Regenerative endodontic procedure using Emdogain: a case series

Emdogain (Straumann^® Emdogain^®, Basel, Switzerland) is an enamel matrix derivative and has an important role in odontogenesis, by potentializing pulp tissue repair and regeneration, as showed in biological studies. Nevertheless, the benefits of using Emdogain as a scaffold in clinical regenerative endodontic procedures has not been demonstrated and is not yet fully understood. The aim of this report was to show three clinical cases that had different preoperative conditions and underwent pulp regenerative procedures under an identical clinical protocol. This report also aimed to show the value of using Emdogain to guide angiogenesis and the healing process by reporting clinical and radiographical results. This is a pioneering study on the use of Emdogain in regenerative endodontic procedures in humans.

This report is a retrospective description of clinical findings from three regenerative treatments conducted under an identical protocol in two appointments using Emdogain as a scaffold. The three young Brazilian patients, aged 8, 8, and 12 years old (one female and two male), are from São Luís city, state of Maranhão. All three patients identify as Pardo ethnicity with brown skin color, come from low-income backgrounds, and had necrotic immature permanent teeth. Quantitative assessments of crown shades of treated teeth were determined with VITA Easyshade® Advance 4.0 spectrophotometer (VITA Zahnfabrik, Bad Sackingen, Germany) at baseline to 24-month follow-up. Self-reported pain was measured using the visual analogue scale (VAS) at the time of treatment (shortly after induction of bleeding into the canal) and at 7 day following the procedure. At 12 months, radiographic lesions were resolved. At 24 months there were apical closures, and the three teeth remained in function without symptomatology or signs of failure. All cases had the root length increased and the dentin wall thickened. One case presented radiographic images suggestive of scattered calcified zones in the root canal lumen.

Emdogain may be beneficial as a scaffold in regenerative endodontic procedures. The following outcomes were noted at 24-month follow-up: continuity of root formation, thickening of the root dentin walls, and closure of the root apex.