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Q and A with Straumann about tissue regeneration

Nov. 5, 2010
DentistryIQ recently interviewed Straumann's Marketing Manager, Regenerative Solutions, Anna Stensvaag, about Straumann® Emdogain® tissue regeneration material.
by Vicki Cheeseman, Associate EditorDentistryIQ recently interviewed Straumann’s Marketing Manager, Regenerative Solutions, Anna Stensvaag, about Straumann® Emdogain® tissue regeneration material.Please tell us more about your Emdogain product.Stensvaag: Straumann® Emdogain® is a resorbable, implantable material that, in certain clinical conditions, helps grow new bone and tissue to aid in the rescue of teeth that are compromised by periodontal disease or by gingival recession. When applied onto the cleaned and conditioned root surfaces during periodontal surgery, evidence suggests that Emdogain mimics the biological process of natural tooth development and helps to enable the regeneration of new periodontal tissue. Since its introduction, Emdogain has been used in more than a million patients worldwide and continues to be a leading product for periodontal regeneration.What are the clinical uses for Straumann Emdogain?Stensvaag: Emdogain is indicated for use in conjunction with periodontal surgery to treat intrabony defects, furcation defects, or gingival recession. Within days of periodontal surgery, Emdogain helps new cells begin to form. After several weeks, regeneration of new cementum and periodontal ligament takes place, and early growth of alveolar bone can be observed. In the months following the procedure, the majority of new attachments and bone formation occurs. Regain of clinical attachment and new alveolar bone has been shown to continue over one year.Additional benefits of Emdogain treatment include less postoperative discomfort reported by patients and no follow-up surgery. In addition, clinicians have reported enhanced wound healing. Emdogain is supplied in a prefilled, ready-to-use, sterile syringe, and it does not have to be mixed with other solutions to activate, making application easy to use and hassle-free.
PostopWhat are Emdogain’s advantages?Stensvaag: Straumann Emdogain is a regenerative therapy that helps patients with periodontal disease to grow new bone and tissue naturally without compromising their tooth. In addition, Straumann Emdogain can be used to treat gingival recession caused by trauma to the soft tissue. Individuals treated with Emdogain have experienced bone fill a year following treatment. Regain of clinical attachment and alveolar bone has been shown to continue for more than a year post-treatment with Emdogain.Additional benefits of Emdogain when compared to other treatments (e.g., guided tissue regeneration or connective tissue graft) for severe periodontal disease include less postoperative discomfort reported by patients and no need for a second surgical site. Many clinicians also reported enhanced wound healing with Emdogain. What are the product’s risks, if any?Stensvaag: With any surgical treatment, there are risks based on the patient situation. Any adverse reactions that have been observed when treating a patient with Straumann Emdogain could not be distinguished from typical reactions to the surgery itself and could not be attributed to the use of Emdogain. What can the clinician be assured of in the way of Emdogain’s long-term results?Stensvaag: There are many variables in the treatment of these types of defects, including the healing of individual patients, treatment protocol, and defect severity. Treatment with Straumann Emdogain has been documented in more than 100 clinical evaluations involving over 2,000 defects. Benefits observed in these studies include improved clinical results, histological evidence of periodontal regeneration, less postoperative discomfort reported by patients, and no need for a second surgical site. Describe the clinical procedure involved in the use of Emdogain with bone graft materials.Stensvaag: Straumann Emdogain is indicated for use in conjunction with bone graft materials (allograft, autograft, bovine derived xenograft, beta-TCP, or bioactive glass) in wide defects or where additional soft tissue support is needed. Typically clinicians create a gingival flap, debride the site, and remove the smear layer by applying Straumann PrefGel. The clinician applies Straumann Emdogain, starting at the apical most aspect of the defect. The hydrated graft material is then placed onto the site, possibly applying more Straumann Emdogain if needed. What evidence supports the clinical use and long-term results of Emdogain?Stensvaag: More than 100 clinical publications in peer-reviewed journals demonstrate Emdogain to be safe and effective as an adjunct to periodontal surgery in stimulating the formation of new periodontal attachments. These clinical studies involved more than 3,000 defects and 2,500 patients. Emdogain is also backed by documented results, showing maintained results for up to 10 years.The wealth of scientific evidence supporting the product continues to grow. In the past 12 months alone, more than 40 new scientific articles have been published in peer-reviewed journals, including a systematic review of 18 studies on the treatment of gingival recession. This showed that Emdogain may increase the predictability of surgical outcomes by achieving equal or better root coverage and attachment. Other recently published studies have indicated that less postsurgical discomfort is reported with Emdogain treatment. Describe the clinical evidence Emdogain shows for periodontal regeneration.Stensvaag: True periodontal regeneration, as defined by consensus and published by the AAP is the regeneration of cementum, periodontal ligament, and alveolar bone. The only means of determining true periodontal regeneration is through the histological evaluation of sections obtained after treatment. Emdogain has undergone both preclinical and clinical histological evaluation to demonstrate its ability to promote true periodontal regeneration. Please discuss the use of Emdogain in conjunction with the coronally advanced flap procedure as a common approach to obtain root coverage.Stensvaag: Clinicians are familiar with the CAF procedure alone or in conjunction with a connective tissue graft. The clinician would create the gingival flap as he or she would for any other CAF procedure, ensuring that there will be tension-free closure. After debriding the site, the clinician would apply Straumann PrefGel to remove the smear layer for two minutes. The site is thoroughly rinsed and kept free of saliva and blood. Emdogain will then be applied to the root surface, starting at the apical most aspect of the defect. The clinician would then coronally reposition the flap to the CEJ and suture. The clinician would also de-epithelialize the adjacent papilla to allow for adequate blood supply as he or she would with other CAF procedures. Emdogain allows for a simple alternative to an autogenous connective tissue graft, which includes harvesting additional tissue from the patient’s palate. This creates a second surgical site, while providing for an increase in keratinized tissue over a coronally advanced flap alone. For more information about Straumann products, visit