Emdogain: últimos avances en regeneración periodontal / Emdogain: an update in periodontal regeneration

Emdogain es un compuesto de proteínas derivadas de la matriz del esmalte, 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 cuidada selección del paciente, el empleo de una técnica adecuada así como el riguroso control postoperatorio son factores importantes para el éxito del tratamiento (AU)

Emdogain is a compound of proteins derived from the enamel matrix which are a crucial factor in initiating the formation of a cellular root cementum and stimulate the development of the periodontal ligament and alveolar bone. The main indication for the application of EMD is the intrabony defects treatment with significant clinical attachment level gains, probing depht reductions and minimal gingival recession. The application of EMD is a simple procedure with less risk than other techniques and less invasive than conventional guided tissue regeneration. A careful selection of the patient, the use of an adecuate technique and the strict postoperatory control are all very important factors for the treatment success (AU)

Morbidity and economic complications following mucogingival surgery in a hemophiliac HIV-infected patient: a case report.

BACKGROUND: This report describes the surgical treatment of a gingival recession in a hemophiliac HIV-infected patient. To our knowledge, mucogingival surgery has not been described previously in these patients. METHODS: Under the supervision of the patient's hematologist, a subepithelial connective tissue graft procedure was carried out to treat the recession. The treatment was performed after substitution therapy with factor VIII concentrate, supported by local antifibrinolytic treatment with epsilonaminocaproic acid. RESULTS: One week after surgery, the grafted zone showed a normal healing, but an area of necrosis appeared at the donor palatal site with spontaneous bleeding. The administration of factor VIII concentrate had to be prolonged to arrest the hemorrhage. In total, 44,500 units of factor VIII concentrate were used, the cost of which reached around $20,000. After 1 month the donor site had re-epithelialized by secondary intention. The root coverage was around 85% successful. CONCLUSIONS: Because of the surgical risk and the high economic cost in the use of the factor VIII concentrate, we do not recommend performing mucogingival surgery in HIV-infected hemophiliacs unless it is absolutely necessary. Prevention and early treatment must be the goal in the management of these patients.