Emdogain Promising in Regenerative Endodontics: Case Series Reports Successful Pulp Healing in Pediatric Cases

Karime Tavares Lima da Silva, CEUMA University, Rua Josué Montello n° 1, Renascença II, São Luís, MA, Brazil, and colleagues describe successful clinical and radiographic outcomes following the use of Emdogain in three young patients with necrotic, immature permanent teeth.

Emdogain (Straumann Emdogain, Switzerland) has been previously studied for its biological role in promoting dental tissue regeneration, particularly during odontogenesis. However, clinical evidence supporting its use in REPs has been limited. This report is among the first to document its application in human subjects under a standardized protocol.

The case series includes three pediatric patients—two boys and one girl—aged 8 to 12, all from low-income families in São Luís, Maranhão, Brazil. Each patient presented with immature, non-vital permanent teeth, a clinical situation where conventional root canal therapy often falls short. The clinicians employed a two-appointment treatment approach, using Emdogain as a scaffold to facilitate pulp regeneration.

Pain levels were assessed using the Visual Analogue Scale (VAS), and tooth shade changes were objectively measured using a digital spectrophotometer. Radiographic follow-ups were conducted at 12 and 24 months. 

The outcomes were promising across all three cases. By the 12-month mark, periapical lesions had resolved. At 24 months, all treated teeth remained functional, and symptom-free, and exhibited continued root development. Notably, radiographs confirmed apical closure, thickening of dentin walls, and extension of root length in all cases. In one instance, scattered calcified areas within the root canal were observed, possibly indicating ongoing mineralization.

These findings suggest that Emdogain may offer valuable support in guiding angiogenesis and tissue healing in regenerative endodontics. The enamel matrix derivative appears to create a biologically favorable environment for cellular activity essential to pulp-dentin complex regeneration.

While larger clinical studies are required to confirm these preliminary findings, the outcomes from this case series provide encouraging evidence. The study emphasizes the importance of exploring alternative scaffolding materials, particularly in pediatric patients with underdeveloped roots, where preserving natural tooth structure is a key objective.

The researchers note that Emdogain's biocompatibility and its ability to support tissue repair could mark a significant advancement in REP techniques. This material, if further validated, may be integrated into future treatment protocols for managing necrotic immature teeth.

"The use of Emdogain in regenerative endodontic procedures shows early promise in facilitating healing and root maturation. These cases pave the way for further exploration into its role as a reliable scaffold in clinical endodontics," they concluded.

Reference:

da Silva, K.T.L., Ferreira, M.C., Grazziotin-Soares, R. et al. Regenerative endodontic procedure using Emdogain: a case series. J Med Case Reports 19, 205 (2025). https://doi.org/10.1186/s13256-025-05199-x