Effect of enamel matrix derivative protein on the healing of standardized epithelial wounds: a histomorphometric analysis in vivo

Abstract

The enamel matrix derivative (EMD) is a preparation of the enamel matrix proteins secreted by the Hertwig's epithelial root sheath. It has been shown that EMD promotes periodontal wound healing; however, the significance of the protein in repairing skin wounds is insufficiently addressed. The aim of this in vivo histomorphometric investigation was to analyse the effect of EMD protein on the healing of standardised epithelial wounds. Dorsal skin of 22-week-old female guinea pigs (n = 33) was scarified and divided into test- (topical application of EMD) and control-sites (sutured and allowed to heal). Animals were euthanised at specific time intervals and the specimens were then evaluated histomorphometrically. The mean widths of the external wound gaps (WGs) in the test- and control-sites at the 5th, 20th and 35th day of healing were 5·89, 3·6 and 1·01 mm and 6·41, 5·02 and 3·43 mm, respectively. Histomorphometric analysis showed a statistically significant difference in the WGs between the test- and control-sites. A significant increase in the formation of organised connective tissue matrix, collagen fibres and early muscle formation was observed in the test-sites as compared with the control-sites. Within the limits of this study, it is concluded that topical application of the EMD on standardised epithelial allows early wound closure and promotes healing as compared to when the defects are merely sutured.

Emdogain-Regulated Gene Expression in Palatal Fibroblasts Requires TGF-βRI Kinase Signaling

“…Besides what is known from genetic models [58], [59], the local application of recombinant TGF-β causes the formation of a collagen-rich tissue, for example in the skeletal muscle [60]. These findings are consistent with the role of Emdogain in supporting the formation of a collagen matrix in porcine skin wound healing models [3]. It is thus reasonable to assume that Emdogain and recombinant TGF-β are similar in their ability to stimulate the formation of a collagen-rich extracellular matrix.…”

“…The local application of Emdogain has been shown to support skin wound healing [2], [3]. The ability of Emdogain to stimulate soft tissue regeneration has prompted the combination of Emdogain with palatal subepithelial connective tissue to enhance the healing process [4]–[6].…”

Efficacy of Acellular Dermal Matrix and Coronally Advanced Flaps for the Treatment of Induced Gingival Recession Defects: A Histomorphometric Study in Dogs

“…Recent studies [47][48][49] have reported that biomimicry agent (such as enamel matrix derivative [EMD]) proteins promote tissue repair and regeneration at defected sites. These studies [47][48][49] revealed that EMD proteins exhibit the potential to enhance the healing of standardized epithelial wounds, induce cementogenesis, and increase the thickness of gingival tissues. It is therefore hypothesized that treatment of GR defects using ADM with adjunct EMD therapy may enhance gingival tissue thickness and yield positive outcomes in terms of root coverage.…”

Tissue Engineering in Periodontal Tissue

“…In addition to enamel matrix proteins, several studies have demonstrated that EMD contains small amount of growth factors, such as BMPs (Iwata et al, ; Johnson et al, ) and TGF‐β1 (Suzuki et al, ), explaining the complex effects of EMD. A particularly interesting study found that propylene glycol alginate (PGA), the vehicle of EMD, has antibacterial properties, suggesting that the combination of EMD and PGA enhances not only periodontal (Sculean et al, ) but also epithelial wound healing (Mirastschijski et al, ; Al‐Hezaimi et al, ).…”