#Patientcomfort 05. Oct 2021

The legacy of Emdogain®: Emdogain® FL for flapless procedures

The success story of the surgical application is the base of the new Emdogain® FL for flapless procedures, another milestone towards minimal invasiveness.

Improved patient comfort - minimally invasive and without flap surgery

Can Emdogain® users avoid the surgical procedure without forgoing all the benefits of preparation? Emdogain® has scrutinized the needs and expectations of the clinician, and around three decades after Prof. Lars Hammarström’s discovery, Emdogain® has again assumed a pioneering role as a biomaterial solution in periodontics. With the Emdogain® FL (for flapless use) treatment approach introduced at IDS in 2019, Straumann was the first to offer minimally invasive sustainable periodontal tissue regeneration without creating a flap.

25 years of Straumann® Emdogain: How matrix proteins led to the breakthrough in regenerative periodontal therapy

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A procedure that is simple, practical and both user-friendly and patient-friendly

This new approach answered a long-standing call to further reduce surgical procedures within periodontology and to offer patients more gentle procedures without sacrificing the quality of the overall result. In the pain assessment, there are clear advantages to a less invasive procedure and patients are more like to sign up to treatment without a scalpel, which actually also makes it easier to preserve teeth over the long term. The procedure is simple, practical and both user-friendly and patient-friendly1 and contributes to an improved quality of life for patients by reducing pain, swelling2 and the levels of systemic markers of inflammation.

Application of Emdogain® FL (Picture courtesy of Prof. Filippo Graziani, Italy)

Renowned periodontists recommend the use of Emdogain® FL for periodontal treatment of pockets with depths of between 5 and 9 mm and no furcation involvement.3 Treatment falls neatly into three steps:

1) After appropriate anesthesia, the gums are gently pushed back to access the affected root surface.

2) Mechanical debridement is performed. The root surface should be as clean as possible so that Emdogain® can develop its effect.

3) After rinsing with sterile saline solution, conditioning the root surface with Straumann® PrefGel® (EDTA, ethylenediaminetetraacetic acid) and rinsing again, Emdogain® FL can be applied into the periodontal pocket. The introduction of a suitable applicator enables Emdogain® FL to be applied into the periodontal pocket after scaling and root planing without the need to prepare a flap. The gingival margin is then carefully adapted against the tooth until the gum surrounds the tooth.

What do international experts in periodontology think about Emdogain®?

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Emdogain® FL stimulates periodontal regeneration4,5, while bleeding on probing (BOP) and probing depth (PPD) are significantly reduced6 and more periodontal pockets can be removed with a closed subgingival cleaning process.7

References:

  1. Expertenrunde: Schmelzmatrixproteine und minimal-invasive Therapie | Quintessenz Verlags-GmbH (quintessence-publishing.com)
  2. Wennström JL, Lindhe J. Some effects of enamel matrix proteins on wound healing in the dento-gingival region. J Clin Periodontol. 2002 Jan;29(1):9-14.
  3. Pecanov-Schröder A. Minimalinvasive parodontale Regeneration. Dentale Implantologie 2019 Jun;23(4):258-259
  4. Shujaa Addin A, Akizuki T, Matsuura T, Hoshi S , Ikawa T, Maruyama K , Ono W, Fukuba S, Izumi Y. Histological healing after non-surgical periodontal treatment with enamel matrix derivatives in canine experimental periodontitis. Odontology. 2018 Jul;106(3):289-296.
  5. Mellonig JT, Valderrama P, Gregory HJ, Cochran DL. Clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases. J Periodontol. 2009 Sep;80(9):1534-40.
  6. Jentsch HFR, Roccuzzo, M, Kasaj A, Fimmers R, Jepsen, S. Flapless application of enamel matrix derivative (EMD) as an adjunct to scaling and root planning –A multicentre randomized feasibility trial. J Clin Periodontol. 2021 May;48(5):659-667. doi: 10.1111/jcpe.13438. Epub 2021 Mar 9.
  7. Graziani F, Gennai S, Petrini M, Bettini L, Tonetti M. Enamel matrix derivative stabilizes blood clot and improves clinical healing in deep pockets after flapless periodontal therapy: A Randomized Clinical Trial. J Clin Periodontol. 2019 Feb; 46(2):231-240.