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REGENERATIVE NEWS
Periodontal Tissue Engineering And Regeneration News – OCT 2010

PERIODONTAL MASTERCLASS REVIEW

Friday 9th July 2010 saw the UK’s first Straumann “Masterclass in Periodontal Regeneration”, held at the ITI Education Centre in Crawley, West Sussex.

60 delegates received a day of lectures and open discussion sessions with Professor Nikos Donos, Head of periodontology at the Estman Dental Institute and Professor Anton Sculean, Head of Periodontology at the University of Berne, Switzerland.

The meeting covered a wide range of topics, including:

  • Periodontal healing and development of guided tissue regeneration (GTR);
  • The role of grafting materials in regenerative periodontal therapy;
  • The techniques for using membranes in regeneration and the complications that can arise;
  • The biologic background and clinical applications of Emdogain in intra-bony, recession, and supra-alveolar defects;
  • The use of Emdogain in furcation defects and combination approaches; and
  • Clinical concepts in regenerative and plastic aesthetic periodontal therapy.

The audience were encouraged to participate in discussion and questioning throughout, and the delegates left at the end of the day with a detailed, up-to-date review of an evidence-based approach to periodontal regeneration.

Straumann plans to hold two further periodontal masterclasses in 2011, one in the North and one in the South in the UK. Provisional dates are 29th and 30th June 2011, so pencil these dates in your diary. Dates and venues will be confirmed in future issues of Regenerative News.
Nada Al-Nahi Discusses The Benefits of Straumann® Emdogain to Design Regenerate Periodontal Tissue and Significantly Improve the Outcome of Periodontal Treatment.

WHEN WERE YOU FIRST INTRODUCED TO STRAUMANN® EMDOGAIN?
As the Specialist Periodontist, I am keen to use the latest regenerative procedures and materials that have sound scientific research and well respected clinicians supporting them. I first used Straumann® Emdogain at Guy’s Hospital, where I trained. Since then, I have been using it successfully in practice since 2001.

IN WHICH CLINICAL SITUATIONS IS THE USE OF STRAUMANN® EMDOGAIN ADVANTAGEOUS?
The prerequisites to using Straumann® Emdogain are well documented in many published articles. Careful patient selection is important, for example, patients with good compliance, who are well motivated with excellent plaque control and bleeding scores that do not exceed 15%, do not smoke greater than 10 cigarettes a day and are not compromised by uncontrolled diabetes, bleeding disorders or serious medical conditions which would prevent one from performing surgery.

The teeth to be treated must have clean root surfaces. Typically, there would have been previous non-surgical therapy, but with deep pocketing remaining and evidence of infrabony defects radiographically. I tend to use Straumann® Emdogain, with consent from patients, in localised infrabony defects, around single-rooted teeth; grade 1 to early Grade 2 mandibular molar furcation defects & infrabony interdental defects (3 and 2 walled). As confirmed in the literature, it does not predictably work in upper molar furcation or suprabony defects so these sites are not suitable.

IS IT DIFFICULT TO MOTIVATE PATIENTS TO ACCEPT TREATMENT WITH STRAUMANN® EMDOGAIN?
Patients are often surprised and disappointed that they have extensive periodontitis, as it is quite insidious in nature with few or no significant signs or symptoms until the teeth have a guarded to poor prognosis, typically. Once the nature of the disease, its treatment options and long-term success rates are explained, most patients will comply with the treatment plans recommended as they would like to preserve their teeth for as long as possible delaying their need for dental implants, but without compromising their future implant potential. Thus, when they are informed one can regenerate a modest but significant amount of their lost bone (usually 2-4mm), they often prefer to have this regenerative option as it may change the prognosis of a tooth from fair to good.

IS STRAUMANN® EMDOGAIN FOR USE BY SPECIALISTS ONLY?
You need to be quite skilled to undertake some of the more advanced papilla preservation procedures and I would advise any clinician wanting to use the product to attend one of the many courses available.

IS THERE AN ALTERNATIVE TO STRAUMANN® EMDOGAIN?
Not really. It is relatively simple to use. The consequences of failure of the procedure are not catastrophic (i.e. if it fails the worst that can happen is lake of bone fill of the defect, but the pocket may still resolve following the surgery). The same cannot be said for other regenerative materials on the market such as resorbable and non-resorbabale membrance using GTR technique and bone substitutes, which are more technique sensitive to carry out. If a membrane exposure or infection of the graft material occurs due to wound breakdown when using Straumman Emdogain because it is not a space filler. Similar results may be achievable with GTR but GTR is more time consuming with potentially higher failure rates.

HOW COST EFFECTIVE IS STRAUMANN® EMDOGAIN IN TERMS OF THE RESULTS ACHIEVED?
There are costs associated with undertaking this kind of complex treatment, but I think that most patients accept this when they understand the results that can be achieved in terms of retaining teeth that have an uncertain outlook. Also, I often get referrals from GDPs requesting Straumann® Emdogain by name, because they have been impressed with the results that have been achieved.

Patients seem to be pleasantly surprised at how minimally invasive the treatment is and certainly value delaying the loss of a tooth.There is definitely an important role for Straumann® Emdogain in the world of periodontology.

For more information about Straumann® Emdogain visit www.straumann.com

Dr Nada Al-Nahi
BDS (Lond) MSc MClinDent (Perio) FDS MRD RCS (Eng)
Registered Specialist Periodontist with the GDC Practice limited to Periodontics and Implant Dentistry Clinical Director of Specialist Dental in the Guildford Nada can be contacted on: 01483 504705 or by email:info@specialistdental.co.uk

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