The Use of Emdogain® in the Treatment of Cervical Lesions Previously Covered by a Bonded Restoration: A Case Report

Root denudation following gingival recessions promotes carious or non-carious cervical lesions with hypersensitivity and esthetic discomfort. To satisfy the immediate demand of the patients, general practitioners used to perform restorative procedures including cervical fillings or bonding techniques (resin-modified restorative glass ionomer, microfin resin composite) to cover the lesion. This approach shows poor long-term results and leads to progression of the recession. Periodontal plastic surgery represents an efficient solution in the treatment of gingival recessions (Wennström and Pini prato, 1998) even if the lesion has been previously covered with a bonded restoration. Conventional periodontal plastic surgery using coronally advanced flap and subepithelial connective tissue grafting for root coverage is clinically predictable but the nature of the attachment gained is still controversial. Pini Prato et al (1992) suggested the use of the technique of guided tissue regeneration in the treatment of cervical lesions associated with gingival recessions to obtain a new connective tissue attachment. In the clinical procedures, the removal of the cervical restoration created a concavity which was covered by the membrane. In this report, the authors present two cases with complete root coverage at 18 months. Nonetheless, inherent in the development of new techniques, the authors accept the technical difficulties in optimally placing the barriers, the lack of predictability, and the high risk of exposure leading to infection. Emdogain®, which is an enamel matrix derivative prepared from developing porcine tooth buds (Biora AB, Malmö), pretends to promote periodontal regeneration by mimicking the process that takes place during the development of the nascent tooth and periodontal tissue (Hammmarström, 1997). Emdogain® has been successfully used to restore a fully functional periodontal ligament, cementum and alveolar bone in patients with advanced intrabony defects (Heijl et al, 1997). In the present case report, we suggest the use of a coronally advanced flap procedure in conjucThe Use of Emdogain® in the Treatment of Cervical Lesions Previously Covered by a Bonded Restoration: A Case Report