Glossary

An enamel matrix derivative, or EMD, is a sterile protein aggregate which comes from the enamel matrix, specifically from amelogenins, and is the precursor of the enamel of developing teeth. The proteins necessary for EMD are harvested from around the developing teeth of pig embryos using a special processing procedure. Enamel matrix protein derivatives are used in the restoration and regeneration of periodontal tissues and assist in the growth or further development of the periodontal ligament, root cementum, and alveolar bone. Though enamel matrix derivatives are harvested from pig embryos, they have not been shown to create a significant immune response when used in humans. The use of EMDs have also demonstrated anti-inflammatory properties. Both of these results suggest that the use of EMD is safe for humans. In addition, the results of EMD therapy are longer-lasting and have been shown to provide significant benefits to patients undergoing periodontal regeneration.

An endodontic implant (also known as an endodontic pin or endodontic stabilizer) is a pin placed into a root canal of a tooth. It extends beyond the apex of the tooth and into the bone. An endodontic implant is also known as a stabilizer because of its function in providing more stability to a weakened tooth. By increasing the root to crown ratio, the implant can provide the patient with tooth stability and allow them to avoid replacement procedures for years. An endodontic implant may be used in situations where a patient has experienced periodontal bone loss, has a chronic abscess where the root apex has been reabsorbed, has a tooth with a very short root, or has a poor crown to root ratio due to tooth fracture. An endodontic stabilizer may also be appropriate in patients where the loss of a tooth would be difficult to manage using other dental processes.

An endosseous distractor, also known as an intraosseous distractor, is a distraction device placed into the edentulous ridge and/or basal bone of the maxilla or mandible used in distraction osteogenesis. Distraction osteogenesis is a process whereby a short bone is made into a longer one through a slow separation process. This process involves surgically cutting a bone then placing a distractor between the two new pieces. The distractor slowly and gently pulls the bone apart, allowing for the growth of new bone in between the existing pieces, thereby creating a longer bone out of what was originally a shorter one. Though the process sounds uncomfortable, osteogenesis is not painful. An endosseous distractor and distraction osteogenesis is used to correct a variety of craniofacial syndromes and is often used for treating children and teenagers. The type of distractor used and the length of time it is required depends upon the syndrome being treated.

An endosseous implant, or an endodontic endosseous implant, is a type of endosteal implant that is meant to mimic the natural root of a tooth by using a vertical column of bone to anchor the dental implant hardware. Endosseous implants are surgically placed inside the natural jawbone and allowed to heal before placing the artificial tooth or crown on the implant hardware. Since children under the age of 16 are still developing and the shape, size, and density of their jawbone is still changing, endosseous implants are typically only recommended for patients over the age of 16 to 18, depending on individual dental practice policies. Implants of this variety are also not recommended for diabetic patients who don’t have good control over their blood sugar due to the increased risk for infection and poor healing. Endosseous implant patients should have good quality and quantity of bone with no surgical contraindications.

An endosseous ramus frame implant, or ramus implant, is a blade form, full-arch, endosseous implant set into both rami and the symphyseal area of the mandible. It is constructed with a horizontal connecting bar that sits along the gingival tissues, creating a U-shaped design when viewed from the occlusal. The tripodal design of the ramus implant provides stability for mandibular dentures and is used as an option when the mandible has significant atrophy. An endosseous ramus frame implant is one of several types of endosseous implants and serves as a stable platform to which lower dentures can be affixed. It is especially useful for patients who have thin, deteriorated, or atrophied lower mandibles. Ramus implants have a high success rate with devices still in place several years after the initial placement. Endosseous ramus frame implants are also relatively easy to place as they come prefabricated and can be adjusted to fit the patient’s unique oral structure.

The endosteum is the tissue lining the medullary cavity of bone. It is composed of a single layer of osteoprogenitor cells and a small amount of connective tissue. In dentistry and oral surgery, the endosteum is generally where an implant is placed prior to a patient receiving a prosthesis. An endosteal implant is placed in the bone of the jaw and acts as a new artificial root which will anchor the restoration. For some patients, an alveolar bone graft or other type of bone graft is required to build up the area before the endosteal implant can be placed. Following the implant surgery, healing and osseointegration must occur prior to the dental prosthesis being affixed. Though endosteal implants can come in several different materials, titanium is most frequently used due to its strength, durability, corrosion-resistance, and biocompatibility. Endosteal implants are available either as screw-type (or cylinder) or blade. 

An envelope flap is a flap that is elevated from a horizontal linear incision, parallel to the free gingival margin, with no vertical incision. It may be either sulcular or submarginal. The envelope flap has been found to create less inflammation following a procedure than other similar types of flaps, such as the triangular. Though other factors of the triangular and envelope flaps are almost the same, the envelope flap is often recommended since it produces less inflammation. The envelope flap gets its name partly due to the method used to close the flap following surgical procedures. The ends of the gingival flaps are positioned and folded against the surface of the roots and then folded like an envelope. The envelope flaps are then held together by sutures or another closing technique. A dressing may also be applied following the flap closing to hold them in place and allow further healing to ensue.