Effects of enamel matrix protein application on the viability, proliferation, and attachment of human periodontal ligament fibroblasts to diseased root surfaces in vitro

Davenport, D. R.; Mailhot, Jason M.; Wataha, John C.; Billman, Michael A.; Sharawy, Mohamed; Shrout, Michael K.

doi:10.1034/j.1600-051x.2003.00150.x

Cited by 39 publications

(31 citation statements)

References 32 publications

(31 reference statements)

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“…3). This finding is in contrast to several prior studies that have reported a stimulation in cell proliferation with EMD for several cell types including primary cultures of human periodontal fibroblasts, 28,32,35 SV40 transformed murine dental follicle cells, 36 and various osteoblastic cell cultures in different stages of differentiation. 37 However, the present study differs from earlier studies in several important respects.…”

Section: Discussioncontrasting

confidence: 86%

“…20,21 All earlier cited reports used PDL cell cultures obtained through explant culture of periodontal ligament tissue. 28,32,35 Explant culture selects for fibroblasts that adventitiously migrate away from the explanted tissue fragments and results in primary cultures of PDL cells without an epithelial component. In the present study, the simple epithelial cell component, which comprised approximately 25% of the total PDL cell culture number, greatly decreased over time in culture with EMD.…”

Section: Discussionmentioning

confidence: 99%

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Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials

Inoue

LeGeros

Hoffman

et al. 2004

J Biomedical Materials Res

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Cells within the periodontal ligament have the potential to regenerate a periodontal connective tissue attachment on pathologically exposed root surfaces as well as on several material surfaces including titanium. However, rather than a periodontal connective tissue attachment, a fibrous encapsulation or chronic inflammatory response has been reported at the material connective tissue interface for most dental materials. Cementum is the first tissue of the periodontal connective tissue attachment to develop and the secretion of enamel matrix related proteins on the newly mineralized dentin surface precedes and is thought to induce cementum formation. Enamel matrix-related proteins may also function in the adult because the application of an acid extract of porcine enamel protein matrix (Emdogain(R), EMD) on pathologically exposed root surfaces has been shown to result in cementum regeneration. Therefore, the objective of the present study was to determine whether the application of EMD to materials that do not normally support cementogenesis in vivo would alter the in vitro phenotype of periodontal ligament (PDL) cells including the synthesis of cementum-associated extracellular matrix proteins. Primary PDL cells were established from 21-day-old Sprague-Dawley rats, and were cultured on four materials commonly encountered in dental practice (gutta percha, calcium hydroxide, amalgam, and super EBA cement) with and without the application of EMD. After 7 or 14 days of culture, total-DNA content, collagen synthesis, alkaline phosphatase activity, and the synthesis of a 42-kDa cementum-associated extracellular matrix protein were determined. PDL cells cultured on all materials had decreased total DNA content. The application of EMD further decreased total DNA content. PDL cells cultured on gutta percha and calcium hydroxide with the application of EMD had similar levels of collagen synthesis and alkaline phosphatase activity but also expressed a 42-kDa cementum extracellular matrix-associated protein when compared to the other groups. These results suggest that EMD can alter the phenotype of PDL cells when cultured on these dental materials.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials

Inoue

LeGeros

Hoffman

et al. 2004

J Biomedical Materials Res

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“…In contrast, EMD had no significant effect on migration or attachment and spreading of PDL cells. In another study aimed at examining the influence of EMD on the viability, proliferation, and attachment of human PDL fibroblasts to diseased root surfaces in vitro, it was shown that the viability of PDL cells was negatively affected by higher doses of EMD over time, while lower doses elicited no change when compared with control cultures (Davenport et al, 2003). Scanning electron microscopy showed that EMD appeared to increase attachment of periodontal ligament fibroblasts to diseased root surfaces.…”

Section: (Ii53) Emd-mode Of Actionmentioning

confidence: 99%

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

Venezia

Goldstein

Boyan

et al. 2004

Critical Reviews in Oral Biology & Medicine

155

110

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Background-Periodontal disease results in the loss of the attachment apparatus. In the last three decades, an increasing effort has been placed on seeking procedures and materials to promote the regeneration of this tissue. The aim of this paper is to evaluate the effect of enamel matrix derivative (EMD) during regenerative procedures. In addition, a meta-analysis is presented regarding the clinical results during regeneration with EMD, to gain evidence as to what can be accomplished following treatment of intrabony defects with EMD in terms of probing depth reduction, clinical attachment level gain, defect fill (using re-entry studies), and radiographic parameters. Methods-The review includes in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findings. In addition, a meta-analysis is presented regarding the regenerative clinical results. For this purpose, we used 28 studies-including 955 intrabony defects treated with EMD that presented baseline and final data on probing depth, clinical attachment level (CAL) gain, or bone gain-to calculate weighted mean changes in the different parameters. The selected studies were pooled from the MEDLINE database at the end of May, 2003. Results-The meta-analysis of intrabony defects treated with EMD resulted in a mean initial probing depth of 7.94 ± 0.05 mm that was reduced to 3.63 ± 0.04 mm (p = 0.000). The mean clinical attachment level changed from 9.4 ± 0.06 mm to 5.82 ± 0.07 mm (p = 0.000). These results were significantly better than the results obtained for either open-flap debridement (OFD) or guided tissue regeneration (GTR). In contrast, histologically, GTR is more predictable than EMD in terms of bone and cementum formation. No advantage was found for combining EMD and GTR. Xenograft, or EMD and xenograft, yielded inferior results compared with EMD alone, but a limited number of studies evaluated this issue. Promising results were noted for the combination of allograft materials and EMD. Conclusions-EMD seems to be safe, was able to regenerate lost periodontal tissues in previously diseased sites based on clinical parameters, and was better than OFD or GTR. Its combination with allograft materials may be of additional benefit but still needs to be further investigated.Key words. Enamel matrix derivative, Emdogain ® , meta-analysis, periodontal regeneration. States Food and Drug Administration (FDA).In 1997, an alternative approach for periodontal regeneration was introduced that was based on embryonic tooth formation (Hammarström, 1997;Heijl et al., 1997). This approach uses an extract of embryonic enamel matrix, termed 'enamel matrix derivative' (EMD), thought to induce mesenchymal cells to mimic the processes that take place during the development of the nascent root and periodontal tissues. The present analysis reviews the data on the effect of EMD as a regenerative promoter. It encompasses in vitro and in vivo studies as well as human case reports, clinical comparative trials, and histologic findin...

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“…In the presence of EMD, human PDL fibroblasts showed some morphological changes that made them more similar to cementoblasts than to fibroblasts, suggesting a process of cellular differentiation [22] . A recent study examined the influence of EMD on the viability, proliferation and attachment of periodontal fibroblasts to diseased root surfaces [23] . The results indicated that cell viability was negatively affected for higher doses over time, while low doses displayed viability effects similar to those of the control.…”

Section: In Vitro Studiesmentioning

confidence: 99%

The Application of an Enamel Matrix Protein Derivative (Emdogain®) in Regenerative Periodontal Therapy: A Review

et al. 2007

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Regenerative periodontal therapy aims at reconstitution of the lost periodontal structures such as new formation of root cementum, periodontal ligament and alveolar bone. Findings from basic research indicate that enamel matrix protein derivative (EMD) has a key role in periodontal wound healing. Histological results from animal and human studies have shown that treatment with EMD promotes periodontal regeneration. Moreover, clinical studies have indicated that treatment with EMD positively influences periodontal wound healing in humans. This review aims to present an overview of evidence-based clinical indications for regenerative therapy with EMD.

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Effects of enamel matrix protein application on the viability, proliferation, and attachment of human periodontal ligament fibroblasts to diseased root surfaces in vitro

Abstract: These in vitro studies support the concept that EMP may act as a suitable matrix for PDLF.

Cited by 39 publications

References 32 publications

Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials

Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials

The Use of Enamel Matrix Derivative in the Treatment of Periodontal Defects: a Literature Review and Meta-analysis

The Application of an Enamel Matrix Protein Derivative (Emdogain®) in Regenerative Periodontal Therapy: A Review

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