REVIEW article
Front. Dent. Med.
Sec. Periodontics
Volume 6 - 2025 | doi: 10.3389/fdmed.2025.1611402
Research progress of enamel matrix derivative on periodontal tissue regeneration: a narrative review
Provisionally accepted
- 1Department of Stomatology, Wenling Maternal and Child Health Care Hospital, Wenling, China
- 2State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases，Sichuan University, Chengdu, China
- 3Department of Neonatology and NICU, Wenling Maternal and Child Health Care Hospital, Wenling, China
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Extensive research has demonstrated that enamel matrix derivative (EMD) facilitates periodontal tissue regeneration, enabling the genuine regeneration of cementum, periodontal ligament, and alveolar bone. Its clinical formulation, Emdogain, is currently employed in the treatment of alveolar bone defects resulting from periodontitis, as well as in dental implantation and tooth replantation procedures. This review aims to synthesize recent findings on the application of EMD in periodontology, with a particular emphasis on its efficacy in addressing alveolar bone defects, peri-implantitis, and related conditions. Furthermore, this review examines the influence of EMD on the proliferation and differentiation of periodontal ligament stem cells, bone marrow stem cells, osteoblasts, and fibroblasts. It also assesses the secretion of various growth factors, including transforming growth factor-β1 (TGF-β1), bone morphogenetic protein-2 (BMP-2), collagen type 1 (COL-1), runt-related transcription factor 2 (RUNX2), and osteocalcin (OCN). Additionally, the review seeks to identify the optimal concentration for EMD application. Collectively, the studies reviewed herein suggest that EMD significantly enhances the proliferation and differentiation of relevant cellular components. The optimal concentration of EMD varies by environment and cell type.In minimally invasive periodontal surgery for intrabony defects, EMD enhances periodontal health, gingival recession coverage, and bone filling. It also benefits openflap debridement and non-surgical treatments. However, EMD offers no extra benefits for Class II furcation defects. In treating gingival recession with coronally advanced flap (CAF) and subepithelial connective tissue graft (SCTG), EMD significantly boosts root coverage, but not with the modified coronally advanced tunnel (MCAT) technique or the semilunar coronally advanced flap. EMD's anti-inflammatory and immunomodulatory properties reduce inflammation around implants. This review indicates that EMD shows potential for periodontal regeneration, but more randomized clinical trials are necessary to assess its effectiveness.
Keywords: Enamel matrix derivative, periodontal regeneration, Periodontitis, Dental Implantation, Tooth Replantation, Wnt/β-catenin signaling pathway
Received: 15 Apr 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Xiang, Zhang and Tao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Enfu Tao, Department of Neonatology and NICU, Wenling Maternal and Child Health Care Hospital, Wenling, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.