Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins.

Abstract

There is increasing evidence that cells of the epithelial root sheath synthesize enamel matrix proteins and that these proteins play a fundamental role in the formation of acellular cementum, the key tissue in the development of a functional periodontium. The purpose of the present study was to explore the effect of locally applied enamel matrix and different protein fractions of the matrix on periodontal regeneration in a buccal dehiscence model in monkeys. Buccal, mucoperiosteal flaps were raised from the canine to the 1st molar on each side of the maxilla. The buccal alveolar bone plate, the exposed periodontal ligament and cementum were removed. Various preparations of porcine enamel matrix with or without vehicles were applied before the flaps were repositioned and sutured. After 8 weeks, the healing was evaluated in the light microscope, and morphometric comparisons were made. Application of homogenized enamel matrix or an acidic extract of the matrix containing the hydrophobic, low molecular weight proteins, amelogenins, resulted in an almost complete regeneration of acellular cementum, firmly attached to the dentin and with collagenous fibers extending over to newly formed alveolar bone. After application of fractions obtained by neutral EDTA extraction containing the acidic, high molecular weight proteins of the enamel matrix, very little new cementum was formed and hardly any new bone. The results of the controls in which no test substance was applied before the repositioning of the flap, were very similar to those obtained with the EDTA extracted material. Propylene glycol alginate (PGA), hydroxyethyl cellulose and dextran were tried as vehicles for the enamel matrix preparations. Only PGA in combination with the amelogenin fraction resulted in significant regeneration of the periodontal tissues.

Cementum‐like tissue deposition on the resorbed enamel surface of human deciduous teeth prior to shedding

“…It was demonstrated that these proteins participate in the formation of acellular cementum but not in that of cellular cementum (Slavkin et al, 1988;Hammarström et al, 1997). In the present study, however, the collagen fibrils of the reparative cementum-like tissue on the resorbed enamel surface represented a fiber population intrinsic to cementum, and this tissue usually had Fig.…”

Amelogenin expression in long bone and cartilage cells and in bone marrow progenitor cells

“…Periodontal tissues regeneration could often be achieved by application of enamel matrix proteins (EMP) (Hammarstrom et al, 1997), a heterogeneous mixture of In-situ hybridization (ISH) analysis on the epiphyseal plate, using rat amelogenin probe. Amelogenin mRNA expression (blue) was detected in specific cells of epiphyseal growth plate.…”

Immunohistochemical analysis of periodontal reattachment on denuded root dentin after periodontal surgery

“…Nine sections of the cervical side planing accelerates the first step of periodontal reattachment, as surgically exposed collagen fibers are expected to intermingle with newly generated fibrous tissue (1,5,23). Further, recent clinical studies have reported that enamel matrix derivative (EMD) accelerates the regeneration of cementum, which is structurally similar to the original cementum (3,15). This study was designed to evaluate the effects of different kinds of root surface treatments on the healing of periodontal tissues, especially on the adhesion of regenerated cementum and dentin, by analyzing several new indices combined with BSP and OPN immunohistochemistry.…”