In Periodontics, Can We Regenerate Lost Hard and Soft Tissue? by Dr. Hatem Algraffee

On average, up to 15 percent of the population suffers from advanced periodontitis, often leading to tooth loss. We know that loss of teeth, in turn, can potentially result in reduced quality of life of the patient. The implications of tooth loss can often be complicated and involve costly restorations to address edentulous sites. All of this, in some cases, may be unnecessary, because regeneration of the lost hard and soft tissue caused by periodontitis can be successfully achieved.

Periodontitis treatment involves addressing the inflammation, as well as subsequent regeneration of the lost periodontal hard and soft tissues in order to regain tooth attachment. Applying Straumann® Emdogain™ to the cleaned root surface of the periodontally diseased tooth helps regeneration of both the hard and soft tissues of the periodontium at the same time.

Emdogain has been available for more than 20 years, yet very few dentists or hygienists are aware that this highly researched product could be used to help address bony defects gingival recession, and now to enhance wound healing in implant cases. I have treated many patients using Emdogain, and more patients worldwide have been treated using the product. In my opinion, there is nothing like it on the market. Additionally, the product is documented in more than 400 clinical publications to deliver predictable results, including studies tracking results over a 10-year period.

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  Straumann® Emdogain™ applied on the root surface to form a matrix layer

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  Within months, the defect fills with newly formed periodontal ligament and facilitates the regeneration of the periodontium, building a new functional attachment.

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  Case 1, before treatment with
  Straumann Emdogain.

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  Case 1, after treatment

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  Case 2, before treatment with
  Straumann Emdogain

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  Case 2, after treatment

How does it work?
When Straumann Emdogain is applied into a pocket, the enamel matrix derived proteins precipitate on the root surface to form a matrix layer. The matrix stimulates the attraction and proliferation of mesenchymal cells from the healthy part of the periodontium and these cells secrete natural cytokines and autocrine substances, promoting the formation of the cement matrix in which the periodontal fibres are fixed. The newly formed cement layer increases in thickness, extending the periodontal ligament, and within 6–9 months the defect fills with newly formed periodontal ligament. As the periodontal ligament is formed, new bone continues to develop. This is illustrated in the before-and-after examples above.

I’ve found the results to be very stable as long as patients maintain their oral hygiene and have a strict hygienist maintenance program.

The use of such a regenerative material has helped change the prognosis of teeth. There are obviously cost considerations to the use of Emdogain, but I have found that once patients understand the benefits, they are more than willing to accept the suggested treatment. Straumann has recently introduced 0.15-milliliter syringes of Emdogain, which allows cost-effective treatment of smaller defects and soft tissue grafting procedures.

Gain practical knowledge
Emdogain is a hidden jewel, which in my opinion has been positioned toward use by specialists only but I feel strongly that many general dentists and their patients would benefit from this unique product. I am involved with PerioAcademy, which was established to enable dental professionals to gain up-to-date practical knowledge and experience in periodontics.

For more information about Straumann Emdogain please call 01293 651230 or visit www.straumann.co.uk.

Dr. Hatem Algraffee, specialist periodontist BDS, MSc, M.Clin.Dent., has been a specialist periodontist for more than 13 years. He dedicates his time to periodontics in private practice and lecturing for PerioAcademy.