• 대한치과의사협회지
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• 제48권1호
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• pp.56-62
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• 2010

In recent years, a number of special treatment procedures have been introduced to reestablish new tooth supporting tissues with varying degrees of success including guided tissue regeneration(GTR), bone grafting(BG) and the use of enamel matrix derivative(EMD). EMD is an extract of enamel matrix and contains amelogenins of various molecular weights. Emdogain(EMD) might have some advantages over other methods of regenerating the tissue supporting teeth lost by gum disease, such as less postoperative complications. Emdogain contains proteins(derived from developing pig teeth) believed to regenerate tooth attachment. The decrease in probing depth after EMD treatment is achieved primarily by clinical attachment gain and bone regeneration and only to a minor extent by gingival recession. In conclsion, EMD seems to be safe, was able to regenerate lost periodontal tissues in previously diseased sites based on clinical parameters.

• 대한소아치과학회지
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• 제35권4호
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• pp.607-618
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• 2008

완전탈구된 치아의 구강외 건조시간에 따른 Emdogain$^{(R)}$의 적용이 재식치의 치주조직의 치유반응에 미치는 효과를 관찰하기 위하여 체중 10-13 kg의 비글 3마리의 상하악 12개의 전치를 발거하여 재식하였다. 구강외 건조시간은 15(I 군), 30(II 군) 및 60분(III 군)으로 분류한 후, 각 군은 Emdogain$^{(R)}$을 적용한 실험군과 적용하지 않은 대조군을 두었다. 건조시간에 따른 Emdogain$^{(R)}$의 적용이 치주조직치유에 미치는 효과를 비교, 평가하기 위하여 치과용 cone beam CT를 이용한 3차원적 영상과 조직학적 관찰을 통하여 다음과 같은 결론을 얻었다. 1. 대조군과 실험군 모두에서 건조 시간이 길어질수록 재식 후 염증성 흡수가 현저히 증가하였다(P<0.001). 2. Emdogain$^{(R)}$의 적용은 대조군에 비하여 염증 억제 효과가 있는 것으로 나타났으며, 특히 I 군과 III 군에서 Emdogain$^{(R)}$ 을 적용한 실험군에서 염증성 흡수의 감소가 나타났으나(P<0.01), II군에서는 차이가 없었다. 3. 치근의 흡수는 치근단 1/3 부위(절편 16, 15, 14순으로)에서 주로 발생하였으며(P<0.05, 0.001), 또한 치경부 1/3 부위(P<0.05)에서도 현저히 나타났다. 4. 치아의 장축에 직각인 절단면에서 관찰된 흡수는 주로 협설측 부위에 주로 발생하였다(P>0.01).

• Journal of Periodontal and Implant Science
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• 제33권2호
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• pp.225-246
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• 2003

Recent study on the enamel matrix derivatives explained on the effects of new bone and new attachment formation in infrabony pocket of periodontal defects. The purpose of this study was to investigate on the biological effects of enamel matrix derivatives to attachment, proliferation and activation of periodontal ligament and osteoblast cells, After treatment of osteoblast and PDL cells with various Emdogain concentration level(0.03${\mu}g$/ml, 3${\mu}g$/ml, 300${\mu}g$/ml), activation of osteogenetic factor, calcified nodule formation and measuring alkaline phosphatase activity(ALP) were performed. 1. Both osteoblast and PDL cell showed increasing initial cell attachment with 300${\mu}g$/ml Emdogain concentration. 2. At the level of 300${\mu}g$/ml, accelerated proliferation of oseoblast and PDL cell was appeared. 3. As Emdogain's concentration increased, increased ALP activation of osteoblast was shown. In case of PDL cell, Emdogain increased ALP activation prominently at the level of 300${\mu}g$/ml. 4. No statistically significant activating change were founded at all of the concentrations of Emdogain on the activating of transcript factor Runx2 for differentiating osteoblast. 5. At the level of 300${\mu}g$/ml, calcified nodule formation was increased prominently to compare with other concentration. These results indicated that Emdogain should activate initial attachment, proliferation and activation, but not on Runx2 activation and can be used for useful tool of the treatment of periodontal tissue regeneration.

• Restorative Dentistry and Endodontics
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• 제25권2호
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• pp.159-169
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• 2000

The purpose of this study was to examine the tissue response to experimental furcation perforations immediately treated with Super EBA, Ketac Silver, MTA and Emdogain using surgical microscope. Forty experimental furcation perforations were created in the mandibular and maxillary premolars and molars of 4 adult dogs and immediately repaired with experimental materials. The animals were sacrificed after 16 weeks and radiographic and histologic results were evaluated. The results were as follows. 1 All materials tested in this experiment revealed a certain degree of extrusion of the filling materials and infiltration of inflammatory cells into the periodontal space. Except MTA group, epithelial down-growth of the surrounding gingiva was found in all experimental groups. 2. Both Ketac Silver and Emdogain group showed the greatest degree of inflammatory reaction and bone resorption. 3. Super EBA group showed moderate inflammation and newly bone formation under the perforation area. 4. MTA group showed minor inflammation, new bone regeneration toward restorative materials and partially cementum growth onto the surface of the material. This group demonstrated a favorable prognosis.

• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.539-555
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• 2000

Recently, it was reported that enamel matrix derivative may be beneficial in periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The aim of present study was to evaluate the effect of enamel matrix derivative($Emdogain^?$)and Caso4 sulfate paste in 1-wall intrabony defects in beagle dogs. Surgically created 1-wall intrabony defects were randomly assigned to receive root debridement alone or $Emdogain^{(R)}$ or $Emdogain^{(R)}$ and Caso4. Clinical defect size was 4 X 4mm. The control group was treated with root debridement alone,and Experimental group I was treated with enamel matrix derivative application, and Experimental group II was treated with enamel matrix derivative and Caso4 sulfate paste application,. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows: 1. The length of junctional epithelium was $0.41{\pm}0.01mm$ in the control group, $0.42{\pm}0.08mm$in the experimental group I and $0.50{\pm}0.13mm$in the experimental group II. 2. The connective tissue adhesion was $0.28{\pm}0.02mm$ in the control group, $0.13{\pm}0.08mm$ in the experimental group I and $0.19{\pm}0.02mm$ in the experimental group II. 3. The new cementum formation was $3.80{\pm}0.06mm$ in the control group, $4.12{\pm}0.43mm$ in the experimental group I and $4.34{\pm}0.71mm$ in the experimental group II. 4. The new bone formation was $1.43{\pm}0.03mm$ in the control group, $1.53{\pm}0.47mm$ in the experimental group I and $2.25{\pm}1.35mm$ in the experimental group II. Although there was limitation to present study, the use of enamel matrix derivative in the treatment of periodontal 1-wall intrabony defect enhanced new cementum and bone formation. Caso4 sulfate paste will be the candidate for carriers to deliver enamel matrix derivative, and so enhance the regenerative potency of enamel matrix derivative.

• 대한치주과학회:학술대회논문집
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• 대한치주과학회 2004년도 춘계학술대회
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• pp.28-28
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• 2004

• 대한치주과학회:학술대회논문집
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• 대한치주과학회 2004년도 제44회 종합학술대회 연제초록
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• pp.119-120
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• 2004

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.194-203
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• 2013

Objectives: To investigate the effect of enamel matrix derivative (EMD) on periodontal healing of replanted teeth in animal models. Materials and Methods: The authors searched MEDLINE, PubMed, EMBASE, Cochrane Library, Web of Knowledge and Scopus for articles published up to Oct 2012. Animal studies in which EMD was applied in transplanted or replanted teeth with adequate controls and histological data were considered. Normal periodontal healing or root resorption determined by histology after EMD was applied in replanted teeth with adequate controls was used as outcome measures. The following search strategy was used: ('Emdogain' OR 'enamel matrix proteins' OR 'enamel matrix derivative') AND ('avulsion' OR 'transplantion' OR 'autotransplantation' OR 'replantation'). Results: Six animal studies were included in the final review. There was great heterogeneity in study design among included studies. Two studies with similar study designs were identified and analyzed by a meta-analysis. The pooled estimates showed a significantly higher normal healing and surface resorption and significantly less inflammatory and replacement resorption in EMD-treated groups compared with non-EMD-treated groups. Conclusions: With the limitations of this systematic review, the use of EMD led to greater normal periodontal healing and surface root resorption and less inflammatory and replacement root resorption in the presence of periodontal ligaments. However, no definite conclusion could be drawn with regard to the effect of EMD on periodontal healing and root resorption when no periodontal ligaments exist.

• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.32.1-32.13
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• 2019

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

• 대한치과보철학회지
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• 제54권3호
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• pp.203-209
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• 2016

목적: 치주조직재생을 위해서는 치주인대세포의 증식 및 이주를 촉진시키는 것이 필수적이나 현재까지 이것을 만족시키는 재생술식은 없다. 최근 법랑기질유도체(enamel matrix derivatives)가 치주조직 재생 술식에 적용되고 있으나 그 기전에 대해서는 완전히 알려지지 않았다. 따라서 본 연구의 목적은 법랑기질유도체가 치주인대세포의 증식과 성장인자 발현에 미치는 영향에 대하여 알아보고자 함이다. 재료 및 방법: 건강한 성인의 제 3 대구치로부터 치주인대세포를 추출한 후, 법랑기질유도체(Emdogain (Biora, Malmo, Sweden))의 농도가 각각 0, 12.5, 25, 50, 100, and $200{\mu}g/mL$인 배지에서 배양시켰다. 치주인대 세포증식과 알칼리성 인산분해효소(alkaline phosphatase) 활성도를 측정하고, 발현되는 성장인자를 평가하였다. 결과: 치주인대세포의 세포증식은 $25{\mu}g/mL$이상의 농도의 법랑기질유도체를 첨가한 군에서, 알칼리성 인산분해효소 활성도는 $50{\mu}g/mL$의 법랑기질유도체를 첨가한 군에서 각각 유의하게 증가하였고, $50{\mu}g/mL$의 법랑기질유도체를 첨가한 군에서 치주인대세포의 VEGF (vascular endothelial growth factor)와 TGF(transforming growth factor)-${\beta}$의 발현이 유의하게 증가하였다. 결론: 법랑기질 유도체는 인간 치주인대세포의 세포증식과 알칼리성 인산분해효소 활성을 증진시키고, VEGF와 TGF-${\beta}$등 성장인자의 발현을 촉진함으로써 치주조직 재생에 기여할 수 있을 것이다.