Inflammatory external root resorption following surgical treatment for intra-bony defects: a report of two cases involving Emdogain and a review of the literature.
BACKGROUND
Enamel matrix-derived proteins have been shown to regenerate periodontal tissues lost as a result of disease in humans. Emdogain, a commercial preparation of porcine enamel matrix derivative (EMD), has been shown to induce new cementum, periodontal ligament and bone formation in human periodontal defects. Although a number of studies have reported successful outcomes, local adverse effects have so far not been reported in the literature. This case report describes two examples of external inflammatory resorption following surgical root surface debridement and the use of Emdogain.


METHODS
The treatment in both cases involved raising a full-thickness flap following completion of non-surgical therapy. The granulation tissue from the defect was removed and the root surfaces debrided. Emdogain was applied following the manufacturers' instructions and involved conditioning the root surfaces with Pref-Gel and applying the Emdogain to the defect. The flaps were sutured and the site reviewed regularly. Radiographs were taken before the treatment was undertaken and also at 6 months to assess the healing of the defect.


RESULTS
External inflammatory root resorption was observed on the treated teeth 6-24 months after therapy.


CONCLUSIONS
External inflammatory root resorption may be an unusual adverse event following Emdogain treatment.
St George
Geoffrey
G
Unit of Endodontology, Eastman Dental Institute for Oral Health Care Sciences, London, WC1X 8LD, UK. g.stgeorge@eastman.ucl.ac.uk
Darbar
Ulpee
U
Thomas
Gareth
G