Use of Enamel Matrix Derivative in Combination with Bone Substitute for the Treatment of an Intrabony Defect: A Case Report

牙釉基質衍生物與牙骨質的生長有關，且已被證實將其應用於牙周手術中可以引導牙骨質的再生。牙釉基質衍生物也可與生物膜或骨替代物合併使用，以維持適當的空間，提供牙周組織再生所需。本病例報告發生於一位三十八歲的男性患者，經基本牙周治療後，其下顎左側第二大臼齒的遠心側仍存在一牙周骨內缺損，因此使用牙釉基質衍生物合併人工合成移植骨雙相磷酸鈣，來治療牙周骨內缺損。治療十八個月後的臨床檢測顯示，該處牙周囊袋深度減少3mm，並獲得3mm臨床附連高度，患齒維持無搖動度，也無探測後出血情形。相較於術前，放射線攝影的檢查可見該處明顯的放射線密度增加，顯示原先的骨內缺損獲得改善。由本例得知，審慎的評估骨缺損型態與精確的手術技巧，使用牙釉基質衍生物合併人工合成移植骨來治療牙周骨內缺損，可以改善臨床的牙周狀況和增加放射線的密度，因此使用牙釉基質衍生物合併人工合成移植骨雙相磷酸鈣可以作為治療牙周骨內缺損的一種選擇。

關鍵字

牙釉基質衍生物；骨內缺損；牙周再生；移植骨

並列摘要

Enamel matrix derivative (EMD) is a group of proteins involved in the development of cementum and may be used as a means of regenerating acellular extrinsic fiber cementum. EMD has been combined with different space-maintaining products, such as membranes or bone substitutes, in order to enhance the space available for periodontal regeneration. In this report we used EMD in combination with alloplastic graft biphasic calcium phosphate (BCP) as part of periodontal surgery in order to reduce an intrabony defect. Eighteen months after treatment, the clinical measurements demonstrated a 3 mm reduction in probing depth and a 3 mm gain in clinical attachment level without tooth mobility and bleeding upon probing. The increase in radiodensity of the radiographs suggested an increase in bone level after treatment. When defect morphology is appropriately evaluated, and the surgical procedure is carefully performed, the use of EMD in combination with BCP may help to improve clinical parameters and radiographic bone level; this thus could be an alternative treatment modality for intrabony defects.

並列關鍵字

enamel matrix derivative ； intrabony defect ； periodontal regeneration ； bone graft

國際替代計量

Use of Enamel Matrix Derivative in Combination with Bone Substitute for the Treatment of an Intrabony Defect: A Case Report

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