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.

In dentistry, enamel matrix derivative (EMD) is an extract of porcine fetal tooth material used to biomimetically stimulate the soft and hard tissues surrounding teeth to regrow (in a process known as regeneration) following tissue destruction.

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