Enamel matrix derivative
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In dentistry, enamel matrix derivative (EMD) is an extract of porcine fetal tooth material used to stimulate the soft and hard tissues surrounding teeth to regrow following tissue destruction in a process known as regeneration.
Discovery of EMP's role in cementogenesis
There are three hard tissues that comprise human teeth: enamel, dentin and cementum. The majority of the tooth structure is formed from dentin, and the enamel serves as the superficial layer of the crown while the cementum serves to cover the root. In 1997, however, it was discovered that a very thin layer of enamel actually exists between the dentin and cementum on adult human teeth. This led researchers to conclude that enamel matrix proteins (or EMPs) laid down by Hertwig’s epithelial root sheath serve as precursors to acellular cementum during its formation, known as cementogenesis.[1] The presence of acellular cementum acts to signal the development of periodontal ligament fibers, followed by new alveolar bone, thus leading to the formation of the tissues of the periodontium.[2] and
based on the high degree of homology between porcine and human enamel proteins.[3] 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.[4] 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.
References
- ^ Hammarström, L. Enamel matrix, cementum development and regeneration. J Clin Perio 1997;24:658-68.
- ^ Beertsen W, McCulloch CAG, Sodek J. The periodontal ligament: A unique, multifunctional, connective tissue. Perio 2000 1997;13:20-40.
- ^ Brooks, SJ, et al. Biochemistry and molecular biology of amelogenin proteins of developing dental enamel. Arch Oral Bio 1995;40:1-14
- ^ 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
External links
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