The effect of enamel matrix protein on gingival tissue thickness in vivo

Abstract

The enamel matrix derivative (EMD) has been used extensively as an adjunct to root coverage procedures to achieve periodontal regeneration. However, its effect on gingival tissues has not been elucidated. The aim of this investigation was to evaluate histometrically the change in gingival soft tissue thickness around dehiscence-type defects treated with EMD. Five adult female beagle dogs were used. Buccal osseous dehiscences were surgically created on the maxillary canines and the second and fourth premolars. Thirty defect sites were randomly assigned to test and control groups (15 defect sites for each group). The test group received EMD application, whereas the control group did not. After 4 months of healing, the dogs were killed and tissue blocks were prepared. Histometric analysis showed that the mean thickness of gingival tissue was 1.76 ± 0.23 mm in EMD-treated sites compared to 0.72 ± 0.11 mm for control sites. The difference between the test and control groups was statistically significant (P < 0.0001). It appears that EMD has a positive influence on the increase in gingival tissue thickness when used in dehiscence-type defects in the beagle dog.

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.…”

Healing of localized gingival recessions treated with a coronally advanced flap alone or combined with an enamel matrix derivative and a porcine acellular dermal matrix: a preclinical study

“…It is an effective agent for stimulating periodontal regeneration with formation of a new acellular extrinsic fiber cementum, which firmly attaches to the denuded root surface [22,23]. Moreover, it has recently been demonstrated that EMD has a positive influence on the increase in gingival thickness in dehiscence-type defects in dogs [24]. These results might propose a new rationale for the increased predictability of CAF in achieving complete root coverage when EMD and/or PADM is used adjunctively.…”

In vitro models for evaluation of periodontal wound healing/regeneration

“…For instance, application of Emdogain during coronally positioned flap procedures for correction of gingival recession resulted in an increase in the width and density of the keratinized gingiva compared with the control treatment. Emdogain also stimulated an increase in gingival tissue thickness in dehiscence‐type defects in Beagle dogs and increased the speed of early connective tissue healing around dental implants . These clinical observations suggest that Emdogain may have direct effects on gingival healing and gingival fibroblasts.…”