Discovery and Role of Enamel Matrix Proteins (EMPs) - Human teeth consist of enamel, dentin, and cementum. - Enamel is the outer layer of the crown, dentin forms the majority of the tooth structure, and cementum covers the root. - A thin layer of enamel was discovered between dentin and cementum on adult human teeth. - EMPs laid down by Hertwigs epithelial root sheath serve as precursors to acellular cementum during cementogenesis. - Acellular cementum signals the development of periodontal ligament (PDL) fibers and new alveolar bone, leading to the formation of the periodontium.

Enamel Matrix Derivative (EMD) - EMD was introduced in 1996. - EMD is a commercially prepared and purified extract of enamel matrix proteins. - EMD is primarily composed of amelogenin. - EMD promotes PDL fibroblast proliferation and growth. - EMD is produced from fetal pigs due to the high degree of homology between porcine and human enamel proteins.

Mechanism of Action of EMD - The exact mechanism of how EMD participates in the regeneration process is still unclear. - EMD promotes periodontal ligament fibroblast proliferation and growth. - EMD inhibits epithelial cell proliferation and growth. - EMD stimulates the release of autocrine growth factors from periodontal ligament undifferentiated mesenchymal cells. - EMD stimulates osteoprotegerin, triggering osteoblasts and inhibiting osteoclastogenesis and osteoclastic function.

References - Hammarström, L., Enamel matrix, cementum development and regeneration, J Clin Perio 1997;24:658-68. - Beertsen W, et al., The periodontal ligament: A unique, multifunctional, connective tissue, Perio 2000 1997;13:20-40. - Sculean A, et al., The application of an enamel matrix protein derivative (Emdogain) in regenerative periodontal therapy: A review, Med Princ Pract 2007;16:167-80. - Brooks, SJ, et al., Biochemistry and molecular biology of amelogenin proteins of developing dental enamel, Arch Oral Bio 1995;40:1-14. - Boyan, BD, et al., Porcine fetal enamel matrix derivative enhances bone formation induced by demineralised freeze dried bone allograft in vivo, J Perio 2000;71:1278–1286.

Additional Information about EMD - Enamel matrix derivative is marketed as Emdogain by the Swedish company Biora. - Straumann acquired Biora in 2003 and began producing Emdogain under the Straumann name. - EMD promotes periodontal tissue regeneration by preventing the faster-growing epithelium from occupying the space once occupied by the periodontal ligament and alveolar bone. - EMD has been shown to have positive effects on bone growth and the development of the periodontium. - Enamel matrix derivative is used in regenerative periodontal therapy.