Dental Biomaterials Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Department of Life Sciences Engineering, Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran.
J Prosthodont. 2018 Oct;27(8):733-736. doi: 10.1111/jopr.12753. Epub 2018 Jan 11.
Furcations are complicated periodontal defects. Untreated furcations lead to loss of the involved teeth and supporting tissues. It has been demonstrated that regenerative biomaterials are beneficial in reconstruction of the bone surrounding furcation-affected teeth. These biomaterials range from bone grafts and nonresorbable/resorbable barrier membranes to biologics that are able to trigger inactive regenerative processes in periodontal tissues. Selection of appropriate material(s) to treat furcations is challenging. The aim of this article is to provide a comparative outlook on different biomaterials applicable in regeneration of furcations with a focus on enamel matrix derivative (EMD).
Scientific databases including PubMed/MEDLINE, ScienceDirect, and EMBASE were searched, and 28 articles were found primarily for this specific study. Full texts were studied to identify relevant studies; 17 studies were excluded because of irrelevancy, while 11 main studies were ultimately selected. Other references have been used for general statements.
EMD is a protein complex widely used in the regeneration of different periodontal defects. To assess the effects of EMD for treatment of root furcations, clinical studies involving EMD with and without barrier membranes and bone grafts were selected and compared. Briefly, this study reveals that when EMD is combined with open flap debridement (OFD), guided tissue regeneration (GTR), or bone grafting (BG), the amount of class II furcations converted to class I increases significantly. EMD also reduces tissue swelling and patient discomfort after treatment.
This study provides evidence to find the best combination of biomaterials to treat furcation defects. The best results are obtained if EMD is combined with β-TCP/HA alloplastic bone grafts.
分叉区是复杂的牙周缺损。未治疗的分叉区会导致受累牙齿及其支持组织的丧失。已经证明，再生生物材料有利于重建受分叉影响的牙齿周围的骨组织。这些生物材料范围从骨移植物和不可吸收/可吸收的屏障膜到能够触发牙周组织中不活跃的再生过程的生物制剂。选择合适的材料来治疗分叉区是具有挑战性的。本文的目的是提供一个不同生物材料的比较观点，这些材料适用于分叉区的再生，重点是釉基质衍生物（EMD）。
包括 PubMed/MEDLINE、ScienceDirect 和 EMBASE 在内的科学数据库进行了搜索，主要针对这项特定研究发现了 28 篇文章。研究全文以确定相关研究；17 项研究因不相关而被排除，而最终选择了 11 项主要研究。其他参考文献用于一般性陈述。
EMD 是一种广泛用于不同牙周缺损再生的蛋白质复合物。为了评估 EMD 治疗根分叉的效果，选择并比较了涉及 EMD 与屏障膜和骨移植物的临床研究。简而言之，这项研究表明，当 EMD 与翻开瓣清创术（OFD）、引导组织再生（GTR）或骨移植（BG）联合使用时，将 II 类分叉转化为 I 类的数量显著增加。EMD 还可以减少治疗后组织肿胀和患者不适。
本研究提供了寻找治疗分叉缺陷的最佳生物材料组合的证据。如果 EMD 与 β-TCP/HA 同种异体骨移植物结合使用，则可以获得最佳效果。
