FIRM ANCHOR AGE FOR TEETH Straumann® Emdogain – for periodontal regeneration
Patient information
TABLE OF CONTENTS 2
What is periodontitis?
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From plaque to tooth loss
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Diseases of the periodontium
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Treatment process
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Starting treatment
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Regenerative treatment Regeneration with Straumann® Emdogain
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The first weeks after treatment
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Long-term effect with Straumann® Emdogain
17 Benefits
of Straumann® Emdogain
18 Straumann
– the company
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INTRODUCTION Usually, healthy teeth are firmly anchored and do not come loose, because teeth require a firm foundation for a strong bite. An essential prerequisite for an esthetically and functionally intact periodontium is good dental hygiene. If plaque is not regularly and thoroughly removed, bacteria may colonize the jaw, destroy tissues and may finally cause diseases of the periodontium (periodontitis). Many adults, not only older patients, are affected by this inflammatory disease which, if left untreated, may result in tooth loss. In many misleading cases people do not even notice the initial warning signs, such as bleeding gums or swelling. However, if periodontitis is not treated early enough, it may cause gingival recession and bone loss in the jaw; the tooth will loosen and finally lost. Straumann offers help with the biological product Emdogain. To date, it has been used in over a million patients worldwide. StraumannÂŽ Emdogain promotes the regeneration of periodontal tissue by mimicking the natural processes of tooth development. This regenerative approach supports the body in sustainably regenerating the natural periodontium, to ensure a renewed, firmer anchorage.
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WHAT IS PERIODONTITIS? Pay attention to swollen, reddened or bleeding gingiva – it may be the first sign of periodontitis, an inflammatory disease of the periodontium, which includes the gingiva and jaw bones. The majority of adults is affected. About three in four adults suffer from periodontitis during their lives – many without initially knowing it. The cause of periodontitis is bacteria and their toxins that have time and space to proliferate, preferably in the niches between the teeth and the gingiva, causing bacterial plaque to develop. If plaque is not removed (including removal from between the teeth) by appropriate
oral hygiene, tartar develops due to mineral deposits. Due to its rough surface structure, tartar is an ideal foundation for additional layers of plaque. Because tartar adheres very strongly to the tooth surface, a normal toothbrush is no longer sufficient and its removal requires professional cleaning by a dentist or dental hygienist. If tartar is left, the inflammatory process can continue to develop. Continued inflammation means that in the advanced stages of periodontitis, the jaw bone and the fibers retaining the teeth atrophy, which leads to loosening of teeth and, in the worst case, tooth loss.
moderate periodontitis
% 60
32.2 %
14.1 %
52.7 %
severe periodontitis 20.5 %
50 40 30 20 10 0
1997 DMS III
2005 DMS IV
Source: German oral health study (Deutsche Mundgesundheitsstudie, DMS IV), November 2006
Development of periodontitis in 35- to 44-year-old adults from 1997 to 2005
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WHAT ARE THE RISKS OF PERIODONTITIS? Does periodontitis have adverse effects on the heart? Studies show that chronic inflammation may promote cardiovascular disease as periodontal bacteria do not remain restricted to the oral cavity. Bacteria and their toxins can enter the bloodstream from the tooth socket and endanger the rest of the body. Once
in the bloodstream, the immune system is mobilized and tries to neutralize the bacteria. If the inflammation is not treated, the immune cells remain active. People suffering from periodontitis may therefore be at higher risk of cardiovascular diseases, such as heart attacks and strokes.
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FROM PLAQUE TO TOOTH LOSS STAGES OF PERIODONTITIS
1. Plaque accumulates on the tooth at the gingival margin. The gum becomes inflamed; it bleeds:
Mild gingivitis caused by plaque and tartar formation
2. The gingival margin is loosing attachment to the tooth, bacteria are multiplying, plaque is adhering to the tartar, the surrounding bone atrophies:
Severe gingivitis and inflammation of the periodontium (periodontitis)
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3. The gum recedes. Jaw bone and tooth fibers continue to atrophy, the tooth loosens and may fall out:
Massive inflammation and atrophy of the periodontium
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DISEASES OF THE PERIODONTIUM
How severely is the jaw bone affected by periodontal disease, and what is the effect of periodontitis on the entire periodontium?
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If periodontitis remains untreated, the inflammatory process will continue into deeper regions at the root of the tooth. Bone defects, mostly funnelshaped, will develop in the area of the interdental spaces.
Loss of bone around teeth with a root, known as bone defect
There are also diseases in which the gingiva and the underlying bone recede without prior inflammation. There are many reasons for this: incorrect tooth cleaning, displaced teeth, or bruxism are some examples. Gingival recession is not only an esthetic problem but may also be painful for the patient because it exposes the neck of the tooth and causes hypersensitivity. Widespread inflammation-free recession of the gingiva and the underlying bone, known as recession defect
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TREATMENT PROCESS The most important aim of treating periodontitis is to heal the inflammatory disease. Therapy starts with the initial treatment, in which the patient is shown how to clean his or her teeth in the best way, even areas that are difficult to reach, such as interdental spaces. The teeth are also professionally cleaned to
remove the hard deposits as thoroughly as possible, first above and then below the gingival margin. If this treatment of the root surface in the gingival sulcus is not sufficient, surgical treatment with cleaning will be required.
TREATMENT STEPS 1
2
3
4
STEPS
RESULTS
DIAGNOSIS
INITIAL THERAPY
REGENERATION
Clinical and radiological
Periodontitis
Periodontal pretreatment to establish ability to maintain oral hygiene, removal of plaque and tartar
Surgical therapy with StraumannÂŽ Emdogain, bone graft material can also be applied for larger defects
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STARTING TREATMENT
Removal of plaque and tartar
INITIAL THERAPY In the first phase of periodontitis treatment, the external causes of the disease are eliminated to establish the conditions required for healing. The bacterial infection is treated first in the hygiene phase, with professional tooth cleaning by dental hygi-
enists at the dental practice and instruction of the patient in oral hygiene. Professional cleaning includes removal of plaque, tartar and the bacteria that cause the disease. After the initial therapy, the degree of oral tissue inflammation is reduced.
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REGENER ATIVE TREATMENT Regeneration with Straumann® Emdogain*
Straumann® Emdogain is applied to the defect; its gel-like consistency enables it to be applied evenly
PRINCIPLE OF MIMICRY
Emulating nature – Straumann® Emdogain mimics the biological process of natural tooth development. It promotes regeneration of hard and soft periodontal tissues. The goal of the regeneration is the renewal and complete restoration of the structure and function of the lost tissue. Straumann® Emdogain is scientifically well documented and
has already been used in over a million patients worldwide. THE METHOD
Straumann® Emdogain is applied to the exposed, cleaned root surface in a minor surgical procedure.
*Straumann® Emdogain is a biological product which contains proteins of porcine origin.
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Bone regeneration with Straumann® BoneCeramic
Filling with Straumann® BoneCeramic
Bone graft material can be used with Straumann® Emdogain to replace the missing tissue in larger defects. Synthetic materials such as Straumann® BoneCeramic are an established alternative to the patient’s own bone. Straumann® BoneCeramic is a fully synthetic bone graft material that supports the growth of new, vital
bone. The aim here is also to regenerate as much natural tissue as possible.
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THE FIRST WEEKS AFTER TREATMENT
Treatment with StraumannÂŽ Emdogain starts a process of regeneration and healing. The process should proceed as undisturbed as possible. You should follow some general rules during the healing period. To avoid disturbing the healing process, do not clean the teeth in the area of the wound for the first few days after the operation.
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The following instructions are for the first few weeks after treatment.
Removal of sutures by the treating dentist Cleaning of teeth by dental professionals Continue to avoid the interdental spaces
WEEK 1
Use an antibacterial mouthwash several times a day Avoid alcohol, nicotine, coffee, black tea and fresh dairy products Avoid the treated area when chewing Avoid hard and chewy foods Do not clean the treated area with a toothbrush
FROM WEEK 6
Cleaning of teeth by dental professionals Clean teeth carefully in treated area, including the interdental spaces The treating dentist will schedule regular checkups to check the progress of the healing.
WEEKS 2–6
Rinse with an antibacterial mouthwash
Because every surgical procedure involves potential risks, the patient should consult a dentist before treatment. The patient will be given information on the possible risks during a consultation, and advised as to whether this treatment is suitable. The procedure in the first
few weeks after treatment may vary depending on the individual patient. The treating dentist must therefore inform the patient of what to do during this period and the patient must follow these instructions.
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LONG-TERM EFFECT WITH STRAUMANN ® EMDOGAIN Straumann® Emdogain supports the regeneration of the body’s own tissue that has been lost because of periodontitis. The result can be a solid, functional new attachment in the bone and soft tissue.
EXAMPLE: BONE DEFECT
By courtesy of Dr. Gunnar Heden, Karlstad, Sweden
Initial diagnosis The loss of periodontium has caused a pronounced bone defect
One year after treatment with Straumann® Emdogain It has been possible to regenerate the natural structures
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EXAMPLE: RECESSION DEFECT
By courtesy of Prof. G. Zucchelli, Bologna, Italy
Before treatment 5.0 mm recession defect
8 months after treatment with StraumannÂŽ Emdogain Root completely covered
Important: The success of periodontal treatment depends on the active cooperation of the patient. Appointments for treatment and aftercare must be kept. Patients must also practice careful daily oral hygiene.
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BENEFITS OF STRAUMANN ® EMDOGAIN
Supports tooth retention Biological basis: Straumann® Emdogain promotes regeneration of the periodontiums Holistic therapeutic approach: Restoration of natural state Scientifically proven: Straumann® Emdogain has been documented in over 400 scientific papers Used worldwide: Straumann® Emdogain has been used in over a million patients
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STR AUMANN – THE COMPANY Who we are, and what we stand for, is what sets us apart.
SWISS QUALITY WITH INTERNATIONAL RESEARCH
Straumann provides solutions for a range of dental conditions and is a leading global supplier in dental implantology and oral tissue regeneration. By developing some of the most significant technologies and processes in collaboration with leading clinics, research institutes and universities, Straumann has contributed to advances in dental regeneration and restoration as well as dental prosthetics and patient treatment. To complement its product
portfolio, Straumann develops and manufactures products that help to heal periodontally compromised teeth or to support implant procedures. These include innovative products such as Straumann® Emdogain, a proteinbased gel which regenerates dental tissue, and Straumann® BoneCeramic, a novel, fully synthetic bone graft substitute. Headquartered in Basel, Straumann is an international group of companies that distributes its products in over 60 countries worldwide. Its
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Straumann headquarters in Basel, Switzerland
guiding principle is ‹simply doing more›. This involves developing innovative solutions that enable dentists to treat their patients based on the latest research. The company’s trademarks are reliability and quality: Straumann solutions are thoroughly researched and scientifically proven – now and in the future.
This leaflet contains information designed to provide basic information on dental health. It is not a substitute for specialist advice from a qualified dentist.
© Institut Straumann AG, 2013. All rights reserved. Straumann ® and/or other trademarks and logos from Straumann ® mentioned herein are the trademarks or registered trademarks of Straumann Holding AG and/or its affiliates. All rights reserved.
www.straumann.com
03/13 152.137/en BA10313
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