Biological mediators and periodontal regeneration: a review of enamel matrix proteins at the cellular and molecular levels.
BACKGROUND
Despite a large body of clinical and histological data demonstrating beneficial effects of enamel matrix proteins (EMPs) for regenerative periodontal therapy, it is less clear how the available biological data can explain the mechanisms underlying the supportive effects of EMPs.


OBJECTIVE
To analyse all available biological data of EMPs at the cellular and molecular levels that are relevant in the context of periodontal wound healing and tissue formation.


METHODS
A stringent systematic approach was applied using the key words "enamel matrix proteins" OR "enamel matrix derivative" OR "emdogain" OR "amelogenin". The literature search was performed separately for epithelial cells, gingival fibroblasts, periodontal ligament cells, cementoblasts, osteogenic/chondrogenic/bone marrow cells, wound healing, and bacteria.


RESULTS
A total of 103 papers met the inclusion criteria. EMPs affect many different cell types. Overall, the available data show that EMPs have effects on: (1) cell attachment, spreading, and chemotaxis; (2) cell proliferation and survival; (3) expression of transcription factors; (4) expression of growth factors, cytokines, extracellular matrix constituents, and other macromolecules; and (5) expression of molecules involved in the regulation of bone remodelling.


CONCLUSIONS
All together, the data analysis provides strong evidence for EMPs to support wound healing and new periodontal tissue formation.
Bosshardt
Dieter D
DD
University of Berne, School of Dental Medicine, Department of Periodontology, Berne, Switzerland. dieter.bosshardt@zmk.unibe.ch
D001685:Biological Factors / Q000627:therapeutic use; D019902:Chondrocytes / Q000187:drug effects; D003739:Dental Cementum / Q000187:drug effects; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D004847:Epithelial Cells / Q000187:drug effects; D005347:Fibroblasts / Q000187:drug effects; D005881:Gingiva / Q000187:drug effects; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D010006:Osteoblasts / Q000187:drug effects; D010510:Periodontal Diseases / Q000601:surgery*; D010513:Periodontal Ligament / Q000187:drug effects
D001685:Biological Factors; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins