#Patientcomfort 04. Sep 2020

"When it comes to regeneration, there is no fast lane" – an interview with Dr. Antonios Zampelis about the 25 years anniversary of Emdogain®

You can’t buy experience – you earn it. In its 25 years of commercial availability, Straumann® Emdogain® has earned the respect of thousands of periodontists, oral surgeons, implantologists and dentists around the world. In 2020 we are celebrating Emdogain’s® 25th anniversary of the first clinical use . Since then, respected leaders in the field of regenerative dentistry have counted on Straumann® Emdogain® to improve the clinical outcome in various treatment indications. Some of them shared with us their experiences and personal consideration about the concepts of expertise and experience in this series of anniversary interviews. Our interview partner of today is Dr. Antonios Zampelis from Sweden.

Dr. Zampelis, since when are you based in Sweden, in Karlstad?

I have been living in Sweden as a child already. I got my dental degree in Athens, Greece, where I  worked as a general dentist and, for four years, as a specialist. I received my specialist training in Gothenburg, Sweden and have been working as a specialist in Sweden since 2011.

Have you always wanted to become a dental specialist?

I wanted to be the next Jacques Yves Cousteau and study sharks. When I realized that sharks never run out of teeth, I turned to periodontology instead! Joking aside, my father was a periodontist and I grew up in his practice so more or less I always took for granted that I would become a periodontist too. Now that I have become one, I wouldn’t change it for the world.

What were your challenges as a student?

I always found it intriguing that the academic environment in many countries bases its teaching on opinions and dogmas. When I moved to Sweden and was exposed to an evidence-based teaching I was thrilled. This has followed me ever since.

“Listen to your heart, find your niche within your field and work hard to be as good as you can. When it comes to regeneration, there is no fast lane. Practice makes it perfect.” A. Zampelis
 

How was your start as periodontist?

I have always been exposed to periodontology, so a lot of my clinical work revolved around periodontics. My start as a periodontist involved also a lot of implant and prosthetics treatments. However, when I moved to Sweden I slowly drifted away from implants and fell more and more in love with periodontal regeneration.

Which are your past projects that you enjoyed the most?

I taught myself finite element analysis and defended a master’s thesis on implant biomechanics. More recently, we have evolved in our clinic a combined approach for predictably treating advanced endo-periodontal lesions that I am particularly proud of. We will soon try to publish our findings.

What is your experience with our 25 years proven product and for which indications are you using Emdogain®?

I like using Emdogain® because it is a truly biological approach and is supported by abundant evidence. There is a misconception that Emdogain® only works on smaller defects and that could not be further from the truth. When tissue management and suturing are optimized, Emdogain® can work on big lesions just as well as any other regenerative method. I like the predictability of the results, the lack of postoperative morbidity and the simplicity of the method. And the initial tissue healing is far better that any other regenerative procedure.

You are the author of the Emdogain® song – probably the only musical piece dedicated to a regenerative material – how did it happen?

Some years back, Straumann® had a music contest and I instantly knew that I wanted to participate. I did not feel inspired to do something about implants, I did however feel like doing something about Emdogain®, as periodontal regeneration is my passion. The words just came out! I have been fascinated by the a capella movement and wanted to do an a capella piece, thus this was my chance. The original was shot in my storage room with a cell phone! With Straumann®’s support we redid the song with a proper sound recording and a professional camera.

Do you have other artistic inclinations?

Besides music, I like photography and try to sketch, albeit with dubious results.

On what attributes do you think Emdogain®’s success is based?

It is without a doubt an original and unique product with a biological basis. I think that its biggest advantage, compared to other regenerative procedures, is also a drawback of sorts. Taking for granted that the surgical flap and suturing are the same, Emdogain® is so unbelievably simple to use that one might doubt that it can be as effective! And yet, it is as simple as pressing a button!  

“Straumann® Emdogain® is a truly biological approach supported by abundant evidence. When tissue management and suturing are optimized, it can work even on big lesions. The initial tissue healing is far better with Emdogain® than with any other regenerative procedure.” A. Zampelis
 

What does it mean for you to become a better clinician?

The more I delve into the world of minimally invasive surgery and periodontal regeneration, the more I appreciate the joy of saving teeth. Becoming a better clinician through challenging cases makes the world better, one tooth at a time!

Based on your personal experience, what is the advice you would give to a young specialist who is just starting a career?

Listen to your heart, find your niche within your field and work hard to be as good as you can. When it comes to regeneration, there is no fast lane. Practice makes perfect, periodontal regeneration is a relationship, you have to work on so that you can enjoy it for a lifetime!

And looking back, what was the advice that you appreciated most when you were at the beginning of your career?

Dare to make mistakes. And learn from them. A very wise man who was involved in the foundation of BIORA once saw me make wrong judgement during a surgery. Afterwards he told me “Now that it will go wrong, learn from it and do not repeat it again”.


Case description: 51 years old male, healthy, no medications. Smokes 8 to10 cigarettes per day. Referred because of  tooth 21 which exhibits deep pocketing and repeated acute symptoms (sweeling, pain). The tooth was treated at first with one instance of non-surgical procedure, as the patient had had acute symptoms prior to our examination. The tooth was subsequently treated with periodontal surgery and with EMD as a complement. A buccal flap was elevated, and wediscovered a defect that was extending to the palatal aspect of the root. After root debridement, Straumann® Prefgel® and Straumann® Emdogain® were applied. The flap was sutured with 6-0 Prolene sutures. The sutures were removed after two weeks. Reevaluation with probing and new periapical x-ray evaluation were performed after 6 months and follow-up 12, 24 and 36 months after surgery.


Straumann® Emdogain® is a unique gel containing enamel matrix derivative of porcine origin. The main component is amelogenin, which has demonstrated the ability to stimulate certain cells types involved in the healing process of soft and hard tissues towards a regenerative pattern, thus leading to true periodontal regeneration1 and accelerated oral wound healing2. Emdogain® has a respected legacy as an irreplaceable tool for periodontology backed by extensive and long-term clinical documentation including studies with 10 years follow-up3,4. Over the past 25 years it has been used in over 2.5 million patients5 and it is documented in over 1,000 scientific publications, including over 600 clinical papers6. For more information: click here.

References

  1. Bosshardt DD. Biological mediators and periodontal regeneration: a review of enamel matrix proteins at the cellular and molecular levels. J Clin Periodontol. 2008;35(8 Suppl):87‐105.doi:10.1111/j.1600-051X.2008.01264.x.
  2. Miron RJ, Dard M, Weinreb M. Enamel matrix derivative, inflammation and soft tissue wound healing. J Periodontal Res. 2015 Oct;50(5):555-69.
  3. Sculean A, Kiss A, Miliauskaite A, Schwarz F, Arweiler NB, Hannig M. Ten-year results following treatment of intra-bony defects with enamel matrixproteins and guided tissue regeneration. J Clin Periodontol. 2008 Sep;35(9):817-24.
  4. McGuire MK, Scheyer ET, Nunn M. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue: comparison of clinical parameters at 10 years. J Periodontol. 2012 Nov;83(11):1353-62.
  5. Based on the number of syringes sold to date, globally.
  6. According to PUBMED search for “Emdogain” OR “enamel matrix derivative”.