EMD Enhances Fibroblast Colonization And Morphologic Changes On Root Surface

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Background: EmdogainŽ, a formulation of enamel matrix derivative (EMD), is used clinically for periodontal regeneration to stimulate periodontal ligament (PDL), cementum, and bone formation. Its effect on gingival fibroblasts colonization and/or differentiation has not been studied before. Objectives: This study evaluated EMD efficacy on the colonization and morphological changes of human gingival fibroblasts (HGFs) on healthy etched root surfaces for potential use in periodontal tissue engineering. Methods: Extracted healthy human teeth were scaled and root planed. Roots were cut into longitudinal and transversal sections. Root samples were then fixed in 12 well plates and etched with 24% EDTA. Root samples in the test group were coated with EMD. HGFs were seeded on the surface of etched roots with or without EMD coating for 15 days. Scanning electron microscopy (SEM) was used to evaluate cellular attachment and morphology of HGFs on root surfaces with or without EMD coating. HGFs were plated on EMD-coated and uncoated wells (4 wells/treatment) for 15 days and evaluated for alkaline phosphatase activity (ALP). Results: 1. SEM analysis revealed the following: [a] HGF adhered readily on all etched root surfaces with or without EMD coatings. [b] Cells grown on root EMD-treated surfaces presented a change in cellular morphology compared to the controls. Those cells exhibited a round shape with discrete cytoplasmic extensions at periphery with EMD coating covering the cell surface (Figure-1). 2. ALP activity was significantly stimulated by EMD treatment compared to the control (paired t-test, P<0.005). (Figure-2) Conclusion: The results of this study indicates that HGFs in the presence of EMD exhibit morphological changes that make them more similar to osteoblasts or cementoblasts than to fibroblasts. In addition, the significant increase in ALP activity by EMD suggests that EMD might have enhanced cellular differentiation of HGFs that could substitute PDL fibroblasts in periodontal tissue engineering.