title: Enamel matrix protein adsorption to root surfaces in the presence or absence of human blood.
abstract: BACKGROUND
  The clinical use of an enamel matrix derivative (EMD) has been shown to promote formation of new cementum, periodontal ligament (PDL), and bone and to significantly enhance the clinical outcomes after regenerative periodontal surgery. It is currently unknown to what extent the bleeding during periodontal surgery may compete with EMD adsorption to root surfaces. The aim of this study is to evaluate the effect of blood interactions on EMD adsorption to root surfaces mimicking various clinical settings and to test their ability to influence human PDL cell attachment and proliferation.
  
  
  METHODS
  Teeth extracted for orthodontic reasons were subjected to ex vivo scaling and root planing and treated with 24% EDTA, EMD, and/or human blood in six clinically related settings to determine the ability of EMD to adsorb to root surfaces. Surfaces were analyzed for protein adsorption via scanning electron microscopy and immunohistochemical staining with an anti-EMD antibody. Primary human PDL cells were seeded on root surfaces and quantified for cell attachment and cell proliferation.
  
  
  RESULTS
  Plasma proteins from blood samples altered the ability of EMD to adsorb to root surfaces on human teeth. Samples coated with EMD lacking blood demonstrated a consistent even layer of EMD adsorption to the root surface. In vitro experiments with PDL cells demonstrated improved cell attachment and proliferation in all samples coated with EMD (irrespective of EDTA) when compared to samples containing human blood.
  
  
  CONCLUSIONS
  Based on these findings, it is advised to minimize blood interactions during periodontal surgeries to allow better adsorption of EMD to root surfaces.
authors: Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Richard J
authors: RJ
authors: Miron
authors: Dieter D
authors: DD
authors: Bosshardt
authors: Oliver
authors: O
authors: Laugisch
authors: Christos
authors: C
authors: Katsaros
authors: Daniel
authors: D
authors: Buser
authors: Anton
authors: A
authors: Sculean
mesh_terms: D000327:Adsorption; D001769:Blood; D001798:Blood Proteins / Q000494:pharmacology; D002448:Cell Adhesion / Q000502:physiology; D002452:Cell Count; D018929:Cell Culture Techniques; D049109:Cell Proliferation; D002614:Chelating Agents / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000493:pharmacokinetics*; D003739:Dental Cementum / Q000378:metabolism / Q000648:ultrastructure; D003746:Dental Enamel Proteins / Q000493:pharmacokinetics*; D012534:Dental Scaling; D004492:Edetic Acid / Q000627:therapeutic use; D004912:Erythrocytes / Q000166:cytology; D005337:Fibrin / Q000493:pharmacokinetics; D005452:Fluoresceins; D005456:Fluorescent Dyes; D006801:Humans; D007150:Immunohistochemistry; D008855:Microscopy, Electron, Scanning; D010513:Periodontal Ligament / Q000166:cytology; D010590:Phalloidine / Q000031:analogs & derivatives; D016745:Root Planing; D014092:Tooth Root / Q000187:drug effects / Q000378:metabolism* / Q000648:ultrastructure
chemical_list: D001798:Blood Proteins; D002614:Chelating Agents; D020099:Coated Materials, Biocompatible; D003746:Dental Enamel Proteins; D005452:Fluoresceins; D005456:Fluorescent Dyes; C109069:enamel matrix proteins; C037191:fluorescein isothiocyanate-phalloidin; D010590:Phalloidine; D005337:Fibrin; D004492:Edetic Acid