Scientific research support

Preclinical | Histology | Clinical 1 | Clinical 2

We have gone to great lengths to provide investigative evidence to determine the ability of the enamel matrix proteins to promote the supporting growth of the lost periodontal tissue.

Consequently, studies were done on the preclinical, histological and clinical levels as shown in the charts.


Preclinical - clinically relevant model

Evidence for Indications Method/
Material 		Results Conclusion(s)

Periodontal regeneration1

Peridontal defects in baboons

Flap surgery with or without enamel matrix proteins

Significant regeneration of cementum, periodontal ligament with sharpey’s fibers, new bone tissue

Greater tissue formation with Straumann® Emdogain

Regeneration is superior to repair

No dependence on exogenous growth factors, bone replacement grafts, barrier membranes or combination

Human Histology

Evidence for Indications Method/
Material 		Results Conclusion(s)

Periodonal regeneration2

Human teeth affected by periodontitits

Treatment with Enamel Matrix Derivative 6 weeks before extraction

New vital bone-like tissue and de novo formation of mineralized connective tissue with EMD

Immediate vital autogenous tissue growth in a time-critical situation

Clinical

Evidence for Indications Method/
Material 		Results Conclusion(s)

Periodontal pocket depth (PPD) reduction3

Angular osseous defects

Flap surgery with or without Straumann® Emdogain

Up to 8mm PPD reduction, 3 times greater defect fill with Straumann® Emdogain

Treatment with Straumann® Emdogain superior to flap surgery alone

Clinical attachment level (CAL) gain8

Angular osseous defects

Flap surgery with or without Straumann® Emdogain

> 4.5 mm CAL gain with Straumann® Emdogain and 1.5 mm more compared to flap surgery

Treatment with Straumann® Emdogain superior to flap surgery alone

Bone fill4 and regeneration of periodontal attachment 5

1-and 2-wall defects

Modidfied Widman flap (MWF) with Straumann® Emdogain or placebo

36 % gain of initial bone loss and 60-70 % bone fill

Straumann® Emdogain regenerates periodonotal attachment and promotes bone gain even in advanced periodontal defects

Root coverage and increased keratinized tissue6

Miller Class I, II and III recession defects

CAF with or without Straumann® Emdogain

80 -96% root coverage and significant increase of keratinized tissues

Better results in the treatment of recession with Straumann® Emdogain

Degree of root coverage7

Recession defects of ≥ 4 mm

CAF with subepithelial connective tissue or CAF with Straumann® Emdogain

4 – 8mm root coverage and better early healing in the test group

Addition of Straumann® Emdogain to CAF results in root coverage similar to subepithelial graft but without morbididity and complications

Clinical

Evidence for Indications Method/
Material 		Results Conclusion(s)

Better results compared to GTR8

Class II mandibular furcation defects

Straumann® Emdogain or bioresorbable membrane

Significantly greater reduction in horizontal furcation depth with Emdogain

Better clinical results following enamel matrix derivative compared to membrane therapy

Long-term results9,10

Intrabony defects

Treatment with Straumann® Emdogain

Re-entry

stable results after 7/9 years

Effects of Straumann® Emdogain last at least 4 and up to 9 years

Increased effect over time11

Deap intrabony defect (PD ≥ 5mm, CAL ≥ 6mm, ≥ 3mm intrabony defect)

Prospective case series

4.3 mm CAL gain after 1 year, further 0.3 mm CAL gain after 5 years, reduction of 0.3 mm after 5 years

4.9 mm PD reduction, further 1.1 mm after 5 years

Clinical gain with Straumann® Emdogain stable over time and demonstrate further improvement

Customer and patient satisfaction7

Recession defects of ≥ 4 mm

CAF with subepithelial connective tissue or CAF with Straumann® Emdogain

Same results without the intervention and potential complication to gain connective tissue

Easy to use, less time consuming, no risk of complications

Higher quality of life for patient12

Class II mandibular furcation defects

Straumann® Emdogain or bioresorbable membrane

50% less postoperative pain/swelling following enamel matrix derivative

Higher quality of life for patients compared to membrane therapy

Complication free treatment13

Intrabony defects of ≥ 3 mm

Straumann® Emdogain or GTR membrane

94% less complications occurred in the patients treated with Straumann® Emdogain

Straumann® Emdogain displayed safer compared to GTR membranes

Better wound healing7,14

Recession defects of ≥ 4 mm

CAF with subepithelial connective tissue or CAF with Straumann® Emdogain

Better early healing in the test group at 1 week

Straumann® Emdogain has a beneficial effect on the early wound healing

Better predictability and outcome15

Deep intrabony defects ≥ 3 mm

Prospective multicentre randomized controlled study of papilla preservation flap surgery

Significant higher CAL and better pocket reduction

Straumann® Emdogain increased the predictability of clinically significant results and decreased the probability of obtaining negligible or no gains in CAL

1    Cochrane D.L. et al, The Effect of Enamel Matrix Proteins on Periodontal Regeneration as Determinded by Histolgical Analyses, J. Periodontol 2003; 74: 1043-1055
2    Bosshardt D.D. et al, Effects of Enamel Matrix Proteins on tissue formation along the roots of human teeth, Periodont Res 2005; 40: 158-167
3    Froum SJ.et al, A comparative study utilizing open flap debeidement with and without enamel matrix derivative in the treatment of periodontal intrabony defects, a 12 month re-entry, J. Periodontology 2001; 72: 25-34
4    Heden G. et al, Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects, a series of case reports J. Periodontology 1999; 26: 855-860
5    Heijl L. et al, Enamel meatrix derivative (Emdogain)in the treatment of intrabony periodontal defects, J Clin Periodontol, 1997; 24: 705-714
6    Cueva M.A.et al. A comparative study of coronally advanced flaps with and without the addition of Enamel Matrix Derviatve in the treatment of marinal tissue recession, J. Periodontology 2004; 75: 949-956
7    McGuire et. al Evaluation of Human Recession Defects Treated with Coronally Advanced Flaps and Either Enamel Matrix Derivative or Connective Tissue. Part 1: Comparison of Clinical Parameters: J Periodontol 2003; 74: 1110-1125
8    Jepsen S, et al A Randomized Clinical Trial Comparing Enamel Matrix Derivative and Membrane Treatment of Buccal Class II Furcation Involvement in Mandibular Molars. Part I: Study Design and Results for Primary Outcomes J. Periodontol 2004; 75: 1150-1160
9    Rasperini et al, Long-term clinical observation of treatment of infrabony defects with enamel matrix derivative (Emdogain): surgical reentry. Int J Periodontics Restorative Dent, 2005; 25(2): 121-127
10    Sculean et al. 9-year results following treatment of intrabony periodontal defects with an enamel matrix derivative: report of 26 cases. Int J Periodontics Restorative Dent 2007; 27(3): 221-229
11    Heden G. et al, Five-Year Follow-Up of Regenerative Periodntal Therapy with Enamel Matix Derivative at Sites With Angular Bone Defects, J Periodontol February 2006; Vol 77, Number 2, 295-301
12    Meyle J, et al A Randomized Clinical Trial Comparing Enamel Matrix Derivative and Membrane Treatment of Buccal Class II Furcation Involvement in Mandibular Molars. Part II: Secondary Outcomes. J Periodontol 2004; 75: 1188-1195
13    Sanz M, et al Treatment of intrabony defects with Enamel Matrix Proteins or Barrier MembranesJ Periodontol, 2004; 75: 726-733
14    Wennstrom JL, Lindhe J. Some effects of enamel matrix proteins on wound healing in the dento-gingival region. J Clin Periodontol. 2002; 29(1): 9-14
15    Tonetti M.S. et al, Enamel matrix proteins in the regenerative therapy of deep intrabony defects, J Clin Periodontol. 2002 Apr; 29(4):317-25

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