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Enamel matrix derivative

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Enamel matrix derivative (EMD) or enamel matrix proteins are proteins that have been found to play a key role in the development of tooth-supporting tissues. For clinical use in regenerative periodontal procedures, they are derived from developing porcine teeth[1] based on the high degree of homology between porcine and human enamel proteins.[2] It was introduced in 1996 and marketed as Emdogain by the Swedish company Biora, until Straumann acquired Biora in 2003 and began producing it under the Straumann name.

Mechanism of action

It is still unclear how EMD participates in the regeneration process.[3] It has been suggested that EMD, and certainly the amelogenin component of it, works to induce formation of acellular cementum and contribute to the regeneration of the periodontal tissues by stimulating proliferation of mesenchymal cells, inhibiting proliferation of epithelial cells and promoting the secretion of certain growth factors, such as TGF-β1, by periodontal ligament cells.

Application of EMD results in a more efficient healing of the periodontal hard tissues with reference to the vertical and horizontal defect resolution in conjunction with open flap debridement than open flap debridement alone.[4]

References

  1. ^ Hammarström, L; Enamel matrix, cementum development and regeneration. J Clin Periodontol 1997 Sep;24(9 Pt 2):658-68.
  2. ^ Brooks, SJ, et al. Biochemistry and molecular biology of amelogenin proteins of developing dental enamel. Arch Oral Bio 1995;40:1-14
  3. ^ Boyan, BD, et al. Porcine fetal enamel matrix derivative enhances bone formation induced by demineralized freeze dried bone allograft in vivo. J Perio 2000;71:1278-1286
  4. ^ Chitsazi, MT; Farahani, RMZ: Efficacy of open flap debridement with and without enamel matrix derivatives in the treatment of mandibular degree II furcation involvement, Clin Oral Invest July 11, 2007