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Biomimetics in Periodontal Regeneration: Rationale and Clinical Use of Enamel Matrix Derivative

Table of Contents

1 Evolving Periodontal Regenerative Therapies
2 The Biologic Concept
3 Presurgical Evaluation and Patient Selection
4 Treatment of Intrabony Periodontal Defects
5 Mechanism of Action for Enamel Matrix Derivative
6 Treatment Outcome
7 Combined Regenerative Therapy
8 Treatment of Furcation-Involved Teeth
9 Use of Enamel Matrix Derivative with Root-Coverage Procedures
10 Safety of Enamel Matrix Derivative


Regeneration of tooth support is one of the primary goals in periodontal therapy. Until recently, two strategies have generally been used for this purpose. The first is to fill the periodontal defect with a graft material, and the second is to isolate the defect with a barrier membrane. In general, these therapies have had limited success in both predictability and extent of healing response.

Protein products have taken on a unique role in therapeutics. When findings from laboratory and clinical investigations demonstrated that the use of enamel matrix proteins could facilitate regeneration of periodontal tissues lost to periodontal disease, a new era began in periodontal regenerative therapy. The subsequent development of enamel matrix derivative (EMD) has paved the way for clinicians to offer a biomimetic approach to periodontal regeneration—that is, a therapy that mimics the biologic events that take place during nascent development of the periodontal attachment.

This book explains the principles for the clinical use of EMD in a simple, straightforward, and practical manner. It will benefit clinicians already working in the area of periodontal regeneration and increase the interest of general practitioners and students in biology-based (as opposed to mechanical) regenerative treatment approaches. The manual is organized so that the clinician can view the step-by-step process of using EMD in regenerative surgical treatment and then return as necessary for a quick reference. Detailed explanations are provided where deeper understanding is needed.

The first two chapters provide an overview of evolving trends in periodontal regeneration and of the biologic basis for EMD-facilitated periodontal regeneration. Subsequent chapters address patient selection; mechanism of action for EMD; treatment of intrabony defects, gingival recession, and furcation-involved teeth; treatment outcome; combined regenerative treatment approaches; and product safety.

The practical nature of this book is exemplified in the chapters on surgical technique. They are designed to promote understanding of the technical aspects of EMD-facilitated periodontal regeneration within the context of the preclinical and clinical evidence provided in other chapters. Although success rates vary significantly in different hands, an understanding of the biologic basis for the use of EMD in periodontal regenerative procedures and a working knowledge of the surgical techniques will optimize the potential for success.

Editorial Reviews
From Book News, Inc.
Cochran (periodontics, University of Texas Health Science Center) explains principles for the clinical use of enamel matrix derivative (EMD) in periodontal regeneration in this manual for general practitioners, clinicians working in periodontal regeneration, and students studying biology-based regenerative treatment approaches. After an overview of trends in periodontal regeneration and the biological basis for the use of EMD, the manual addresses aspects of patient selection, mechanisms of action, and treatment of various conditions, with step-by-step procedures illustrated by color photos and drawings and b&w X-rays.Book News, Inc.®, Portland, OR

Book Info
Univ. of Texas Health Science Center, San Antonio. Explains the principles for the clinical use of enamel matrix derivative (EMD). Provides the step-by-step process in EMD regenerative surgical treatment. Discusses the biologic concepts, presurgical evaluation, patient selection, treatment outcome, and more. DNLM: Dental Enamel Proteins--therapeutic use.

David L. Cochran, DDS, MMSc, PhD
Professor and Chairman, Department of Periodontics
University of Texas Health Science Center
San Antonio, Texas

Jan L. Wennström, LDS, Odont Dr
Professor and Chairman, Department of Periodontology
Faculty of Odontology
Göteborg University
Göteborg, Sweden

Eiji Funakoshi, DDS, MSD
Private Practice
Fukuoka, Japan

Lars Heijl, DDS, MS, PhD
Director, Postgraduate Program, Department of Periodontology
Faculty of Odontology
Göteborg University
Göteborg, Sweden