title: Effects of enamel matrix derivative on vascular endothelial growth factor expression and microvessel density in gingival tissues of periodontal pocket: a comparative study.
abstract: BACKGROUND
  Vascular endothelial growth factor (VEGF) stimulates proliferation and migration of endothelial cells, and correlates with inflammatory resolution and periodontal tissue healing. Enamel matrix derivative (EMD) seems to stimulate soft tissue healing. Our aim was to assess if topical EMD application in an instrumented periodontal pocket could affect angiogenesis at the gingival level.
  
  
  METHODS
  A total of 56 periodontal sites in 28 patients were treated with a single session of comprehensive scaling and root planing under local anesthesia after recording the clinical attachment level (CAL). EMD gel in the test site or only the vehicle propylene glycol alginate in aqueous solution in the control site of the same mouth was applied onto the root surfaces and into the pocket and left in place for 3 minutes. After 48 hours, gingival biopsies were collected for histologic and immunohistochemical analysis for VEGF and CD34 (for microvessel density [MVD] count) antibodies. Statistical comparisons were performed by analysis of variance test.
  
  
  RESULTS
  Endothelial VEGF expression and MVD were statistically different in the test site compared to the control site. VEGF expression and MVD of the control site were not correlated with CAL, whereas the test site showed high correlations among CAL and endothelial VEGF or MVD.
  
  
  CONCLUSIONS
  EMD induces proliferation and viability and angiogenesis of human microvascular cells. Recent clinical and histologic studies found EMD to be useful as an adjunct to scaling and root planing in single-rooted teeth. Our findings may help to understand the mechanisms involved in soft tissue healing, through the ability of EMD to increase angiogenesis at periodontal pockets.
authors.affiliation: Department of Clinical Specialistic and Dental Sciences - Periodontology, Polytechnic University of Marche, Torrette, Ancona, Italy. simonedomenico@yahoo.it
authors.forename: Simone Domenico
authors.initials: SD
authors.lastname: Aspriello
authors.forename: Antonio
authors.initials: A
authors.lastname: Zizzi
authors.forename: Liana
authors.initials: L
authors.lastname: Spazzafumo
authors.forename: Corrado
authors.initials: C
authors.lastname: Rubini
authors.forename: Teresa
authors.initials: T
authors.lastname: Lorenzi
authors.forename: Daniela
authors.initials: D
authors.lastname: Marzioni
authors.forename: Pedro
authors.initials: P
authors.lastname: Bullon
authors.forename: Matteo
authors.initials: M
authors.lastname: Piemontese
mesh_terms: D000287:Administration, Topical; D043925:Angiogenesis Inducing Agents / Q000008:administration & dosage*; D055113:Chronic Periodontitis / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D003746:Dental Enamel Proteins / Q000008:administration & dosage*; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005881:Gingiva / Q000098:blood supply* / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008297:Male; D055806:Microvessels / Q000187:drug effects; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000187:drug effects* / Q000502:physiology; D017622:Periodontal Attachment Loss / Q000150:complications / Q000628:therapy; D010514:Periodontal Pocket / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects / Q000378:metabolism
chemical_list: D043925:Angiogenesis Inducing Agents; D003746:Dental Enamel Proteins; D042461:Vascular Endothelial Growth Factor A; C109069:enamel matrix proteins