• The Journal of the Korean dental association
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• v.48 no.1
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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 the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.607-618
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• 2008

This study three-dimensionally and histologically assessed the effect of Emdogain$^{(R)}$ on periodontal healing in replanted teeth in three beagle dogs which were 1 to 2 years old, weighing from 10 to 13 ㎏. Twelve maxillary and mandibular incisors were intentionally extracted and replanted after 15(Group I), 30(Group II) and 60(Group III) minutes of air dry storage with and without the application of Emdogain$^{(R)}$. The following conclusions could be drawn from the present investigation. 1. Increased incidence of inflammatory healing response in periodontal tissue was proportional to air dry time in Both control and experimental group(P<0.001). 2. Treatment Group showed lower inflammatory root resorption, especially there were statically significant in Group I, III(P<0.001, Group II : P=0.093). 3. Inflammatory root resorption were mainly occurred in apical third(14, 15-16 section)(P<0.05, 0.001), and cervical third(1 section)(P<0.05). 4. In view of horizontal section of long tooth axis, Main root resorption area were 1, 4, 5 line area(bucco-lingual area)(p<0.01).

• Journal of Periodontal and Implant Science
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• v.33 no.2
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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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• v.25 no.2
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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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• v.30 no.3
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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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• 2004.05a
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• pp.28-28
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• 2004

• 대한치주과학회:학술대회논문집
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• 2004.11a
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• pp.119-120
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• 2004

• Restorative Dentistry and Endodontics
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• v.38 no.4
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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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• v.44 no.3
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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.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.203-209
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• 2016

Purpose: Stimulating the proliferation and migration of periodontal ligament cells (PDLCs) has become the main goal of periodontal regeneration. To accomplish this goal, regeneration procedures have been developed, but results have not been predictable. Recently, tissue engineering using enamel matrix derivatives (EMDs) and growth factors has been applied to periodontal regeneration; however, the mechanism of EMDs is largely unknown. The aim of this study was to investigate the effects of EMDs on the proliferation and release of growth factors from PDLCs. Materials and methods: Human PDLCs were removed from individually extracted 3rd molars of healthy young adults, and cultured in the media containing EMDs (Emdogain, Biora, Malmo, Sweden) at concentration of 0, 12.5, 25, 50, 100, and $200{\mu}g/mL$ each. Cell proliferation and ALP (alkaline phosphatase) activity were measured. The evaluation of growth factors released by PDLCs was also performed by one-way analysis of variance (ANOVA) and Bonferroni's multiple comparison test. Results: Significantly increased proliferation and ALP activity were observed in PDLCs treated with over $25{\mu}g/mL$ and $50{\mu}g/mL$ EMDs, respectively. Additionally, treatment of PDLCs with $50{\mu}g/mL$ resulted in significantly increased release of vascular endothelial growth factor (VEGF) and transforming growth factor $(TGF)-{\beta}$ after 24 h and 48 h, respectively. Conclusion: EMDs enhance the proliferation and ALP activity of PDLCs, and promote the release of growth factors, including VEGF and $TGF-{\beta}$, from PDLCs. Therefore EMDs could be one of the effective methods for periodontal regeneration.