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Enamel Matris Türevinin (Emdogain®) Dental İmplant Osseointegrasyonu Üzerindeki Etkilerinin Değerlendirilmesi

Yıl 2021, Cilt: 18 Sayı: 1, 54 - 58, 28.04.2021

Alihan Bozoğlan Mehmet Gül Serkan Dündar

https://doi.org/10.35440/hutfd.852296

Öz

Amaç: Bu çalışmanın amacı, Enamel matris türevinin (Emdogain®) kemik grefti ile karıştırılarak defekt oluşturulan bölgeye uygulanmasından sonra yeni kemik rejenerasyonunun kemik implant kaynaşmasına etkisinin değerlendirilmesidir.
Materyal ve metod: Deneyde toplamda 20 adet sprague dawley rat kullanılmıştır. Herbir grupta 10 adet rat bulunmaktadır. Ratlar, % 55’lik nem ve 22 ±2°C sıcaklık kontrollü bulunan odada bulundurulmuştur. Ayrıca 12 saat aydınlık 12 saat karanlık döngüsünde tabi tutulmuştur. Deneklerin sağ tibiya kemiklerinin metafiziyel kısımlarındaki kortikokansellöz kemiğine kaviteler açıldı. Bu kavitelere 2.5 mm çapında 4 mm uzunluğundaki titanyum implantlar yerleştirildi ve boyun bölgesinde implant boyunun 2 mm’sine tekabül edecek şekilde kontrol grubuna sadece kemik defekti yerleştirildi. Deney grubuna ise kemik grefti ve Enamel matris türevinin (Emdogain®) yerleştirildi. 8 hafta sonra denekler sakrifiye edildi.
Bulgular: Yapılan analizler sonucunda kemik implant kaynaşması emdogain uygulanan grupta yüksek bulunmasına rağmen istatistiksel olarak anlamlı bir fark elde edilememiştir. Aynı şekilde glukoz, ast, alt, alp, üre, kreatinin ve kalsiyum seviyeleri değerlendirilmiş ve istatistiksel olarak anlamlı bir fark elde edilememiştir. Fakat fosfor seviyesinde deney grubunda anlamlı derece bir düşme tespit edilmiştir (p < 0.05).
Sonuç: Emdogain uygulaması greft materyalinin etkisini artırmaktadır ve aynı zamanda implant kemik kontağına olumlu etkisi bulunmaktadır. Fakat 8 haftalık kısa iyileşme periyodunda etkisi sınırlı olmaktadır. Emdogain uygulamasının etkisinin kesin olarak anlaşılması için uzun zamanlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

dental implant kemik grefti Emdogain

Teşekkür

Çalışmanın etik kurul onayı, Fırat Üniversitesi Hayvan Deneyleri Yerel Etik Kurulu tarafından verilmiştir (Tarih:16/01/2019, Karar No: 2019/01/03).

Kaynakça

  • Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014; 41(6): 443–76.
  • Alsaadi G, Quirynen M, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol. 2007; 34(7): 610–17.
  • Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Factors influencing early dental implant failures. Journal of dental research 2016; 95(9): 995-1002.
  • Cha HS, Kim A, Nowzari H, Chang HS, Ahn KM. Simultaneous sinus lift and implant installation: prospective study of consecutive two hundred seventeen sinus lift and four hundred sixty-two implants. Clin Implant Dent Relat Res 2014; 16: 337–47.
  • Kim A, Kar K, Nowzari H, Cha HS, Ahn KM. Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implant placement: a case series. Implant Dent 2013; 22: 438–43.
  • Kim A, Kar K, Nowzari H, Ahn KM, Cha H. Subapical osteotomy to correct dental implant malpositioning and vertical ridge deficiency: a clinical report. J Prosthet Dent 2012; 108: 204–8.
  • Gestrelius S, Andersson C, Johansson AC, Persson E, Brodin A, Rydhag L et al. Formulation of enamel matrix derivative for surface coating. Kinetics and cell colonization. J Clin Periodontol 1997; 24: 678–84.
  • Gestrelius S, Andersson C, Lidström D, Hammarström L, Somerman M. In vitro studies on periodontal ligament cells and enamel matrix derivative. J Clin Periodontol 1997; 24: 685–92.
  • Kasaj A, Willershausen B, Junker R, Stratul SI, Schmidt M. Human periodontal ligament fibroblasts stimulated by nanocrystalline hydroxyapatite paste or enamel matrix derivative. An in vitro assessment of PDL attachment, migration, and proliferation. Clin Oral Investig 2012; 16(3): 745–54.
  • Hoang AM, Oates TW, Cochran DL. In vitro wound healing responses to enamel matrix derivative. J Periodontol 2000; 71: 1270–77.
  • Van der Pauw MT, Van den Bos T, Everts V, Beertsen W. Enamel matrix‐derived protein stimulates attachment of periodontal ligament fibroblasts and enhances alkaline phosphatase activity and transforming growth factor β1 release of periodontal ligament and gingival fibroblasts. J Periodontol 2000; 71: 31–43.
  • Yan XZ, Rathe F, Gilissen C, van der Zande M, Veltman J, Junker R, Yang F, Jansen JA, Walboomers XF. The effect of enamel matrix derivative (Emdogain®) on gene expression profiles of human primary alveolar bone cells. J Tissue Eng Regen Med. 2014; 8(6): 463-72. doi: 10.1002/term.1545. Epub 2012 Jun 11. PMID: 22689476.
  • Thorat M, Pradeep AR, Pallavi B. Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2011 Oct;38(10):925-32. doi: 10.1111/j.1600-051X.2011.01760.x. Epub 2011 Jul 21. PMID: 21777267.
  • Sculean A, Donos N, Schwarz F, Becker J, Brecx M, Arweiler NB. Five-year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. J Clin Periodontol. 2004 Jul;31(7):545-9. doi: 10.1111/j.1600-051X.2004.00518.x. PMID: 15191590.
  • Yukna RA, Mellonig JT. Histologic evaluation of periodontal healing in humans following regenerative therapy with enamel matrix derivative. A 10-case series. J Periodontol. 2000 May;71(5):752-9. doi: 10.1902/jop.2000.71.5.752. PMID: 10872956.
  • Choukroun J, Adda F, Schoeffler C. An opportunity in perio-implantology: The PRF. Implantodontie. 2001; 42: 55– 62.
  • Aspriello SD, Zizzi A, Spazzafumo L. Effects of enamel matrix derivative on vascular endothelial growth factor expression and microvessel density in gingival tissues of periodontal pocket: a comparative study. J Periodontol. 2011; 82(4): 606-12. doi: 10.1902/jop.2010.100180.
  • Boyan BD, Weesner TC, Lohmann CH, Andreacchio D, Carnes DL, Dean DD, et al. Porcine fetal enamel matrix derivative enhances bone formation induced by demineralised freeze dried bone allograft in vivo. J Periodontol.2000; 71(8): 1278–86. doi:10.1902/jop.2000.71.8.1278.
  • Rosen PS, Reynolds MA. A retrospective case series comparing the use of demineralized freeze-dried bone allograft and freeze-dried bone allograft combined with enamel matrix derivative for the treatment of advanced osseous lesions. J Periodontol. 2002; 73(8): 942-9.doi: 10.1902/jop.2002.73.8.942.
  • Harrel SK, Wilson TG, Nunn ME. Prospective assessment of the use of enamel matrix proteins with minimally invasive surgery. J Periodontol. 2005; 76(3): 380-4. doi: 10.1902/jop.2005.76.3.380.
  • Hoidal MJ, Grimard BA, Mills MP, Schoolfeld JD, Mellonig JT, Mealey BL. Clinical evaluation of demineralized freeze-dried bone allograf with and without enamel matrix derivative for the treatment of periodontal osseous defects in humans. J Periodontol. 2008; 79(12): 2273-80. doi: 10.1902/ jop.2008.080259.
  • Velasquez-Plata D, Scheyer ET, Mellonig JT. Clinical comparison of an enamel matrix derivative used alone or in combination with a bovine-derived xenograft for the treatment of periodontal osseous defects in humans. J Periodontol. 2002; 73(4): 433-40. doi: 10.1902/jop.2002.73.4.433.
  • Lekovic V, Camargo PM, Weinlaender M, Nedic M, Aleksic Z, Kenney EB. A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans. J Periodontol. 2000; 71(7): 1110-6. doi: 10.1902/ jop.2000.71.7.1110.
  • Gurinsky BS, Mills MP, Mellonig JT. Clinical evaluation of demineralized freeze-dried bone allograft and enamel matrix derivative versus enamel matrix derivative alone for the treatment of periodontal osseous defects in humans. J Periodontol. 2004; 75(10): 1309-18. doi: 10.1902/ jop.2004.75.10.1309.
  • Miteva MD. Emdogain (EMD) and platelet-rich plasma (PRP) in periodontal regeneration. Scripta Scientifica Medicinae Dentalis 2019 ; 5(1): 27-32.

Evaluation of the Effects of the Enamel Matrix Derivative (Emdogain®) on Dental Implant Osseointegration

Yıl 2021, Cilt: 18 Sayı: 1, 54 - 58, 28.04.2021

Alihan Bozoğlan Mehmet Gül Serkan Dündar

https://doi.org/10.35440/hutfd.852296

Öz

Background: The aim of this study is to evaluate the effect of new bone regeneration on bone implant fusion after the Enamel matrix derivative (Emdogain®) is mixed with bone graft and applied to the defect area.
Materials and Methods: A total of 20 sprague dawley rats were used in the experiment. There are 10 rats in each group. Rats were kept in a room with 55% humidity and 22 ± 2 ° C temperature controlled. It was also subjected to a 12 hour light and 12 hour dark cycle. Cavities were opened in the corticocancellous bone in the metaphyseal parts of the right tibia bones of the subjects. Titanium implants with a diameter of 2.5 mm and a length of 4 mm were placed in these cavities, and only a bone defect was placed in the control group, corresponding to 2 mm of the implant length in the neck region. Bone graft and Enamel matrix derivative (Emdogain®) were placed in the experimental group. After 4 weeks, the subjects were sacrificed.
Results: As a result of the analysis, although bone implant fusion was found to be high in the emdogain group, no statistically significant difference was found. Likewise, glucose, ast, alt, alp, urea, creatinine and calcium levels were evaluated and no statistically significant difference was found. However, a significant decrease was detected in the phosphorus level in the experimental group (p <0.05).
Conclusions: Emdogain application increases the effect of the graft material and also has a positive effect on implant bone contact. However, its effect is limited in the short recovery period of 8 weeks. Long-term studies are needed to fully understand the effect of Emdogain administration.

Anahtar Kelimeler

dental implant bone graft Emdogain

Kaynakça

  • Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil. 2014; 41(6): 443–76.
  • Alsaadi G, Quirynen M, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol. 2007; 34(7): 610–17.
  • Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Factors influencing early dental implant failures. Journal of dental research 2016; 95(9): 995-1002.
  • Cha HS, Kim A, Nowzari H, Chang HS, Ahn KM. Simultaneous sinus lift and implant installation: prospective study of consecutive two hundred seventeen sinus lift and four hundred sixty-two implants. Clin Implant Dent Relat Res 2014; 16: 337–47.
  • Kim A, Kar K, Nowzari H, Cha HS, Ahn KM. Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implant placement: a case series. Implant Dent 2013; 22: 438–43.
  • Kim A, Kar K, Nowzari H, Ahn KM, Cha H. Subapical osteotomy to correct dental implant malpositioning and vertical ridge deficiency: a clinical report. J Prosthet Dent 2012; 108: 204–8.
  • Gestrelius S, Andersson C, Johansson AC, Persson E, Brodin A, Rydhag L et al. Formulation of enamel matrix derivative for surface coating. Kinetics and cell colonization. J Clin Periodontol 1997; 24: 678–84.
  • Gestrelius S, Andersson C, Lidström D, Hammarström L, Somerman M. In vitro studies on periodontal ligament cells and enamel matrix derivative. J Clin Periodontol 1997; 24: 685–92.
  • Kasaj A, Willershausen B, Junker R, Stratul SI, Schmidt M. Human periodontal ligament fibroblasts stimulated by nanocrystalline hydroxyapatite paste or enamel matrix derivative. An in vitro assessment of PDL attachment, migration, and proliferation. Clin Oral Investig 2012; 16(3): 745–54.
  • Hoang AM, Oates TW, Cochran DL. In vitro wound healing responses to enamel matrix derivative. J Periodontol 2000; 71: 1270–77.
  • Van der Pauw MT, Van den Bos T, Everts V, Beertsen W. Enamel matrix‐derived protein stimulates attachment of periodontal ligament fibroblasts and enhances alkaline phosphatase activity and transforming growth factor β1 release of periodontal ligament and gingival fibroblasts. J Periodontol 2000; 71: 31–43.
  • Yan XZ, Rathe F, Gilissen C, van der Zande M, Veltman J, Junker R, Yang F, Jansen JA, Walboomers XF. The effect of enamel matrix derivative (Emdogain®) on gene expression profiles of human primary alveolar bone cells. J Tissue Eng Regen Med. 2014; 8(6): 463-72. doi: 10.1002/term.1545. Epub 2012 Jun 11. PMID: 22689476.
  • Thorat M, Pradeep AR, Pallavi B. Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2011 Oct;38(10):925-32. doi: 10.1111/j.1600-051X.2011.01760.x. Epub 2011 Jul 21. PMID: 21777267.
  • Sculean A, Donos N, Schwarz F, Becker J, Brecx M, Arweiler NB. Five-year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration. J Clin Periodontol. 2004 Jul;31(7):545-9. doi: 10.1111/j.1600-051X.2004.00518.x. PMID: 15191590.
  • Yukna RA, Mellonig JT. Histologic evaluation of periodontal healing in humans following regenerative therapy with enamel matrix derivative. A 10-case series. J Periodontol. 2000 May;71(5):752-9. doi: 10.1902/jop.2000.71.5.752. PMID: 10872956.
  • Choukroun J, Adda F, Schoeffler C. An opportunity in perio-implantology: The PRF. Implantodontie. 2001; 42: 55– 62.
  • Aspriello SD, Zizzi A, Spazzafumo L. Effects of enamel matrix derivative on vascular endothelial growth factor expression and microvessel density in gingival tissues of periodontal pocket: a comparative study. J Periodontol. 2011; 82(4): 606-12. doi: 10.1902/jop.2010.100180.
  • Boyan BD, Weesner TC, Lohmann CH, Andreacchio D, Carnes DL, Dean DD, et al. Porcine fetal enamel matrix derivative enhances bone formation induced by demineralised freeze dried bone allograft in vivo. J Periodontol.2000; 71(8): 1278–86. doi:10.1902/jop.2000.71.8.1278.
  • Rosen PS, Reynolds MA. A retrospective case series comparing the use of demineralized freeze-dried bone allograft and freeze-dried bone allograft combined with enamel matrix derivative for the treatment of advanced osseous lesions. J Periodontol. 2002; 73(8): 942-9.doi: 10.1902/jop.2002.73.8.942.
  • Harrel SK, Wilson TG, Nunn ME. Prospective assessment of the use of enamel matrix proteins with minimally invasive surgery. J Periodontol. 2005; 76(3): 380-4. doi: 10.1902/jop.2005.76.3.380.
  • Hoidal MJ, Grimard BA, Mills MP, Schoolfeld JD, Mellonig JT, Mealey BL. Clinical evaluation of demineralized freeze-dried bone allograf with and without enamel matrix derivative for the treatment of periodontal osseous defects in humans. J Periodontol. 2008; 79(12): 2273-80. doi: 10.1902/ jop.2008.080259.
  • Velasquez-Plata D, Scheyer ET, Mellonig JT. Clinical comparison of an enamel matrix derivative used alone or in combination with a bovine-derived xenograft for the treatment of periodontal osseous defects in humans. J Periodontol. 2002; 73(4): 433-40. doi: 10.1902/jop.2002.73.4.433.
  • Lekovic V, Camargo PM, Weinlaender M, Nedic M, Aleksic Z, Kenney EB. A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans. J Periodontol. 2000; 71(7): 1110-6. doi: 10.1902/ jop.2000.71.7.1110.
  • Gurinsky BS, Mills MP, Mellonig JT. Clinical evaluation of demineralized freeze-dried bone allograft and enamel matrix derivative versus enamel matrix derivative alone for the treatment of periodontal osseous defects in humans. J Periodontol. 2004; 75(10): 1309-18. doi: 10.1902/ jop.2004.75.10.1309.
  • Miteva MD. Emdogain (EMD) and platelet-rich plasma (PRP) in periodontal regeneration. Scripta Scientifica Medicinae Dentalis 2019 ; 5(1): 27-32.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Alihan Bozoğlan 0000-0003-3420-5816

Mehmet Gül 0000-0002-5721-8778

Serkan Dündar 0000-0003-3944-1957

Yayımlanma Tarihi 28 Nisan 2021
Gönderilme Tarihi 2 Ocak 2021
Kabul Tarihi 23 Şubat 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 1

Kaynak Göster

Vancouver Bozoğlan A, Gül M, Dündar S. Enamel Matris Türevinin (Emdogain®) Dental İmplant Osseointegrasyonu Üzerindeki Etkilerinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18(1):54-8.
 Kapak Resmi İndir

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty