Effects of Enamel Matrix Derivative on Vascular Endothelial Growth Factor Expression and Microvessel Density in Gingival Tissues of Periodontal Pocket: A Comparative Study

Background: Vascular endothelial growth factor (VEGF) stimulates proliferation and migration of endothelial cells, and correlates with inflammatory resolution and periodontal tissue healing. Enamel matrix derivative (EMD) seems to stimulate soft tissue healing. Our aim was to assess if topical EMD a...

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Bibliographic Details
Published in:Journal of periodontology (1970) 2011-04, Vol.82 (4), p.606-612
Main Authors: Aspriello, Simone Domenico, Zizzi, Antonio, Spazzafumo, Liana, Rubini, Corrado, Lorenzi, Teresa, Marzioni, Daniela, Bullon, Pedro, Piemontese, Matteo
Format: Article
Language:English
Subjects:
Administration, Topical
Angiogenesis Inducing Agents - administration & dosage
Biological and medical sciences
CD34 antigen
chronic periodontitis
Chronic Periodontitis - complications
Chronic Periodontitis - metabolism
Chronic Periodontitis - therapy
Dental Enamel Proteins - administration & dosage
Dental Scaling
Dentistry
Double-Blind Method
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Female
Gingiva - blood supply
Gingiva - drug effects
Gingiva - metabolism
Humans
immunohistochemistry
Male
Medical sciences
Microvessels - drug effects
Middle Aged
Neovascularization, Physiologic - drug effects
Neovascularization, Physiologic - physiology
Non tumoral diseases
Otorhinolaryngology. Stomatology
Periodontal Attachment Loss - complications
Periodontal Attachment Loss - therapy
periodontal pocket
Periodontal Pocket - complications
Periodontal Pocket - metabolism
Periodontal Pocket - therapy
Severity of Illness Index
Statistics, Nonparametric
tissues
vascular endothelial growth factor
Vascular Endothelial Growth Factor A - drug effects
Vascular Endothelial Growth Factor A - metabolism
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Summary:Background: Vascular endothelial growth factor (VEGF) stimulates proliferation and migration of endothelial cells, and correlates with inflammatory resolution and periodontal tissue healing. Enamel matrix derivative (EMD) seems to stimulate soft tissue healing. Our aim was to assess if topical EMD application in an instrumented periodontal pocket could affect angiogenesis at the gingival level. Methods: A total of 56 periodontal sites in 28 patients were treated with a single session of comprehensive scaling and root planing under local anesthesia after recording the clinical attachment level (CAL). EMD gel in the test site or only the vehicle propylene glycol alginate in aqueous solution in the control site of the same mouth was applied onto the root surfaces and into the pocket and left in place for 3 minutes. After 48 hours, gingival biopsies were collected for histologic and immunohistochemical analysis for VEGF and CD34 (for microvessel density [MVD] count) antibodies. Statistical comparisons were performed by analysis of variance test. Results: Endothelial VEGF expression and MVD were statistically different in the test site compared to the control site. VEGF expression and MVD of the control site were not correlated with CAL, whereas the test site showed high correlations among CAL and endothelial VEGF or MVD. Conclusions: EMD induces proliferation and viability and angiogenesis of human microvascular cells. Recent clinical and histologic studies found EMD to be useful as an adjunct to scaling and root planing in single‐rooted teeth. Our findings may help to understand the mechanisms involved in soft tissue healing, through the ability of EMD to increase angiogenesis at periodontal pockets.
ISSN:0022-3492
1943-3670
DOI:10.1902/jop.2010.100180