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The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study Lim Hyun-Chang 1, Yang Jin-Hyuk 1, Chae Gyoung-Joon 1, Kim Sung-Tae 1, Jung Ui-Won 1, Kim Chang-Sung 1, Lee Yong-Keun 2, Choi Seong-Ho 1 1 Department of Periodontology, Oral Science Research Center, College of Dentistry, Yonsei University 2 Department and Research Institute of Dental Biomaterials and Bioengineering, College of Dentistry, Yonsei University Abstract The purpose of this study is to evaluate the effect of enamel matrix protein and -tricalcium phosphate(-tcp) which was applied into the surgically created gap defect around implants in mongrel dogs. Method and material: Two mongrel dogs were used. All mandibular premolars and first mandibular molar were extracted. After 8weeks, 3 implant osteotomies were prepared in each side of the mandible, gap defects were prepared by 4.8/6.5 profile drill. Standard plus implants(rt. side) and TE implants(lt. side) of SLA surface were installed. The width of gap defect was 1.25mm in Standard plus group and 0.5mm in TE group. Both groups were divided into three subgroups according to graft materials ; 1. No materials(control), 2. enamel matrix protein, 3. enamel matrix protein +-TCP. The dogs were sacrificed following an 8-week healing period. Specimens were analyzed histologically. Result: The primary stability of implants was mostly insufficient, due to removal of most of crestal cortical bone and implant design without self-cutting edge. Histologically, in subgroup 1 with no graft procedure, the gap defect was barely filled with new bone and remained as a wedge shaped defect. In subgroup 2 with enamel matrix protein graft, healing in the gap defect occurred up to the upper portion of rough surface. The healing of subgroup 3 with enamel matrix protein and - TCP graft, was relatively inferior to subgroup 2. Conclusion: In spite of limits of this study, it is suggested that the application of enamel matrix protein has favorable effects on the healing of peri-implant gap defect in dog. Further studies would be needed. Keyword : gap defect, enamel matrix protein, -tricalcium phosphate, primary stabilty 36 Implantology Vol. 12, No. 3 2008

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original article Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 38 Implantology Vol. 12, No. 3 2008

Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 39

original article Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 40 Implantology Vol. 12, No. 3 2008

Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 41

original article Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 Lim Hyun-Chang et al; The histologic study of the effect of enamel matrix protein and -tricalcium phosphate in gap defect model in dogs : pilot study. Implantology 2008 42 Implantology Vol. 12, No. 3 2008

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tion sockets: a prospective multicenter study. Int J Oral Maxillofac Implants 1994;9:31-40. 9. Hammerle CH, Lang NP. Single stage surgery combining transmucosal implant placement with guided bone regeneration and bioresorbable materials. Clin Oral Implants Res 2001;12:9-18. 10.,,, et al. 1. 1997;27:767-783. 11.,,, et al.. 2004;34:593-605. 12.,,, et al. 1 Emdogain Emdogain Calcium Sulfate Paste. 2000;30:539-552. 13. Froum S, Lemler J, Horowitz R, Davidson B. The use of enamel matrix derivative in the treatment of periodontal osseous defects: a clinical decision tree based on biologic principles of regeneration. Int J Periodontics Restorative Dent 2001;21:437-49. 14. Heijl L, Heden G, Svardstrom G, Ostgren A. Enamel matrix derivative (EMDOGAIN) in the treatment of intrabony periodontal defects. J Clin Periodontol 1997;24:705-14. 15. Mellonig JT. Enamel matrix derivative for periodontal reconstructive surgery: technique and clinical and histologic case report. Int J Periodontics Restorative Dent 1999;19:8-19. 16. Hammarstrom L. Enamel matrix, cementum development and regeneration. J Clin Periodontol 1997;24:658-68. 17. Boyan BD, Weesner TC, Lohmann CH, et al. Porcine fetal enamel matrix derivative enhances bone formation induced by demineralized freeze dried bone allograft in vivo. J Periodontol 2000;71:1278-86. 18. Schwartz Z, Carnes DL, Jr., Pulliam R, et al. Porcine fetal enamel matrix derivative stimulates proliferation but not differentiation of preosteoblastic 2T9 cells, inhibits proliferation and stimulates differentiation of osteoblast-like MG63 cells, and increases proliferation and differentiation of normal human osteoblast NHOst cells. J Periodontol 2000;71:1287-96. 19. E.Lynch S, Marx RE, Nevins M, Wisner-Lynch LA. Tissue Engineering, Application in oral and maxillofacial surgery and periodontics, 2nd ed. 2008:26-36. 20. Artzi Z, Weinreb M, Givol N, et al. Biomaterial resorption rate and healing site morphology of inorganic bovine bone and beta-tricalcium phosphate in the canine: a 24-month longitudinal histologic study and morphometric analysis. Int J Oral Maxillofac Implants 2004;19:357-68. 21. Zijderveld SA, Zerbo IR, van den Bergh JP, et al. Maxillary sinus floor augmentation using a beta-tricalcium phosphate (Cerasorb) alone compared to autogenous bone grafts. Int J Oral Maxillofac Implants 2005;20:432-40. 22. Schulte W, Kleineikenscheidt H, Lindner K, Schareyka R. [The Tubingen immediate implant in clinical studies]. Dtsch Zahnarztl Z 1978;33:348-59. 23. Cardaropoli G, Araujo M, Hayacibara R, et al. Healing of extraction sockets and surgically produced - augmented and non-augmented - defects in the alveolar ridge. An experimental study in the dog. J Clin Periodontol 2005;32:435-40. 24. Casati MZ, Sallum EA, Nociti FH, Jr., et al. Enamel matrix derivative and bone healing after guided bone regeneration in dehiscence-type defects around implants. A histomorphometric study in dogs. J Periodontol 2002;73:789-96. 25. Botticelli D, Berglundh T, Buser D, Lindhe J. Appositional bone formation in marginal defects at implants. Clin Oral Implants Res 2003;14:1-9. 45