Derivado de la matriz del esmalte en periodoncia: Resultados clínicos
DOI:
https://doi.org/10.33448/rsd-v14i12.50428Palabras clave:
Proteínas del esmalte dental, Resorción ósea, Regeneración tisular guiada periodontal.Resumen
La búsqueda de biomateriales capaces de estimular la regeneración de los tejidos periodontales ha sido constante en la investigación odontológica. La literatura describe ampliamente el empleo de distintos biomateriales y técnicas quirúrgicas, tales como injertos óseos, regeneración tisular guiada y el uso de factores de crecimiento. Con el descubrimiento de las proteínas derivadas de la matriz del esmalte en 1997, se introdujo una nueva perspectiva en las terapias regenerativas periodontales. Desde entonces, la matriz derivada del esmalte (MDE) ha adquirido relevancia debido a su capacidad para modular los procesos biológicos involucrados en la regeneración periodontal. La MDE ha sido evaluada en diversos abordajes terapéuticos periodontales, incluidos defectos supraóseos e infraóseos, lesiones interradiculares (furcaciones) y recesiones gingivales, así como en asociación con diferentes biomateriales. El objetivo del presente estudio fue dilucidar, mediante una revisión actualizada de la literatura, los resultados clínicos de las distintas aplicaciones de la MDE y su potencial regenerativo en la terapia periodontal contemporánea. Los estudios analizados indican que la anatomía de los defectos periodontales influye directamente en los resultados clínicos, observándose mayores mejoras en defectos infraóseos más profundos. En el tratamiento de estos defectos, especialmente los defectos verticales y las lesiones de furca mandibulares, la MDE presenta resultados clínicos favorables cuando se asocia a la terapia periodontal básica, aunque no demuestra superioridad en comparación con el uso de membranas en procedimientos de regeneración tisular guiada. En el manejo de las recesiones gingivales, la MDE muestra beneficios en los parámetros clínicos evaluados y contribuye positivamente al proceso de revascularización tisular. En cuanto a su asociación con otros biomateriales, la literatura señala una ventaja principalmente cuando se combina con injertos óseos bovinos. Por el contrario, su asociación con hueso autógeno, biovidrios y plasma rico en fibrina no demuestra beneficios clínicos adicionales significativos. En conjunto, los resultados refuerzan la indicación de la MDE como una alternativa eficaz en la terapia regenerativa periodontal.
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Derechos de autor 2025 Ribamar Lazanha Lucateli, Marina Angélica Marciano, Thiago Bessa Marconato Antunes, Michel R. Messora
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