title: Twenty years of enamel matrix derivative: the past, the present and the future.
abstract: On June 5th, 2015 at Europerio 8, a group of leading experts were gathered to discuss what has now been 20 years of documented evidence supporting the clinical use of enamel matrix derivative (EMD). Original experiments led by Lars Hammarström demonstrated that enamel matrix proteins could serve as key regenerative proteins capable of promoting periodontal regeneration including new cementum, with functionally oriented inserting new periodontal ligament fibres, and new alveolar bone formation. This pioneering work and vision by Lars Hammarström has paved the way to an enormous amount of publications related to its biological basis and clinical use. Twenty years later, it is clear that all these studies have greatly contributed to our understanding of how biologics can act as mediators for periodontal regeneration and have provided additional clinical means to support tissue regeneration of the periodontium.
  
  
  
  This review article aims to: (1) provide the biological background necessary to understand the rational for the use of EMD for periodontal regeneration, (2) present animal and human histological evidence of periodontal regeneration following EMD application, (3) provide clinically relevant indications for the use of EMD and (4) discuss future avenues of research including key early findings leading to the development of Osteogain, a new carrier system for EMD specifically developed with better protein adsorption to bone grafting materials.
authors.affiliation: Department of Periodontology, Nova Southeastern University, Fort Lauderdale, Florida, USA.|Department of Periodontology, University of Bern, Bern, Switzerland.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Miron
authors.affiliation: Department of Periodontology, University of Bern, Bern, Switzerland.
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
authors.affiliation: Department of Periodontics, Dental School, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Cochran
authors.affiliation: Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, NY, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Froum
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zucchelli
authors.affiliation: Department of Periodontology and Dental Implantology, Dental School, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Carlos
authors.initials: C
authors.lastname: Nemcovsky
authors.affiliation: Department of Periodontology, Queen Marry University of London, London, UK.
authors.forename: Nikos
authors.initials: N
authors.lastname: Donos
authors.affiliation: Department of Biomaterials, Faculty of Dentistry, University of Oslo, Oslo, Norway.
authors.forename: Staale Petter
authors.initials: SP
authors.lastname: Lyngstadaas
authors.affiliation: Section of Experimental Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany.
authors.forename: James
authors.initials: J
authors.lastname: Deschner
authors.affiliation: New York University, College of Dentistry, New York, NY, USA.
authors.forename: Michel
authors.initials: M
authors.lastname: Dard
authors.affiliation: Department of Periodontology, Malmö University, Malmö, Sweden.
authors.forename: Andreas
authors.identifier: 0000-0001-8161-3754
authors.initials: A
authors.lastname: Stavropoulos
authors.affiliation: Department of Oral Implantology, Wuhan University, Wuhan, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Periodotology, Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trombelli
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Center, Mainz, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kasaj
authors.affiliation: Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Shirakata
authors.affiliation: Accademia Toscana di Ricerca Odontostomatologica, Firenze, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cortellini
authors.affiliation: European Research Group on Periodontology (ERGOPerio), Genova, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tonetti
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.|Foundation IRCCS Ca' Granda Polyclinic, Milan, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Rasperini
authors.affiliation: Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.
authors.forename: Søren
authors.initials: S
authors.lastname: Jepsen
authors.affiliation: Department of Periodontology, University of Bern, Bern, Switzerland.
authors.forename: Dieter D
authors.initials: DD
authors.lastname: Bosshardt
mesh_terms: D016301:Alveolar Bone Loss; D000818:Animals; D003739:Dental Cementum; D003746:Dental Enamel Proteins; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D010513:Periodontal Ligament; D014945:Wound Healing
chemical_list: D003746:Dental Enamel Proteins
keywords: EMD; Emdogain; Osteogain; enamel matrix derivative; enamel matrix proteins; intrabony defect; periodontal regeneration