Levels of tissue inhibitor of metalloproteinases‐1 and matrix metalloproteinases‐1 and ‐8 in gingival crevicular fluid following treatment with enamel matrix derivative (EMDOGAIN^®)

Abstract

The mechanism of enamel matrix derivative (EM D) action on the periodontal wound healing process is not well understood. However, earlier in vitro studies from our laboratory demonstrated that EMD stimulated the proliferation of both periodontal ligament and gingival fibroblast cells. Therefore, the purpose of this study was to further evaluate the effect of EMD on the early wound healing process by assessing the protein levels of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in gingival crevicular fluid (GCF). Sixteen patients, each of whom had one or two pairs of infrabony defects located contralaterally in the same arch, were included in this clinical trial. Thirty-six infrabony defects were randomly assigned treatment with flap surgery plus EMD or flap surgery plus placebo. At baseline and at 2, 4 and 12 week follow-up evaluation visits, GCF was sampled with paper strips. After determination of GCF volume, TIMP-1, MMP-1 and MMP-8 GCF levels were measured by an enzyme-linked immunosorbent assay. Intragroup analysis: At week 2 following surgery, when compared to baseline all parameters in each study group, except MMP-1, significantly increased (p<0.05). There were no significant differences between 4 or 12 weeks and baseline in either study group. Intergroup analysis: At 4 weeks after surgery, GCF volume and TIMP-1 levels showed a significant decrease (p<0.05) in the EMD group, when compared to the placebo group. MMP-1 levels at weeks 2, 4 and 12, and MMP-8 levels at weeks 4 and 12 were significantly lower (p < 0.05) in the EMD group compared to the placebo group. EMD compared to placebo treated sites demonstrated a more rapid return to baseline levels of TIMP-1, MMP-1 and MMP-8. These findings suggest that treatment with flap surgery and EMD, compared to flap surgery with placebo, accelerated healing at an earlier stage of wound healing following surgery.

Zymographic Techniques for the Analysis of Matrix Metalloproteinases and their Inhibitors

“…In those cases, other assays might be more suitable, such as enzyme-linked immunosorbent assay (ELISA) or Western blot analysis. For example, MMP-8 is difficult to detect with zymography, but with other techniques it might be possible to measure protein levels (78,79). …”

Treatment of Intrabony Periodontal Defects With Enamel Matrix Derivative: A Literature Review

“…This anecdotal observation was recently substantiated by the statistically significant reduction of matrix metalloproteinase levels observed in EMD-treated defects during the postsurgical inflammatory healing phase. 91 In addition, it was reported that higher proportions of EMD sites reached several clinical signs characterizing resolution of gingival inflammation faster during wound healing. 92 In conclusion, local irritation tests, sensitization studies, and observations of clinical reactions indicated that EMD is a well tolerated and clinically safe product to use in periodontal therapy.…”

Matrix metalloproteinase-8 and substance P levels in root canal exudates of nonvital teeth

“…2,[11][12][13][14][15][16] A time resolved immunofluorometric assay (IFMA), ELISA 그리고 a dentoAnalyzer device 등을 이용해서 MMP-8을 분석해 본 결과 방법에 상관없이 일치하는 결과 를 보였다는 연구도 있었지만, 16 ELISA의 경우 다른 방법 들과는 다른 종류의 antibody를 사용하게 되어서 조금 다 른 결과를 보일 수도 있다고 보고되기도 했다. 17 치주영역에 서는 치은 열구액을 채취하여 chair-side에서 MMP-8의 농도를 측정하여 진단에 이용할 수 있는 기구가 개발되어 있다.…”