Upotreba proteina caklinskog matriksa kod regenerativne terapije periimplantitisa

master's thesis

• Title (english): Use of enamel matrix proteins in regenerative therapy of periimplantitis
• Author: Nino Penava
• Mentor: Domagoj Vražić (mentor)
• Committee member: Domagoj Vražić (predsjednik povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Committee member: Samir Čimić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Periodontology); Zagreb
• Defense date and country: 2020-07-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Periodontology

Abstract

Dentalni implantati sve su češći izbor prilikom nadoknade izgubljenih zuba, a samim
tim raste i broj komplikacija. Najčešće biološke komplikacije su periimplantatni mukozitis i
periimplantitis, biofilmom uzrokovane upale periimplantatnog mekog tkiva bez, odnosno s
progresivnim gubitkom potporne kosti. Međutim, još ne postoji jedinstveni protokol u
njegovom liječenju. U slučaju periimplantatnog mukozitisa najčešće je dovoljna nekirurška
terapija, dok je za liječenje periimplantitisa metoda izbora kirurška terapija. Ovisno o
konfiguraciji defekta odlučujemo se za resektivnu ili regenerativnu kirurgiju. U regenerativnoj
kirurgiji najčešće se upotrebljavaju koštani nadomjesni materijali u kombinaciji s
membranom. Iako se ova kombinacija pokazala uspješnom, sve se više istraživanja fokusira
na bioaktivna sredstva koja bi mogla potaknuti regeneraciju. U skupinu bioaktivnih sredstava
spadaju i proteini caklinskog matriksa koji sudjeluju u razvoju zuba tijekom mineralizacije
cakline. Emdogain® komercijalno je dostupan preparat proteina caklinskog matriksa i sastoji
se uglavnom od amelogenina otopljenog u kiselom propilen glikol alginatu. Proteini
caklinskog matriksa najprije su se uspješno koristili u terapiji parodontnih infrakoštanih
defekata i recesija, da bi se u novije vrijeme krenuli upotrebljavati i u terapiji periimplantatnih
bolesti. Do sada objavljene studije uglavnom su niže razine dokaza, ali sugeriraju da bi
proteini caklinskog matriksa mogli imati pozitivni učinak na regeneraciju kosti izgubljene
periimplantitisom. Međutim, nedostaju veća randomizirana kontrolirana istraživanja koja bi
ustvrdila njihovu točnu ulogu.

Abstract (english)

Dental implants are being used more and more to replace missing teeth, which in turn causes
more complications. The most common biological complications are periimplantitis, periimplant mucositis, and biofilm mediated inflammation of the peri-implant soft tissues
with/without the progressive loss of the supporting bone. However, we do not yet have a
single treatment for peri-implant diseases. In case of peri-implant mucositis, nonsurgical
therapy is often sufficient, but treating periimplantitis often requires surgery. Depending on
defect configuration, we opt either for resective or regenerative surgery. In the latter, the most
frequently used are bone grafts in combination with the membrane. Although this
combination has proved to be successful, more and more research now focuses on bioactive
agents that could stimulate regeneration. The bioactive agents include enamel matrix proteins
that take part in tooth development during enamel mineralization. Emdogain® is a
commercially available product of enamel matrix proteins that consists mostly of amelogenins
diluted in acid propylene glycol alginate. Enamel matrix proteins were first successfully used
in the treatment of recessions and infrabony periodontal defects. Today, they are applied to
periimplantitis-affected sites as well. Studies published so far have mostly been positioned
lower on the evidence-based medicine pyramid but they do suggest that enamel matrix
proteins have a positive effect on bone regeneration. However, larger randomized controlled
studies are needed to determine their exact role.

• Keywords: parodontalne bolesti; periimplantitis; zubni implantati; amelogenin
• Keywords (english): Periodontal Diseases; Peri-Implantitis; Dental Implants; Amelogenin
• Language: croatian
• URN:NBN: urn:nbn:hr:127:292069
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-01-20 11:30:32