Enamel Matrix Derivative Promotes Reparative Processes in the Dental Pulp

Abstract

During odontogenesis, amelogenins from the preameloblasts are translocated to differentiating odontoblasts in the dental papilla, suggesting that amelogenins may be associated with odontoblast changes during development. In the present study, we have explored the effects of enamel matrix derivative (EMD) on the healing of a pulpal wound. Coronal pulp tissue of permanent maxillary premolars of miniature swine were exposed through buccal class V cavities. The exposed pulp was capped with EMD. The contralateral teeth served as controls and were capped with a calcium hydroxide paste (Dycal). The cavities were sealed with glass-ionomer cement. After 2 and 4 weeks, the histology of the teeth was analyzed. In the EMD-treated teeth, large amounts of newly formed dentin-like hard tissue with associated formative cells outlined the pulpal wound separating the cavity area from the remaining pulp tissue. Inflammatory cells were present in the wound area but not subjacent to the newly formed hard tissue. Morphometric analysis showed that the amount of hard tissue formed in EMD-treated teeth was more than twice that of the calcium-hydroxide-treated control teeth (p < 0.001), suggesting that EMD is capable of promoting reparative processes in the wounded pulp more strongly than is calcium hydroxide.

Pulpal responses following direct pulp capping of healthy dog teeth with dentine adhesive systems

“…[18][19][20][21] Other biologically active approaches, such as the use of tricalcium phosphate ceramics or bioactive moleculesbased materials have also been investigated, but their use has remained up till now on an experimental level. 8,[22][23][24] During the last decade, dentine adhesives have been proposed as an alternative to Ca(OH) 2 based materials in direct pulp capping treatment. It has been claimed that a properly hybridized dentineadhesive interface can seal both dentine and pulp effectively, thus protecting the wound area from additional injury and post-operative infection and permitting complete tissue healing through the inherent capacity of the dentine-pulp complex.…”

Recent Advances in Pulp Capping Materials: An Overview

“…It might create a favourable environment for promoting wound healing in the injured pulp tissues [34]. Nakamura Y et al, concluded that amount of hard tissue formed in EMD treated teeth was more than twice that of the calcium hydroxide treated control teeth [35].…”

The Future Role of a Molecular Approach to Pulp-Dentinal Regeneration

“…Osteodentin followed by homogeneous and wellmineralized atubular reparative dentin was seen after capping treatment with bone sialoprotein [Decup et al, 2000]. Hard tissue formation at a distance from the capping was found after placement of enamel matrix derivatives in the exposed pulp [Nakamura et al, 2001].…”