Tal Maymon-Gil, Evgeny Weinberg, Carlos Nemcovsky, Miron Weinreb
Background: Enamel Matrix Proteins (EMPs) play a role in enamel formation and the development of the periodontium. Sporadic clinical observations of periodontal regeneration treatments with Enamel Matrix Derivative (EMD), a commercial formulation of EMPs, suggest it also promotes post-surgical healing of soft tissues. In vitro studies showed that EMD stimulates various cellular effects, which could potentially enhance wound healing. This study examined the in-vivo effects of EMD on healing of an oral mucosa surgical wound in rats.
Methods: A bilateral oral mucosa wound was created via a crestal incision at the anterior edentulous maxilla of Sprague-Dawley rats. Full thickness flaps were raised and following suturing, EMD was injected underneath the soft tissues on one side while the EMD vehicle was injected in the contralateral side. Animals were sacrificed after 5 or 9 days and the wound area was subjected to histological and immunohistochemical analysis of epithelial gap, number of macrophages, blood vessels, proliferating cells and collagen content in the connective tissue. Gene expression analysis was also conducted 2 days after surgery.
Results: EMD had no effect on epithelial gap of the wound. On both days 5 and 9 EMD treatment increased significantly the number of blood vessels and the collagen content. EMD also enhanced (by 20-40%) the expression of transforming growth factor (TGF) β1 and TGFβ2, vascular endothelial growth factor (vEGF), interleukin-1β (IL-1β), matrix metalloproteinase-1 (MMP-1), Versican and Fibronectin.
Conclusions: EMD improves oral mucosa incisional wound healing by promoting formation of blood vessels and collagen fibers in the connective tissue.