enamel matrix derivative + autogenous bone

A combination therapy used in periodontal regenerative procedures for treating deep periodontal intra-osseous defects. This combination therapy has shown significant clinical effectiveness in improving soft tissue conditions and promoting bone regeneration. ## Efficacy and Clinical Applications Enamel matrix derivative combined with autogenous bone graft has demonstrated impressive clinical outcomes in the treatment of deep periodontal intra-osseous defects. In a study of 13 patients with 15 deep one- to two-wall intra-osseous defects, this combination therapy resulted in significant improvements in several clinical parameters: - Pocket probing depth (PPD) decreased from 9.4±1.8 mm before surgery to 4.7±1.2 mm post-surgery - Clinical attachment level (CAL) improved from 10.5±2.0 mm pre-surgery to 6.2±1.7 mm post-surgery - CAL gain averaged 4.3±1.4 mm, with 93.3% of defects showing CAL gain ≥3 mm - Minimal gingival recession change of 0.4±0.7 mm The treatment approach involves a regenerative procedure based on supra-crestal soft tissue preservation in association with the combined application of autogenous bone and enamel matrix derivative. ## Mechanism of Action Enamel matrix derivative works by: - Stimulating attachment of periodontal ligament fibroblasts - Enhancing alkaline phosphatase activity - Promoting transforming growth factor β1 release from periodontal and gingival fibroblasts - Increasing expression of specific mineralization markers in osteoblasts When combined with autogenous bone graft, this therapy creates an optimal environment for periodontal regeneration and healing, facilitating gains in clinical attachment level and reduction of probing depth. ## Case Reports A case report documented successful treatment of a 40-year-old female patient with moderate generalized chronic periodontitis using debridement flaps with enamel matrix derivative and autogenous bone graft. The treatment resulted in total remission of periodontal pockets. ## Long-term Success The success of this treatment approach depends on constant maintenance and periodontal evaluation every three months to prevent recurrence. The combination therapy is particularly effective for treating containing bone defects.

Other names

EMD + ABAB/EMD