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1.
J Periodontal Res ; 59(3): 589-598, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38481308

ABSTRACT

OBJECTIVES: In order to evaluate the effect of methacrylated hyaluronic acid (HAMA) hydrogels containing the recombinant human amelogenin (rhAm) in vitro and in vivo. BACKGROUND: The ultimate goal in treating periodontal disease is to control inflammation and achieve regeneration of periodontal tissues. In recent years, methacrylated hyaluronic acid (HAMA) containing recombinant human amyloid protein (rhAm) has been widely used as a new type of biomaterial in tissue engineering and regenerative medicine. However, there is a lack of comprehensive research on the periodontal regeneration effects of this hydrogel. This experiment aims to explore the application of photoresponsive recombinant human amelogenin-loaded hyaluronic acid hydrogel for periodontal tissue regeneration and provide valuable insights into its potential use in this field. MATERIALS AND METHODS: The effects of rhAm-HAMA hydrogel on the proliferation of human periodontal ligament cells (hPDLCs) were assessed using the CCK-8 kit. The osteogenic differentiation of hPDLCs was evaluated through ALP staining and real-time PCR. Calvarial parietal defects were created in 4-week-old Sprague Dawley rats and implanted with deproteinized bovine bone matrix in different treatment groups. The animals were euthanized after 4 and 8 weeks of healing. The bone volume of the defect was observed by micro-CT and histological analysis. RESULTS: Stimulating hPDLCs with rhAm-HAMA hydrogel did not significantly affect their proliferation (p > .05). ALP staining and real-time PCR results demonstrated that the rhAm-HAMA group exhibited a significant upregulation of osteoclastic gene expression (p < .05). Micro-CT results revealed a significant increase in mineralized tissue volume fraction (MTV/TV%), trabecular bone number (Tb.N), and mineralized tissue density (MTD) of the bone defect area in the rhAm-HAMA group compared to the other groups (p < .05). The results of hematoxylin and eosin staining and Masson staining at 8 weeks post-surgery further supported the results of the micro-CT. CONCLUSIONS: The results of this study indicate that rhAm-HAMA hydrogel could effectively promote the osteogenic differentiation of hPDLCs and stabilize bone substitutes in the defects that enhance the bone regeneration in vivo.


Subject(s)
Amelogenin , Bone Regeneration , Cell Differentiation , Cell Proliferation , Hyaluronic Acid , Hydrogels , Periodontal Ligament , Rats, Sprague-Dawley , Hyaluronic Acid/pharmacology , Animals , Bone Regeneration/drug effects , Amelogenin/pharmacology , Amelogenin/therapeutic use , Humans , Periodontal Ligament/drug effects , Rats , Cell Proliferation/drug effects , Cell Differentiation/drug effects , Recombinant Proteins/pharmacology , Recombinant Proteins/therapeutic use , Osteogenesis/drug effects , Male , X-Ray Microtomography , Cells, Cultured , Methacrylates , Biocompatible Materials/pharmacology
2.
BMC Oral Health ; 24(1): 279, 2024 Feb 27.
Article in English | MEDLINE | ID: mdl-38413983

ABSTRACT

BACKGROUND: Several methods were introduced for enamel biomimetic remineralization that utilize a biomimetic analogue to interact and absorb bioavailable calcium and phosphate ions and induce crystal nucleation on demineralized enamel. Amelogenin is the most predominant enamel matrix protein that is involved in enamel biomineralization. It plays a major role in developing the enamel's hierarchical microstructure. Therefore, this study was conducted to evaluate the ability of an amelogenin-inspired peptide to promote the remineralization potential of fluoride and a supersaturated calcium phosphate solution in treating artificially induced enamel carious lesions under pH-cycling regimen. METHODS: Fifty enamel slices were prepared with a window (4*4 mm2 ) on the surface. Five samples were set as control healthy enamel and 45 samples were subjected to demineralization for 3 days. Another 5 samples were set as control demineralized enamel and 40 enamel samples were assigned into 8 experimental groups (n=5) (P/I, P/II, P/III, P/AS, NP/I, NP/II, NP/III and NP/AS) according to peptide treatment (peptide P or non-peptide NP) and remineralizing solution used (I; calcium phosphate solution, II; calcium phosphate fluoride solution, III; fluoride solution and AS; artificial saliva). Samples were then subjected to demineralization/remineralization cycles for 9 days. Samples in all experimental groups were evaluated using Raman spectroscopy for mineral content recovery percentage, microhardness and nanoindentation as healthy, demineralized enamel and after pH-cycling. Data were statistically analysed using two-way repeated measures Anova followed by Bonferroni-corrected post hoc test for pairwise multiple comparisons between groups. Statistical significance was set at p= 0.05. Additionally, XRD, FESEM and EDXS were used for crystal orientation, surface morphology and elemental analysis after pH-cycling. RESULTS: Nanocrystals clumped in a directional manner were detected in peptide-treated groups. P/II showed the highest significant mean values in mineral content recovery (63.31%), microhardness (268.81±6.52 VHN), elastic modulus (88.74±2.71 GPa), nanohardness (3.08±0.59 GPa) and the best crystal orientation with I002/I300 (1.87±0.08). CONCLUSION: Despite pH changes, the tested peptide was capable of remineralizing enamel with ordered crystals. Moreover, the supplementary use of calcium phosphate fluoride solution with peptide granted an enhancement in enamel mechanical properties after remineralization.


Subject(s)
Dental Caries , Fluorides , Humans , Fluorides/pharmacology , Amelogenin/pharmacology , Amelogenin/therapeutic use , Cariostatic Agents/pharmacology , Cariostatic Agents/therapeutic use , Biomimetics , Calcium Phosphates/pharmacology , Calcium Phosphates/therapeutic use , Minerals , Phosphates , Tooth Remineralization/methods , Hydrogen-Ion Concentration
3.
Quintessence Int ; 54(8): 622-628, 2023 Sep 19.
Article in English | MEDLINE | ID: mdl-37010441

ABSTRACT

OBJECTIVE: To histologically evaluate the effects of a novel human recombinant amelogenin (rAmelX) on periodontal wound healing/regeneration in intrabony defects. METHOD AND MATERIALS: Intrabony defects were surgically created in the mandible of three minipigs. Twelve defects were randomly treated with either rAmelX and carrier (test group) or with the carrier only (control group). At 3 months following reconstructive surgery, the animals were euthanized, and the tissues histologically processed. Thereafter, descriptive histology, histometry, and statistical analyses were performed. RESULTS: Postoperative clinical healing was uneventful. At the defect level, no adverse reactions (eg, suppuration, abscess formation, unusual inflammatory reaction) were observed with a good biocompatibility of the tested products. The test group yielded higher values for new cementum formation (4.81 ± 1.17 mm) compared to the control group (4.39 ± 1.71 mm) without reaching statistical significance (P = .937). Moreover, regrowth of new bone was greater in the test compared to the control group (3.51 mm and 2.97 mm, respectively, P = .309). CONCLUSIONS: The present results provided for the first-time histologic evidence for periodontal regeneration following the use of rAmelX in intrabony defects, thus pointing to the potential of this novel recombinant amelogenin as a possible alternative to regenerative materials from animal origins.


Subject(s)
Alveolar Bone Loss , Humans , Animals , Swine , Amelogenin/pharmacology , Amelogenin/therapeutic use , Alveolar Bone Loss/drug therapy , Alveolar Bone Loss/surgery , Alveolar Bone Loss/pathology , Dental Cementum/pathology , Dental Cementum/surgery , Bone Regeneration , Swine, Miniature , Wound Healing , Guided Tissue Regeneration, Periodontal/methods
4.
Article in English | MEDLINE | ID: mdl-35472108

ABSTRACT

Combined surgical procedures have been introduced that combine periodontal regenerative/reconstructive procedures in intrabony defects with a connective tissue graft to compensate for a deficient bone wall and limit soft tissue shrinkage, but little is known about the reproducibility of these advanced surgical techniques. This 12-case series applies a combined surgical procedure, combining amelogenins, bone substitutes, and connective tissue graft to treat deep intrabony defects associated with gingival recession. Twelve deep intrabony defects with a mean clinical attachment loss of 9.9 ± 2.1 mm, mean probing depth (PPD) of 7.8 ± 1.5 mm, mean recession of the tip of the interdental papilla (TP) of 2.1 ± 1.5 mm, and mean buccal recession (REC) of 2.3 ± 1.8 mm were treated. At 1 year, the average attachment gain was 5.1 ± 1.8 mm (P < .001), the residual PPD was 2.9 ± 0.7 mm (P < .001), no change was observed in the TP (-0.4 ± 0.8 mm, P = .078), and the REC slightly decreased to 1.7 ± 1.5 mm (P = .047). These results suggest that the proposed technique led to predictable clinical outcomes that support regeneration while maintaining or improving the position of the soft tissue margin for the interdental and buccal aspects in deep intrabony defects associated with gingival recession.


Subject(s)
Alveolar Bone Loss , Bone Substitutes , Dental Enamel Proteins , Gingival Recession , Alveolar Bone Loss/drug therapy , Alveolar Bone Loss/surgery , Amelogenin/therapeutic use , Bone Substitutes/therapeutic use , Connective Tissue/surgery , Dental Enamel Proteins/therapeutic use , Follow-Up Studies , Gingival Recession/surgery , Guided Tissue Regeneration, Periodontal/methods , Humans , Periodontal Attachment Loss/drug therapy , Periodontal Attachment Loss/surgery , Reproducibility of Results , Treatment Outcome
5.
J Orthop Res ; 39(7): 1540-1547, 2021 07.
Article in English | MEDLINE | ID: mdl-32410235

ABSTRACT

Lateral ligament tears, also known as high-grade ankle sprains, are common, debilitating, and usually heal slowly. Ten to thirty percent of patients continue to suffer from chronic pain and ankle instability even after 3 to 9 months. Previously, we showed that the recombinant human amelogenin (rHAM+ ) induced regeneration of fully transected rat medial collateral ligament, a common proof-of-concept model. Our aim was to evaluate whether rHAM+ can regenerate torn ankle calcaneofibular ligament (CFL), an important component of the lateral ankle stabilizers. Right CFLs of Sabra rats were transected and treated with 0, 0.5, or 1 µg/µL rHAM+ dissolved in propylene glycol alginate (PGA). Results were compared with the normal group, without surgery. Healing was evaluated 12 weeks after treatment by mechanical testing (ratio between the right and left, untransected ligaments of the same rat), and histology including immunohistochemical staining of collagen I and S100. The mechanical properties, structure, and composition of transected ligaments treated with 0.5 µg/µL rHAM+ (experimental) were similar to untransected ligaments. PGA (control) treated ligaments were much weaker, lax, and unorganized compared with untransected ligaments. Treatment with 1 µg/µL rHAM+ was not as efficient as 0.5 µg/µL rHAM+ . Normal arrangement of collagen I fibers and of proprioceptive nerve endings, parallel to the direction of the force, was detected in ligaments treated with 0.5 µg/µL rHAM+ , and scattered arrangement, resembling scar tissue, in control ligaments. In conclusion, we showed that rHAM+ induced significant mechanical and structural regeneration of torn rat CFLs, which might be translated into treatment for grades 2 and 3 ankle sprain injuries.


Subject(s)
Amelogenin/therapeutic use , Ankle Injuries/drug therapy , Lateral Ligament, Ankle/drug effects , Regeneration/drug effects , Amelogenin/pharmacology , Animals , Disease Models, Animal , Drug Evaluation, Preclinical , Female , Nerve Endings/drug effects , Rats , Recombinant Proteins/pharmacology , Recombinant Proteins/therapeutic use
7.
Rev. Ateneo Argent. Odontol ; 55(1): 35-39, 2016. ilus
Article in Spanish | LILACS | ID: lil-794289

ABSTRACT

Relacionar la importancia del éxito en regeneración tisular guiada y el correcto diagnóstico del problema, en este caso enfermedad periodontaly un contacto prematuro en ORC producto de una obturación de amalgama incorrecta. Caso clínico: tratamiento de un defecto infraóseo de3 paredes mediante la utilización de hueso de origen bovino particulado junto con proteínas derivadas de la matriz del esmalte. Tanto los parámetros clínicoscomo los radiográficos fueron evaluados al inicio, en el postquirúrgico inmediato y a los 12 meses. Conclusión: se observó un alto grado de regeneración pasados los 12 meses del tratamiento. Parecería no ser siempre necesaria la utilización de membrana colágena. Las proteínas derivadas de la matrizdel esmalte serían un sustituto de la membrana en algunos casos. Resulta fundamental el chequeo de la situación oclusal en piezas periodontalmente comprometidas...


Subject(s)
Humans , Female , Periodontal Diseases/therapy , Dental Occlusion, Traumatic/therapy , Alveolar Process/pathology , Guided Tissue Regeneration/methods , Edetic Acid/therapeutic use , Amelogenin/therapeutic use , Dental Enamel Proteins , Follow-Up Studies , Tooth Root , Surgical Flaps , Bone Transplantation/methods
8.
Fogorv Sz ; 107(1): 15-28, 2014 Mar.
Article in Hungarian | MEDLINE | ID: mdl-24812749

ABSTRACT

The solitary vertical or horisonto-vertical bone lesions are mainly characteristic of aggressive periodontitis. Only a combined conservative-surgical approach can result in predictable healing. From the early 50's basically two surgical techniques were used for correcting vertical bony defects. The so called bone resective techniques combined with apically positioned flap resulted in the flattening of the bone contour by removing substantial amount of alveolar bone but compromising the periodontal support of the neighboring teeth. The other surgical approach was the facilitation of the reformation of new periodontal attachment and bone with or without bone grafting. Since the mid 80's the gold standard in the therapy of deep vertical bony defects is the guided tissue regeneration (GTR), although an alternative approach has also been developed using different growth and differentiation factors promoting periodontal wound healing. Today in the clinical practices both in periodontal osseous and mucogingival surgeries the most widely used biological factor is the amelogenin and its commercially available product the Enamel Matrix Derivative (Emdogain). With the presented five solitary horisonto-vertical bony defects of three patients the possibilities and the late results are presented that could have been achieved with the application of EMD and thorough postoperative follow-up. The clinical results were comparable to the current data presented by articles in peer reviewed periodontal journals.


Subject(s)
Alveolar Bone Loss/surgery , Bone Transplantation , Dental Enamel Proteins/therapeutic use , Periodontitis/drug therapy , Periodontitis/surgery , Periodontium/abnormalities , Adult , Aggressive Periodontitis/drug therapy , Aggressive Periodontitis/surgery , Alveolar Bone Loss/etiology , Alveolar Bone Loss/prevention & control , Amelogenin/therapeutic use , Female , Humans , Male , Middle Aged , Periodontitis/diagnostic imaging , Periodontitis/pathology , Periodontium/diagnostic imaging , Periodontium/surgery , Radiography , Wound Healing
9.
Rev. estomatol. Hered ; 24(1): 48-56, ene.-mar. 2014. tab
Article in Spanish | LILACS, LIPECS | ID: lil-743049

ABSTRACT

La periodontitis es una infección crónica de etiología multifactorial, donde las bacterias de la placa dental son el factor iniciador principal. Esta condición induce la pérdida de soporte del aparato de inserción. La cirugía está indicada para detener la progresión de la enfermedad y regenerar el tejido perdido. Se han utilizado diferentes técnicas quirúrgicas para regenerar los tejidos periodontales incluyendo la regeneración tisular guiada (RTG), y el uso de proteínas derivadas de la matriz del esmalte (EMD). EMDOGAIN® es un compuesto de proteínas derivadas de la matriz del esmalte (EMD), que contiene amelogeninas de diferentes pesos moleculares, capaz de inducir la regeneración verdadera del aparato de inserción. Como principal indicación destaca el tratamiento de defectos infraóseos, ganancia de hueso y reducción de la profundidad de sondaje con mínima recesión gingival. Es un procedimiento técnicamente simple, con poco riesgo y menos invasivo que las técnicas de regeneración convencionales. La selección del paciente, el empleo de una técnica adecuada así como el riguroso control postoperatorio son factores importantes para el éxito del tratamiento. En esta revisión de literatura se pretende realizar una mirada retrospectiva de la regeneración periodontal así como una puesta al día de los tratamientos actuales y de la utilización de Emdogain® en la regeneración de defectos periodontales infraóseos y la comparación de este con los distintos tratamientos regenerativos.


Periodontitis is a chronic infection caused by bacteria in dental plaque. This condition causes the loss of the support of attachment apparatus. Surgery is used to stop the progression of the disease and to regenerate the lost tissue. Different surgical techniques are used to regenerate periodontal tissues including guided tissue regeneration (GTR), and the use of protein derived from enamel matrix (EMD). EMDOGAIN ® is a compound derived proteins Enamel matrix (DME) which contains amelogeninas with a variety of molecular weights, capable of inducing true regeneration of the insertion apparatus. As main indication stands out the treatment of infraosseous defects, bone gain and reduction of the probing depth with minimal gingival recession. It is a technically simple procedure with little risk and is less invasive than conventional regeneration techniques. Patient selection, the use of proper technique and the strict postoperative control are important factors for successful treatment. This purpose of this literature is to conduct a review of periodontal regeneration and the use of Emdogain ® in the regeneration of intrabony periodontal defects and comparison with other regenerative treatments.


Subject(s)
Amelogenin/therapeutic use , Periodontal Pocket , Periodontitis/therapy , Dental Enamel Proteins/therapeutic use , Guided Tissue Regeneration
10.
J Wound Care ; 22(9): 453-60, 2013 Sep.
Article in English | MEDLINE | ID: mdl-24005778

ABSTRACT

OBJECTIVE: To evaluate the role of compression in non-healing venous leg ulcers (VLUs) of > 3 months' duration. METHOD: Patients' records from three independent data sets of non-healing VLUs of > 3 months'duration were re-analysed.Two data sets were separate audits of clinical practice and the third comprised patients' records from a randomised controlled trial. Some patients in each data set were never treated with compression. The effect of compression on healing at 6 months was tested with logistic regression. RESULTS: In each data set, patients in the compression and no-compression groups were matched according to ulcer size and duration; there were no differences in comorbidities. Comparing the no-compression with the compression groups, the healing rate at 6 months was 68% vs 48% in study 1, 12% vs 6% in study 2, and 26% vs 11% in study 3. Use of compression was found to be an independent predictor of not healing with an odds ratio of 0.422, 0.456 and 0.408 in studies 1, 2 and 3 respectively. CONCLUSION: The healing rate of non-healing VLUs of > 3 months' duration in the no-compression groups was double that of VLUs in the compression groups. These findings have the potential for treatment modification if confirmed in a prospective trial. DECLARATION OF INTEREST: There were no external sources of funding for this study. The authors have no conflicts of interest that are directly relevant to the content of this manuscript, which remains their sole responsibility.


Subject(s)
Compression Bandages , Leg Ulcer/therapy , Stockings, Compression , Varicose Ulcer/therapy , Wound Healing/physiology , Aged , Amelogenin/therapeutic use , Chi-Square Distribution , Cohort Studies , Female , Humans , Logistic Models , Male , Randomized Controlled Trials as Topic , Statistics, Nonparametric , Treatment Outcome , United Kingdom
11.
Acta Biomater ; 9(7): 7289-97, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23571002

ABSTRACT

Biomimetic reconstruction of tooth enamel is a significant topic of study in materials science and dentistry as a novel approach to the prevention, restoration, and treatment of defective enamel. We have developed a new amelogenin-containing chitosan hydrogel for enamel reconstruction that works through amelogenin supramolecular assembly, stabilizing Ca-P clusters and guiding their arrangement into linear chains. These amelogenin Ca-P composite chains further fuse with enamel crystals and eventually evolve into enamel-like co-aligned crystals, anchored to the natural enamel substrate through a cluster growth process. A dense interface between the newly grown layer and natural enamel was formed and the enamel-like layer improved the hardness and elastic modulus compared with etched enamel. We anticipate that this chitosan hydrogel will provide effective protection against secondary caries because of its pH-responsive and antimicrobial properties. Our studies introduce an amelogenin-containing chitosan hydrogel as a promising biomaterial for enamel repair and demonstrate the potential of applying protein-directed assembly to biomimetic reconstruction of complex biomaterials.


Subject(s)
Amelogenin/therapeutic use , Biomimetic Materials/therapeutic use , Chitosan/therapeutic use , Dental Caries/drug therapy , Dental Enamel/chemistry , Hydrogels/chemistry , Molar, Third/chemistry , Amelogenin/chemistry , Biomimetic Materials/chemical synthesis , Chitosan/chemistry , Dental Caries/pathology , Dental Enamel/transplantation , Humans , Materials Testing , Molar, Third/drug effects , Surface Properties , Treatment Outcome
12.
J Evid Based Dent Pract ; 12(3 Suppl): 89-100, 2012 Sep.
Article in English | MEDLINE | ID: mdl-23040341

ABSTRACT

A review of the current scientific literature was undertaken to evaluate the efficacy of minimally invasive periodontal regenerative surgery in the treatment of periodontal defects. The impact on clinical outcomes, surgical chair-time, side effects and patient morbidity were evaluated. An electronic search of PUBMED database from January 1987 to December 2011 was undertaken on dental journals using the key-word "minimally invasive surgery". Cohort studies, retrospective studies and randomized controlled clinical trials referring to treatment of periodontal defects with at least 6 months of follow-up were selected. Quality assessment of the selected studies was done through the Strength of Recommendation Taxonomy Grading (SORT) System. Ten studies (1 retrospective, 5 cohorts and 4 RCTs) were included. All the studies consistently support the efficacy of minimally invasive surgery in the treatment of periodontal defects in terms of clinical attachment level gain, probing pocket depth reduction and minimal gingival recession. Six studies reporting on side effects and patient morbidity consistently indicate very low levels of pain and discomfort during and after surgery resulting in a reduced intake of pain-killers and very limited interference with daily activities in the post-operative period. Minimally invasive surgery might be considered a true reality in the field of periodontal regeneration. The observed clinical improvements are consistently associated with very limited morbidity to the patient during the surgical procedure as well as in the post-operative period. Minimally invasive surgery, however, cannot be applied at all cases. A stepwise decisional algorithm should support clinicians in choosing the treatment approach.


Subject(s)
Amelogenin/therapeutic use , Bone Transplantation/methods , Guided Tissue Regeneration, Periodontal/methods , Minimally Invasive Surgical Procedures/methods , Periodontal Diseases/surgery , Guided Tissue Regeneration, Periodontal/adverse effects , Humans
13.
J Evid Based Dent Pract ; 12(3 Suppl): 118-26, 2012 Sep.
Article in English | MEDLINE | ID: mdl-23040343

ABSTRACT

UNLABELLED: Protein and peptide-based therapeutics provide a unique strategy for controlling highly specific and complex biologic actions that cannot be accomplished by simple devices or chemical compounds. This article reviews some of the key characteristics and summarizes the clinical effectiveness of protein and peptide-based therapeutics targeting periodontal regeneration. EVIDENCE ACQUISITION: A literature search was conducted of randomized clinical trials and systematic reviews evaluating protein and peptide-based therapeutics for the regeneration of periodontal tissues of at least 6 months duration. Data sources included PubMed and Embase electronic databases, hand-searched journals, and the ClinicalTrials.gov registry. EVIDENCE SYNTHESIS: Commercially marketed protein and peptide-based therapeutics for periodontal regeneration provide gains in clinical attachment level and bone formation that are comparable or superior to other regenerative approaches. Results from several clinical trials indicate that protein and peptide-based therapies can accelerate repair and regeneration when compared with other treatments and that improvements in clinical parameters continue beyond 12 months. Protein and peptide-based therapies also exhibit the capacity to increase the predictability of treatment outcomes. CONCLUSIONS: Clinical and histologic studies support the effectiveness of protein- and peptide-based therapeutics for periodontal regeneration. Emerging evidence suggests that the delivery devices/scaffolds play a critical role in determining the effectiveness of this class of therapeutics.


Subject(s)
Alveolar Bone Loss/therapy , Biocompatible Materials/therapeutic use , Bone Transplantation/methods , Guided Tissue Regeneration, Periodontal/methods , Intercellular Signaling Peptides and Proteins/therapeutic use , Periodontium/surgery , Amelogenin/therapeutic use , Bone Substitutes/therapeutic use , Humans , Platelet-Rich Plasma
14.
J Dermatol Sci ; 67(1): 15-9, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22608215

ABSTRACT

BACKGROUND: Chronic wounds are both time consuming as well as costly. A new therapeutic option for those wounds might be amelogenin, which supplies a temporary matrix to the fibroblasts and keratinocytes. OBJECTIVE: To prove the hypotheses for a divergent therapeutic outcome, we treated granulated vs. sclerotic chronic venous leg ulcers with amelogenin (Xelma®) 1×/week for 5-8 weeks. METHODS: The analysis of the treatment was performed by applying a recently published mathematical model. This model can predict and evaluate different wound treatment methods by treating only few patients which is even more practicable for diseases with different influencing factors within patients groups because it is easier to collect only a small homogenous number of patients than multiple. RESULTS: We treated 12 granulated vs. 16 sclerotic ulcerations. 5 (42%) of the granulated ulcerations with a mean initial wound area of 18.3cm(2) showed optimal wound healing (>90% epithelization). The average area of new epithelia was 11.9cm(2). Nine (56%) of the sclerotic ulcerations showed optimal wound healing with an initial wound area of 7.5cm(2) and a total average area of 4.1cm(2) with new epithelia. For comparison of those groups, we extrapolate to a hypothetic mean sclerotic wound area of 18.3cm(2) analogue to the granulated ulcerations. This calculates to a mean neoepithel of only 6cm(2) for sclerotic ulcerations. Further on, we calculated about 2% of the wound area that proliferated in contrast to about 3% in granulated wounds. CONCLUSIONS: Although sclerotic ulcerations show higher growth rates, Xelma® seems to be more effective in granulated ulcerations. For larger sclerotic ulcerations the mean maximal covered wound area with neoepithelia is reduced to about 33% in contrast to 65% in granulated ulcerations.


Subject(s)
Amelogenin/therapeutic use , Granulation Tissue/drug effects , Models, Biological , Skin/drug effects , Varicose Ulcer/drug therapy , Wound Healing/drug effects , Aged , Aged, 80 and over , Cell Proliferation/drug effects , Chronic Disease , Epithelial Cells/drug effects , Epithelial Cells/pathology , Female , Germany , Granulation Tissue/pathology , Humans , Male , Middle Aged , Pain/etiology , Pain/prevention & control , Sclerosis , Skin/pathology , Time Factors , Treatment Outcome , Varicose Ulcer/complications , Varicose Ulcer/pathology
15.
Med Hypotheses ; 79(2): 143-6, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22564781

ABSTRACT

Tooth defect due to caries, trauma, or acid corrosion are common in mankind. Ceramics, metal and resin were used to repaired tooth defect in the past hundred years, but they cannot instead enamel and dentin in depth in clinic usage for the difference in structure and element. So the formation of organized nanocrystals that resemble enamel is crucial for successful enamel remineralization. Now synthesizing a mimicking structure of human enamel using acellular methods has attracted much interest from research groups who have tried using recombinant enamel making proteins like amelogenin, surfactants, to mimic the biomineralization process to restore the enamel layer. Since amelogenin can be used in the assembly of functional nanostructures, we hypothesis that rationally designed ß-sheet-forming peptides that spontaneously form three-dimensional fibrillar scaffolds in response to specific environmental triggers may potentially be used in inducing tooth-like hydroxyapatite crystal ex vivo which important to treatment/prevention of dental caries, via bioactive surface groups.


Subject(s)
Amelogenin/chemistry , Amelogenin/therapeutic use , Biomimetic Materials/therapeutic use , Durapatite/therapeutic use , Pit and Fissure Sealants/chemistry , Pit and Fissure Sealants/therapeutic use , Tooth/chemistry , Biomimetic Materials/chemical synthesis , Durapatite/chemistry , Humans , Models, Biological , Models, Chemical , Regeneration
16.
J Wound Care ; 21(12): 612-4, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23299272

ABSTRACT

OBJECTIVE: To determine the effect of topically applied amelogenin extracellular matrix protein(AEMP) in patients with non-healing venous leg ulcers combined with atrophie blanche. METHOD: This retrospective case series of patients with non-healing venous leg ulcers with atrophie blanche of the distal proportion of their lower legs, where non-healing was defined as no progress toward healing for 3 months previously, under standard therapy. Patient records were reviewed for associated diseases, wound diagnoses, distal blood pressure, previous treatments and changes in wound area. Patients were treated with AEMP once a week, for a period of 12 weeks, or until full healing. RESULTS: Eleven patient records were reviewed retrospectively. The median age of the patients was 81 years (range 40-95 years), with a mean wound size of 4.7 ± 3.Scm2 and median wound duration of 6 months (range 3-444 months).AII patients had venous or combined arterial/venous insufficiency. After 12 weeks' treatment with AEMP, complete healing, defined as I 00% re-epithelialisation, was documented in four patients (36%), marked improvement(> SO% epithelialisation) in three patients (54%, 55% and 83% wound closure, respectively), slight improvement in one patient (9.4% wound closure), no change for two patients and worsening in one.AEMP was well tolerated, and no patients reported side effects. CONCLUSION: The results of this retrospective study suggest that AEMP improves healing in chronic venous leg ulcers combined with atrophie blanche.


Subject(s)
Amelogenin/therapeutic use , Extracellular Matrix Proteins/therapeutic use , Skin/pathology , Varicose Ulcer/pathology , Varicose Ulcer/physiopathology , Administration, Cutaneous , Aged , Aged, 80 and over , Amelogenin/administration & dosage , Extracellular Matrix Proteins/administration & dosage , Female , Humans , Male , Retrospective Studies , Varicose Ulcer/complications , Venous Insufficiency/complications
17.
Br J Nurs ; 19(19): 1248-52, 2010.
Article in English | MEDLINE | ID: mdl-21155363

ABSTRACT

Hard-to-heal wounds typically present a huge challenge to the clinical team charged with their treatment. Wounds that are extremely painful and/or unsightly can have an extreme psychological impact on the patient, and this can be as crucial a consideration as the complexities involved in managing the physical healing. While resource expenditure on hard-to-heal wounds can be quantified, quality of life is less easy to evaluate, but is clearly of paramount importance to the patient. This article examines the experience of a woman treated for basal cell carcinoma of the scalp--both the immediate emotional impact of the individual stages of treatment and the wider impact on her lifestyle and her family. In addition, it considers the case from the perspective of a key member of the clinical team in order to present a rounded account of the cae study from a human perspective. The woman was finally healed using an advanced wound care product, Xelma®. The objectives of the study were to revisit a case study featured in a recent article (Bond et al, 2009) to provide an update on outcomes and to examine the case from the human perspective; to consider the impact of key clinical decisions on the patient's state of mind and emotions,and on the practicalities of everyday life; and to examine the ase from the perspective of a key clinician.


Subject(s)
Attitude to Health , Carcinoma, Basal Cell/psychology , Cost of Illness , Scalp , Skin Neoplasms/psychology , Wound Healing , Amelogenin/economics , Amelogenin/therapeutic use , Carcinoma, Basal Cell/complications , Carcinoma, Basal Cell/economics , Carcinoma, Basal Cell/therapy , Exudates and Transudates , Female , Humans , Life Style , Middle Aged , Mohs Surgery , Pain/etiology , Quality of Life/psychology , Skin Care/methods , Skin Care/nursing , Skin Care/psychology , Skin Neoplasms/complications , Skin Neoplasms/economics , Skin Neoplasms/therapy , Surgical Flaps
18.
Ulus Travma Acil Cerrahi Derg ; 16(6): 487-90, 2010 Nov.
Article in English | MEDLINE | ID: mdl-21153938

ABSTRACT

BACKGROUND: Ischemia is a troublesome problem that can cause intestinal emergencies and complicate the treatment. Identification of a chemical agent with beneficial effects on the healing process in risky colon anastomosis with the aim of reducing leakage rates is a popular topic in the era of surgical research. Data is lacking about the role of amelogenin, an extracellular matrix protein, during the healing process of gastrointestinal anastomosis. In this study, the effects of amelogenin treatment on ischemic colon anastomosis were evaluated. METHODS: Adult male Wistar Albino rats weighing 200-250 g were divided into three weight-matched groups as normal colon anastomosis group (n=8), ischemic colon anastomosis group (n=8), and amelogenin-treated ischemic colon anastomosis group (n=8). Sufficient equal volume of amelogenin to cover the anastomosis area entirely was applied topically. All animals were sacrificed on postoperative day four. Bursting pressure levels were measured. Peri-anastomotic colon tissue hydroxyproline levels were also assessed. RESULTS: Bursting pressure level of the ischemic colon anastomosis group was significantly lower than the normal colon anastomosis and the amelogenin-treated ischemic colon anastomosis groups, respectively (p=0.006, p=0.008). CONCLUSION: Amelogenin treatment supports the physical strength of ischemic colon anastomosis.


Subject(s)
Amelogenin/therapeutic use , Anastomosis, Surgical/adverse effects , Colonic Diseases/surgery , Amelogenin/administration & dosage , Animals , Colon/metabolism , Colonic Diseases/metabolism , Extracellular Matrix Proteins/administration & dosage , Extracellular Matrix Proteins/therapeutic use , Hydroxyproline/metabolism , Male , Rats , Rats, Wistar , Syringes
19.
Orthod Craniofac Res ; 12(3): 243-53, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19627527

ABSTRACT

Emdogain (enamel matrix derivative, EMD) is well recognized in periodontology, where it is used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The biological effect of EMD is through stimulation of local growth factor secretion and cytokine expression in the treated tissues, inducing a regenerative process that mimics odontogenesis. The major (>95%) component of EMD is Amelogenins (Amel). No other active components have so far been isolated from EMD, and several studies have shown that purified amelogenins can induce the same effect as the complete EMD. Amelogenins comprise a family of highly conserved extracellular matrix proteins derived from one gene. Amelogenin structure and function is evolutionary well conserved, suggesting a profound role in biomineralization and hard tissue formation. A special feature of amelogenins is that under physiological conditions the proteins self-assembles into nanospheres that constitute an extracellular matrix. In the body, this matrix is slowly digested by specific extracellular proteolytic enzymes (matrix metalloproteinase) in a controlled process, releasing bioactive peptides to the surrounding tissues for weeks after application. Based on clinical and experimental observations in periodontology indicating that amelogenins can have a significant positive influence on wound healing, bone formation and root resorption, several new applications for amelogenins have been suggested. New experiments now confirm that amelogenins have potential for being used also in the fields of endodontics, bone regeneration, implantology, traumatology, and wound care.


Subject(s)
Amelogenin/therapeutic use , Dental Enamel Proteins/therapeutic use , Periodontal Diseases/surgery , Amelogenin/physiology , Calcification, Physiologic/physiology , Conserved Sequence , Dental Enamel Proteins/physiology , Extracellular Matrix Proteins/physiology , Humans , Matrix Metalloproteinases/physiology , Osteogenesis/physiology , Regeneration/drug effects , Root Resorption/physiopathology , Wound Healing/physiology
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