da Silva Karime Tavares Lima, Ferreira Meire Coelho, Grazziotin-Soares Renata, Dourado Letícia Gomes, de Castro Rizzi Maia Claudia, da Silva Gisele Rodrigues, Carvalho Ceci Nunes
CEUMA University, Rua Josué Montello n° 1, Renascença II, São Luís, MA, 65075120, Brazil.
Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia (UBC), Vancouver, BC, Canada.
J Med Case Rep. 2025 May 2;19(1):205. doi: 10.1186/s13256-025-05199-x.
Emdogain (Straumann Emdogain, Basel, Switzerland) is an enamel matrix derivative and has an important role in odontogenesis, by potentializing pulp tissue repair and regeneration, as showed in biological studies. Nevertheless, the benefits of using Emdogain as a scaffold in clinical regenerative endodontic procedures has not been demonstrated and is not yet fully understood. The aim of this report was to show three clinical cases that had different preoperative conditions and underwent pulp regenerative procedures under an identical clinical protocol. This report also aimed to show the value of using Emdogain to guide angiogenesis and the healing process by reporting clinical and radiographical results. This is a pioneering study on the use of Emdogain in regenerative endodontic procedures in humans.
This report is a retrospective description of clinical findings from three regenerative treatments conducted under an identical protocol in two appointments using Emdogain as a scaffold. The three young Brazilian patients, aged 8, 8, and 12 years old (one female and two male), are from São Luís city, state of Maranhão. All three patients identify as Pardo ethnicity with brown skin color, come from low-income backgrounds, and had necrotic immature permanent teeth. Quantitative assessments of crown shades of treated teeth were determined with VITA Easyshade® Advance 4.0 spectrophotometer (VITA Zahnfabrik, Bad Sackingen, Germany) at baseline to 24-month follow-up. Self-reported pain was measured using the visual analogue scale (VAS) at the time of treatment (shortly after induction of bleeding into the canal) and at 7 day following the procedure. At 12 months, radiographic lesions were resolved. At 24 months there were apical closures, and the three teeth remained in function without symptomatology or signs of failure. All cases had the root length increased and the dentin wall thickened. One case presented radiographic images suggestive of scattered calcified zones in the root canal lumen.
Emdogain may be beneficial as a scaffold in regenerative endodontic procedures. The following outcomes were noted at 24-month follow-up: continuity of root formation, thickening of the root dentin walls, and closure of the root apex.
Emdogain（瑞士巴塞尔士卓曼公司生产的Emdogain）是一种釉基质衍生物，在牙发生过程中发挥重要作用，生物学研究表明它能促进牙髓组织的修复和再生。然而，在临床再生性牙髓治疗程序中使用Emdogain作为支架的益处尚未得到证实，也未被完全理解。本报告的目的是展示三例术前情况不同但按照相同临床方案接受牙髓再生治疗的病例。本报告还旨在通过报告临床和影像学结果来展示使用Emdogain引导血管生成和愈合过程的价值。这是一项关于在人类再生性牙髓治疗中使用Emdogain的开创性研究。
本报告是对三例再生治疗临床结果的回顾性描述，这三例治疗在两次就诊时按照相同方案进行，使用Emdogain作为支架。三名年轻的巴西患者，年龄分别为8岁、8岁和12岁（一名女性和两名男性），来自马拉尼昂州圣路易斯市。所有三名患者均为棕色皮肤的帕尔多族裔，来自低收入家庭，且患有坏死性未成熟恒牙。在基线至24个月随访期间，使用VITA Easyshade® Advance 4.0分光光度计（德国巴德萨克京的VITA Zahnfabrik公司）对治疗牙齿的冠部颜色进行定量评估。在治疗时（向根管内诱导出血后不久）和治疗后7天，使用视觉模拟量表（VAS）测量自我报告的疼痛程度。在12个月时，影像学病变得到解决。在24个月时，根尖闭合，三颗牙齿仍能正常行使功能，无任何症状或失败迹象。所有病例的牙根长度均增加，牙本质壁增厚。其中一例的影像学图像显示根管腔内有散在的钙化区。
在再生性牙髓治疗程序中，Emdogain作为支架可能有益。在24个月随访时观察到以下结果：牙根形成的连续性、牙根牙本质壁增厚以及根尖闭合。
