissue and bone reformation Furthermore, several studies have shown that EMD alone is highly efficacious in promoting periodontal regeneration without the use of a membrane

Slide 12: 

Ease of Use

Clinical Application : 

Clinical Application Infrabony defect

Clinical Application : 

Clinical Application Debridement of the defect

Clinical Application : 

Clinical Application EMD alone vs. EMD + bone

Clinical Application : 

Clinical Application Pref-gel application

Clinical Application : 

Clinical Application

Clinical Application : 

Clinical Application EMD + bone allograft

Clinical Application : 

Clinical Application

CASE REPORT #1 : 

CASE REPORT #1

Periodontal Regeneration, UR : 

Periodontal Regeneration, UR

Post Op 1 Week : 

Post Op 1 Week

Post Op Week 6 : 

Post Op Week 6

3 Month Follow Up : 

3 Month Follow Up

6 Month Follow Up : 

6 Month Follow Up

Slide 29: 

Initial

Periodontal Regeneration, UL : 

Periodontal Regeneration, UL

2 Week Post Op : 

2 Week Post Op

2 Month Follow Up : 

2 Month Follow Up

4½ Month Follow Up : 

4½ Month Follow Up

Periodontal Regeneration, LL : 

Periodontal Regeneration, LL

2 Week Post Op : 

2 Week Post Op

2½ Month Follow Up : 

2½ Month Follow Up

Periodontal Regeneration, LR : 

Periodontal Regeneration, LR

1 Week Post Op : 

1 Week Post Op

6 Week Follow Up : 

6 Week Follow Up

Periodontal Regeneration:16 Month Follow-up : 

Periodontal Regeneration:16 Month Follow-up

Slide 52: 

Initial 16 Months Post Op

Slide 53: 

Initial 16 Months Post Op

Slide 54: 

Initial

Slide 55: 

Initial 13 Months Post Op

Slide 56: 

Initial

Slide 57: 

Initial 15 Months Post Op

Slide 58: 

Initial 15 Months Post Op

Slide 59: 

Initial

Slide 60: 

Initial 14 Months Post Op

Slide 61: 

Initial

14 Month Follow-up : 

14 Month Follow-up baseline 2.5 months 14 months Changing the perception of periodontal wound healing may require a change in the perceived role of the periodontists “Regenerators” Regenerative “procedures”

THANK YOU : 

THANK YOU CARNIVORE CHALLENGE “The Reganato Lecture Series” Sponsored by Woodlake Family Dental of Naperville, IL