Abstract
Periodontal regeneration is a complex goal, which is commonly pursued with a combination of surgical techniques, biomaterials, and bioactive compounds. One such compound is enamel matrix derivative (EMD), a medical substance that is extracted from porcine tooth germs and which contains several protein fractions with BMP- and TGF-β-like action. Activation of TGF-β signaling is required for EMD activity on cells and tissues, and a growing body of evidence indicates that EMD largely relies on this pathway. As low frequency electromagnetic fields (EMFs) have long been investigated as a tool to promote bone formation and osteoblast activity, and because recent studies have reported that the effects of EMFs on cells require primary cilia, by modulating the presence of membrane-bound receptors (e.g., for BMP) or signal mediators, it can be hypothesized that the application of EMFs may increase cell sensitivity to EMD: as TGFBR receptors have also been identified on primary cilia, EMFs could make cells more responsive to EMD by inducing the display of a higher number of receptors on the cellular membrane.
Highlights
The regeneration of compromised periodontal tissues is a complex endeavor, and has been tackled from different angles over the years, including through the use of surgery, membranes, and growth factors [1]
The present paper focuses on the adjunctive use of low frequency electromagnetic fields (EMFs), which can act synergically with enamel matrix derivative (EMD) to improve tissue regeneration
The first evidence that cilia are required for EMF stimulation dates back to the report by Yan et al [103], who showed that 0.6 mT, 50 Hz pulsed EMFs increased the proliferation, mineralization, and expression of differentiation markers in primary rat calvaria cells, but these effects were not observed when primary cilia were disrupted by siRNA inhibition of the intraflagellar transport protein 88 (IFT88), a molecule that controls the movement of cargo along the axoneme [104]
Summary
The regeneration of compromised periodontal tissues is a complex endeavor, and has been tackled from different angles over the years, including through the use of surgery, membranes, and growth factors [1]. The periodontal ligament does not spontaneously regenerate following periodontitis or trauma, and surgery alone has shown inconsistent results. Enamel matrix derivative (EMD), which is an enamel protein matrix obtained from porcine tooth germs, has yielded promising results, promoting the regeneration of both bone and ligament. Considering the still only partially predictable results of periodontal regeneration, solutions that increase its clinical success are sorely needed. The present paper focuses on the adjunctive use of low frequency electromagnetic fields (EMFs), which can act synergically with EMD to improve tissue regeneration
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