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牙釉基質蛋白:由生物觀點來探討牙周組織再生及病例報告

EMDOGAIN-A Biological Approach to Periodontal Regeneration with a Case Report

摘要


傳統的牙周再生手術藉由清除患部的結石及發炎的肉芽組織後,覆蓋不同的再生膜來達到日後的牙周組織再生重建。有時配合人工骨粉來獲得更多的骨頭再生。牙釉基質蛋白(Emdogain®)取自發育中豬胚胎的牙釉質母細胞所分泌一種類似牙釉蛋白的生長因子,經 由分離後製成粉末狀,可溶解於液態的攜帶因子(PGA)中,在不同的溫度及酸鹼度下,可再度沉澱出來,附著於牙根表面,進而促進造牙骨質母細胞及造骨母細胞的分化。在不使用再生膜及人工骨粉的情況下,達到更好的牙周組織再生效果。臨床上配合牙結石刮除手術及牙根表面酸蝕處理後使用,一年後評估,顯示出良好的牙周組織再生的效果。

並列摘要


The traditional periodontal regenerative procedure is performed by debriding the granulomatous tissues and calculus inside the intrabony defect and covering with barrier membrane to retain the lost periodontal tissue. In order to acquire more new bone formation, bone graft was also combined to use during the procedure. Emdogain was one of the amelogenin-like protein combinant, isolated from the developmental enamel matrix of porcine, and made into the frozen powder status. It can be dissolved in PGA carrier (propylene glycol alginate), and participate again on the root surface under varying temperature and PH value. This enamel matrix derivatives can induce the differentiation of cementoblast and osteoblast and further enhance the periodontal regeneration without any addition of barrier membrane and bone graft.

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