• 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).

• 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.

• 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

• The Journal of Advanced Prosthodontics
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• 제6권5호
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• pp.406-414
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• 2014

PURPOSE. The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS. Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD $25{\mu}g/mL$, and (3) with EMD $100{\mu}g/mL$ on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-${\beta}1$ was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS. From MTT assay, HGF showed more proliferation in EMD $25{\mu}g/mL$ group than control and EMD $100{\mu}g/mL$ group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD $25{\mu}g/mL$ group and EMD $100{\mu}g/mL$ group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-${\beta}1$ was increased at EMD $100{\mu}g/mL$. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD $25{\mu}g/mL$. CONCLUSION. Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-${\beta}1$ in high concentration levels. CLINICAL RELEVANCE. With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.235-250
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• 2005

The current interest in periodontal tissue regeneration has lead to research in bone graft, root surface treatments, guided-tissue regeneration, administration of growth factors, and the use of enamel matrix protein as possible means of regenerating lost periodontal tissue. Several studies have shown that a strong correlation between platelet-rich plasma and the stimulation of remodeling and remineralization of grafted bone exits, resulting in a possible increase of 15-30% in the density of bone trabeculae. The purpose of this study was to study the histopathological results and differences between the use of platelet-rich plasma and the use of enamel matrix $protein(Emdogain^?)$ about bone regeneration at the implant. Implant fixtures were inserted and graft materials placed into the left femur in the experimental group, while the only implant fixtures placed in the control group. In the first experimental group, platelet-rich plasma and xenograft were placed at the supracrestally placed implant site, and in the second experimental group, $Emdogain^{(R)}$ and xenograft placed at the supracrestally placed fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2, 4, and 8 weeks after implant fixture insertion. The results of the experiment are as follows: 1. The rate of osseointegration to the fixture threads was found to be greater in the experimental group compared to in the control group. 2. The histopathological findings showed that the bone regeneration, the partial osseointegration existed at 4 weeks, and that osseointegration and bone density increaced in the experimental groups at 8 weeks. 3. The results showed that new bone formation and bone remodeling increased in the area near to the fixture in the first and second experimental groups at 8 weeks than at 4 weeks. The results showed that in the area distant from the fixture, new bone formation did not increase and bone remodeling decreased in the first experimental group at 4, 8 weeks, and that new bone formation increased in the second experimental group. 4. The histopathological findings showed that AZ deposition in the first experimental group was remarkable at 2, 8 weeks, and in the second experimental group at 2, 4, 8 weeks in the area distant from the fixture threads.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.193-209
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• 2001

The prognosis of transplanted teeth is strongly related with periodontal healing. Several experimental studies showed that the application of enamel matrix derivatives on periodontitis-affected root surfaces resulted in periodontal regeneration. The purpose of this study was to determine the effect of enamel matrix derivatives on periodontitis-affected root surfaces prior to transplantation in dogs. Class III Furcation defects were surgically created on the left second, the third and the fourth premolar in the mandibles of nine mongrel dogs and experimental periodontitis was induced by placing small cotton pellets into defects for 3 weeks. Periodontitis-affected roots were treated by scaling and planing and the coronal portions were removed. Each root was extracted and implanted into recipient bed prepared in the contralateral premolar area. The transplanted roots were grouped according to the treatment modalities; Group I- roots treated with saline only, Group II- roots conditioned by neutral EDTA, and Group III- roots conditioned by neutral EDTA and enamel matrix derivatives ($EMDOGAIN^{(R)}$, BIORA Co., Sweden). The animals were sacrificed at 1 week, 3 weeks, and 10 weeks after transplantation and decalcified specimens were prepared for histologic examination. In Group I, healing was most frequently characterized by root resorption and ankylosis. In Group II, with root resorption and ankylosis in a few specimens, connective tissue attachment was partly seen on denuded root surface, but no cementum formation was seen. In Group III, there was regeneration by new cementum and periodontal ligament on denuded root surface, although slight root resorption and ankylosis were found in a few specimens. This result suggests that enamel matrix derivatives treatment on periodontitis-aggected root surface could reduce the frequency of root resorption and ankylosis and contribute to periodontal regeneration, and might be useful for autologous transplantation.

• Restorative Dentistry and Endodontics
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• 제39권3호
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• pp.187-194
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• 2014

Objectives: The effects of bone morphogenetic protein-2 (BMP-2) and enamel matrix derivative (EMD) respectively with mineral trioxide aggregate (MTA) on hard tissue regeneration have been investigated in previous studies. This study aimed to compare the osteogenic effects of MTA/BMP-2 and MTA/EMD treatment in MC3T3-E1 cells. Materials and Methods: MC3T3-E1 cells were treated with MTA (ProRoot, Dentsply), BMP-2 (R&D Systems), EMD (Emdogain, Straumann) separately and MTA/BMP-2 or MTA/EMD combination. Mineralization was evaluated by staining the calcium deposits with alkaline phosphatase (ALP, Sigma-Aldrich) and Alizarin red (Sigma-Aldrich). The effects on the osteoblast differentiation were evaluated by the expressions of osteogenic markers, including ALP, bone sialoprotein (BSP), osteocalcin (OCN), osteopontin (OPN) and osteonectin (OSN), as determined by reverse-transcription polymerase chain reaction analysis (RT-PCR, AccuPower PCR, Bioneer). Results: Mineralization increased in the BMP-2 and MTA/BMP-2 groups and increased to a lesser extent in the MTA/EMD group but appeared to decrease in the MTA-only group based on Alizarin red staining. ALP expression largely decreased in the EMD and MTA/EMD groups based on ALP staining. In the MTA/BMP-2 group, mRNA expression of OPN on day 3 and BSP and OCN on day 7 significantly increased. In the MTA/EMD group, OSN and OCN gene expression significantly increased on day 7, whereas ALP expression decreased on days 3 and 7 (p < 0.05). Conclusions: These results suggest the MTA/BMP-2 combination promoted more rapid differentiation in MC3T3-E1 cells than did MTA/EMD during the early mineralization period.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.823-837
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• 2005

The purpose of this study was to study the histopathological correlation between the use of platelet-rich plasma and enamel matrix protein used in conjunction with xenograft. compared to a control group with regards to bone regeneration at the grade III furcation area in beagle dogs. Control group was treated with bovine derived bone $powder(Biocera^{(R)})$, and experimental I group was treated with bovine derived bone powder and Platelet-rich plasma and experimental II group was treated with bovine derived bone powder and Enamel matrix $protein(Emdogain^{(R)})$. The regeneration rate of bone formation was observed and compared histopathologically at 2. 4, and 8 weeks after surgery. The results were as follows: 1. In control group and both experimental groups. inflammatory cells were observed but, new bone formation wasn't. 2. In control group, new cementum on the notch was found in 4 weeks, less mature periodontal ligament when compared to that of experimental group was found and cementum formation was great but, regeneration couldn't be seen in 8 weeks. 3. Experimental I group. new bone formation in the area adjacent to alveolar bone and graft material surrounded by more dense connective tissue were found in 4 weeks. New bone formation up to crown portion was found and periodontal ligament was aligned functionally and cementum more mature. 4. Experimental II group, new bone formation was found under the defect area in 4 weeks and new bone formation around graft material in 8 weeks, too, and there were a number of fibroblasts, blood vessels, acellular cementum, which was less mature when compared to that of experimental I group, and dense collagen fiber like which normal periodontal ligament has in periodontal ligament of experimental II group in 8 weeks. 5. As a result of histologic finding, bone formation rate were 18.0${\pm}$7.87%(control group), 34. 05${pm}$7.25%(experimental I group), 19.33 ${pm}$5.15%(experimental II group) in 4 weeks and 21.89${pm}$1.58%(control group), 38.82${pm}$3.2(experimental I group), 37.65${pm}$9.22%(experimental II group) in 8 weeks. 6. Statistically significant ratio of bone formation was observed in experimental I group in 4 weeks and in experimental II group in 8 weeks. When experimental I group was compared to experimental II group, the ratio of bone formation in experimental I group was higher than that in experimental II group in 4 weeks(p<0.05). This results suggest that platelet-rich plasma showed more new bone formation than enamel matrix protein within 4 weeks. And use of enamel matrix protein in the treatment of periodontal bone defects starts to enhance regeneration after 8 weeks in beagle dogs.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.359-372
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• 2003

Among objectives of periodontal therapy. the principal one is the morphological and functional reconstruction of lost periodontal supporting tissues. This includes de novo formation of connective tissue attachment and the regrowth of alveolar bone. The use of enamel matrix derivative(EMD) may be a suitable means of regeneration new periodontal attachment in the infrabony defects. Implant used to replace lost tooth but, implantitis occurred after installation. The purpose of this study was to investigate the effects of EMD on differentiation and growth of osteoblast in titanium disc. Twentyfive millimeter diameter and 1mm thick Ti disc which was coated 25, 50, 100, 200${\mu}g$/ml of EMD(Emdogain(R)) used as experimental group, 25, 50, 100, 200ng/d of rhBMP-2 as positive control group, and no coat as negative control group. A human osteosarcoma cell line Saos-2 was cultured in Ti disc and cell proliferation and Alkaline phosphatase (ALP) activity were measured at 1 and 6 days. PCR was performed at 2 and 8 hours. Semi-quantitative RT-PCR for mRNA expressions of various osteoblastic differentiation markers -type I collagen, ALP, osteopontin, and bone sialoprotein - were performed at appropriate concentrations based upon the results of MTT and ALP assay. Cultured cell-disc complexes were prepared for scanning electron microscopy (SEM) at 2 hour. Data were analyzed using Mann-Whitney and repeated- measures 1-way analysis of variance(SPSS software version 10,SPSS. Chicago. IL). After culture, there was more osteoblast in EMD100${\mu}g$/ml than in EMD50, 200${\mu}g$/ml on day 6. There was significant difference in experimental and positive control group compared control group, as times go by(1 and 6 days). Alkaline phosphatase activity was different significantly in EMD100, 200${\mu}g$/ml and BMP100, 200${\mu}g$/ml on day 6. The results of reverse transcriptase-polymerase chain reaction (RT-PCR) showed that expression of mRNA for ALPase, collagen type I, osteopontin. hone sialoprotein and BMP-2 was detected at 2 hour and 8 hour in EMI 200${\mu}g$/ml subgroup and BMP100ng/ml subgroup. The results of this study suggest that application of enamel matrix derivative on osteoblast attached to titanium surface facilitate the expression of bone specific protein and the differentiation and growth of osteoblast.