%0 Journal Article
%T A REVIEW ON EFFECTIVE APPLICATION OF AN ENAMEL MATRIX DERIVATIVE (EMDOGAIN ) FOR PERIODONTAL SURGERY IN THE PRESENCE OF BLOOD
%A Oana M. CALUSERU
%A A. SCULEAN
%A Y. ZHANG
%A R.J. MIRON
%J International Journal of Medical Dentistry
%D 2013
%I Academy of Romanian Scientists
%X Reconstructive periodontal surgery aims at predictably restoring tooth¡¯s supporting structure lost due to perio©\ dontal disease or trauma. One such modality, which has been demonstrate to promote periodontal regeneration, is an enamel matrix derivative (EMD), consisting of a formu©\ lation of amelogenin proteins from developing porcine enamel. This review article provides a brief update on the effects of blood interaction, occurring during periodontal surgery, on the effectiveness of EMD adsorption on the root surfaces and its implications for periodontal recon©\ structive surgery.The clinical use of an enamel matrix derivative (EMD) has been successfully proved in periodontal surgery, as promoting regeneration of periodontal tissues including new cementum, periodontal ligament (PDL) and alveolar bone [1]. Despite its widespread use, only recently has the effect of blood, occurring during periodontal surgery, been evaluated for contamination of the effectiveness of EMD adsorption onto root surfaces. The aim of this review arti©\ cle is to provide the clinician a summary of findings from in vitro experiments testing the effects of EMD adsorption onto root surfaces in the presence and absence of blood and its effect on PDL cell behavior [2]. Until recently, the extent to which bleeding occurring during periodontal sur©\ gery affects the adsorption of EMD onto root surfaces could not be established.In summary, the teeth extracted for orthodontic reasons were subject to ex vivo scaling and root planing and expo©\ sed to 6 clinically relevant scenarios, as illustrated in figure 1. EMD application is usually performed following root surface conditioning with 24% EDTA. Findings from high resolution scanning electron microscopy (SEM) demons©\ trated that the proteins found in blood (mainly albumin) were able to compete with those found in EMD (Figure 2), reducing the effectiveness of EMD thereafter. No apparent effect of conditioning the surface with 24% EDTA was observed.Clinically ,theeffectofEDT Arootconditioning on the healing of intrabone defects treated with an enamel matrix protein derivative has been tested, however no sta©\ tistical clinical differences were observed between open flat debridement (OFD), followed by root surface conditioning with EDTA, and application of EMD versus that of OFD + EMD alone [3,4].
%U http://www.ijmd.ro/articole/312_12%20caluseru.pdf