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Kumari K, Nath B, Kumar A, Chhabada AK, Kumari R, Prakash G. Comparison of Root Coverage by the Subepithelial Connective Tissue Graft With and Without Root Biomodification: A Comprehensive Clinical Study. Cureus 2023; 15:e44758. [PMID: 37809257 PMCID: PMC10556792 DOI: 10.7759/cureus.44758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Being an autologous graft, a subepithelial connective tissue (SECT) graft shows more predictable root coverage better than other techniques. Hence, it is most likely to be widely used for recession treatment. During root planing, a smear layer forms on the root surface that cannot be removed by water or saline rinsing. To remove this smear layer, root biomodification agents are widely used. The present study was conducted to assess the efficacy of an SECT graft for root coverage with and without root biomodification. METHODS This study included 20 patients with no gender predilection, with an age range of 24-36 years and a mean age of 27.6 ± 4.24 years. The chosen range facilitated the acquisition of data in a relatively homogeneous population, minimizing the confounding effects of factors such as aging-related tissue changes or early-onset periodontal issues. All 40 sites were treated with the SECT and coronally advanced flap. Root conditioning in controls was done with distilled saline and tested using 24% ethylenediaminetetraacetic acid (EDTA) gel (Maquira; STM Meditech, Kerala). At baseline and at one, three, and six months postoperatively, pocket depth (PD) and clinical attachment levels (CALs) were assessed at four sites using a UNC-15 probe, and from the gingival margin to the cementoenamel junction (CEJ), the vertical recession was assessed. RESULTS For the buccal surface, CALs were reduced significantly (p < 0.001). Following root conditioning with 24% EDTA, no difference was seen in the CAL in the control and test group either buccally or interproximally with a p-value of greater than 0.05. For PD, following a SECT graft or root conditioning, no significant change was observed in the buccal or interproximal region (p > 0.05). The vertical recession was significantly reduced with a p-value of less than 0.001 and depth coverage of 97.5%. The difference between the two groups was statistically non-significant (p > 0.05). The root surface coverage decreased significantly from 16.6 ± 2.8 to 0.45 ± 0.4 from baseline to six months, which was statistically significant (p < 0.001). This intergroup difference was non-statistical (p > 0.05). CONCLUSION The present study concludes that the use of an SECT graft in root coverage can significantly improve the CAL, root surface area, and vertical recession both with and without root biomodification. We conclude that there is a significant decrease in the probing depth following SECT grafting and with root biomodification.
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Affiliation(s)
- Khushboo Kumari
- Department of Oral Pathology, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Barsha Nath
- Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Amrit Kumar
- Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | | | - Rosy Kumari
- Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Gyan Prakash
- Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, IND
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Panahipour L, Sordi MB, Kargarpour Z, Gruber R. TGF-β Signalling Mediates the Anti-Inflammatory Activity of Enamel Matrix Derivative In Vitro. Int J Mol Sci 2022; 23:9778. [PMID: 36077174 PMCID: PMC9456059 DOI: 10.3390/ijms23179778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
Enamel matrix derivative (EMD) prepared from extracted porcine fetal tooth material can support the regrow of periodontal tissues. Previous findings suggest that EMD has anti-inflammatory properties and TGF-β activity in vitro. However, the anti-inflammatory activity of EMD is mediated via TGF-β has not been considered. To this aim, we first established a bioassay to confirm the anti-inflammatory activity of EMD. The bioassay was based on the RAW 264.7 macrophage cell line and proven with primary macrophages where EMD significantly reduced the forced expression of IL-6. We then confirmed the presence of TGF-β1 in EMD by immunoassay and by provoking the Smad2/3 nuclear translocation in RAW 264.7 macrophages. Next, we took advantage of the TGF-β receptor type I kinase-inhibitor SB431542 to block the respective signalling pathway. SB431542 reversed the anti-inflammatory activity of EMD and TGF-β in a bioassay when IL-6 and CXCL2 expression was driven by the LPS stimulation of RAW 264.7 macrophages. This central observation was supported by showing that SB431542 reversed the anti-inflammatory activity of EMD using IL-1β and TNF-α-stimulated ST2 bone marrow stromal cells. Together, these findings implicate that the TGF-β activity mediates at least part of the anti-inflammatory activity of EMD in vitro.
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Affiliation(s)
- Layla Panahipour
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Mariane Beatriz Sordi
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Zahra Kargarpour
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
- Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, 1200 Vienna, Austria
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Enamel Matrix Derivative Decreases Pyroptosis-Related Genes in Macrophages. Int J Mol Sci 2022; 23:ijms23095078. [PMID: 35563469 PMCID: PMC9099857 DOI: 10.3390/ijms23095078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 01/06/2023] Open
Abstract
Background: Pyroptosis is a caspase-dependent catabolic process relevant to periodontal disorders for which inflammation is central to the pathophysiology of the disease. Although enamel matrix derivative (EMD) has been applied to support periodontal regeneration, its capacity to modulate the expression of pyroptosis-related genes remains unknown. Considering EMD has anti-inflammatory properties and pyroptosis is linked to the activation of the inflammasome in chronic periodontitis, the question arises whether EMD could reduce pyroptosis signalling. Methods: To answer this question, primary macrophages obtained from murine bone marrow and RAW 264.7 macrophages were primed with EMD before being challenged by lipopolysaccharide (LPS). Cells were then analysed for pyroptosis-signalling components by gene expression analyses, interleukin-1β (IL-1β) immunoassay, and the detection of caspase-1 (CAS1). The release of mitochondrial reactive oxygen species (ROS) was also detected. Results: We report here that EMD, like the inflammasome (NLRP3) and CAS1 specific inhibitors—MCC950 and Ac-YVAD-cmk, respectively—lowered the LPS-induced expression of NLRP3 in primary macrophages (EMD: p = 0.0232; MCC950: p = 0.0426; Ac-YVAD-cmk: p = 0.0317). EMD further reduced the LPS-induced expression of NLRP3 in RAW 264.7 cells (p = 0.0043). There was also a reduction in CAS1 and IL-1β in RAW 264.7 macrophages on the transcriptional level (p = 0.0598; p = 0.0283; respectively), in IL-1β protein release (p = 0.0313), and CAS1 activity. Consistently, EMD, like MCC950 and Ac-YVAD-cmk, diminished the ROS release in activated RAW 264.7 cells. In ST2 murine mesenchymal cells, EMD could not be tested because LPS, saliva, and IL-1β + TNF-α failed to provoke pyroptosis signalling. Conclusion: These findings suggest that EMD is capable of dampening the expression of pyroptosis-related genes in macrophages.
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Panahipour L, Moghaddam DM, Nasirzade J, Kargarpour Z, Gruber R. RNAseq of TGF-β receptor type I kinase-dependent genes in oral fibroblast exposed to milk. BMC Oral Health 2021; 21:581. [PMID: 34789212 PMCID: PMC8597240 DOI: 10.1186/s12903-021-01913-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Milk is a rich source of natural growth factors that may support oral tissue homeostasis and wound healing. We had shown earlier that blocking TGF-β receptor type I kinase with the inhibitor SB431542 abolished the expression of IL11 and other genes in human gingival fibroblasts exposed to the aqueous fraction of milk. Our aim was to identify the entire signature of TGF-β receptor type I kinase-dependent genes regulated by the aqueous fraction of human milk. Result RNAseq revealed 99 genes being strongly regulated by milk requiring activation of the SB431542-dependent TGF-β receptor type I kinase. Among the SB431542-dependent genes is IL11 but also cadherins, claudins, collagens, potassium channels, keratins, solute carrier family proteins, transcription factors, transmembrane proteins, tumor necrosis factor ligand superfamily members, and tetraspanin family members. When focusing on our candidate gene, we could identify D609 to suppress IL11 expression, independent of phospholipase C, sphinosine-1 phosphate synthesis, and Smad-3 phosphorylation and its nuclear translocation. In contrast, genistein and blocking phosphoinositide 3-kinases by wortmannin and LY294002 increased the milk-induced IL11 expression in gingival fibroblasts. Conclusion Taken together, our data revealed TGF-β receptor type I kinase signaling to cause major changes of the genetic signature of gingival fibroblasts exposed to aqueous fraction of human milk. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01913-5.
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Affiliation(s)
- Layla Panahipour
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | | | - Jila Nasirzade
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Zahra Kargarpour
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria. .,Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Austrian Cluster for Tissue Regeneration, Donaueschingenstraße 13, 1200, Vienna, Austria.
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Does enamel matrix derivative application improve clinical outcomes after semilunar flap surgery? A randomized clinical trial. Clin Oral Investig 2018; 23:879-887. [DOI: 10.1007/s00784-018-2506-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/30/2018] [Indexed: 02/01/2023]
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ARONI MAT, OLIVEIRA GJPLD, CHANGOLUISA G, CAMACHO FMT. Coverage of Miller class I and II gingival recessions treated with subepithelial connective tissue graft, acellular dermal matrix, and enamel matrix proteins. Pilot study. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.19515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective The aim of this study was to compare clinical findings obtained in the treatment of gingival recessions using subepithelial connective tissue graft (SECT), acellular dermal matrix (ADM), and enamel matrix proteins (EMP). Material and method Twelve patients with Miller class I and II recession in the canines or upper premolars were randomly divided into groups to receive treatments using SECT, ADM, or EMP. Clinical measurements were performed before and three months after surgical procedures. The data evaluated were as follows: percentage of root coverage, height and width of gingival recession, probe depth, clinical attachment level, and height and thickness of keratinized gingiva. The Kruskal-Wallis test complemented by Dunn’s test was used to perform the between-group, analysis and the Wilcoxon test was used to perform the within-groups analysis. The tests were applied at the 95% confidence level. Result The SECT and ADM groups had a higher percentage of root coverage and greater reduction in the height and width of gingival recessions compared to the EMP group (p<0.05). Conclusion The SECT and ADM are more effective in treating gingival recessions than EMP.
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Stähli A, Miron RJ, Bosshardt DD, Sculean A, Gruber R. Collagen Membranes Adsorb the Transforming Growth Factor-β Receptor I Kinase-Dependent Activity of Enamel Matrix Derivative. J Periodontol 2016; 87:583-90. [PMID: 26777762 DOI: 10.1902/jop.2016.150538] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Enamel matrix derivative (EMD) and collagen membranes (CMs) are simultaneously applied in regenerative periodontal surgery. The aim of this study is to evaluate the ability of two CMs and a collagen matrix to adsorb the activity intrinsic to EMD that provokes transforming growth factor (TGF)-β signaling in oral fibroblasts. METHODS Three commercially available collagen products were exposed to EMD or recombinant TGF-β1, followed by vigorous washing. Oral fibroblasts were either seeded directly onto collagen products or were incubated with the respective supernatant. Expression of TGF-β target genes interleukin (IL)-11 and proteoglycan 4 (PRG4) was evaluated by real time polymerase chain reaction. Proteomic analysis was used to study the fraction of EMD proteins binding to collagen. RESULTS EMD or TGF-β1 provoked a significant increase of IL-11 and PRG4 expression of oral fibroblasts when seeded onto collagen products and when incubated with the respective supernatant. Gene expression was blocked by the TGF-β receptor I kinase inhibitor SB431542. Amelogenin bound most abundantly to gelatin-coated culture dishes. However, incubation of palatal fibroblasts with recombinant amelogenin did not alter expression of IL-11 and PRG4. CONCLUSION These in vitro findings suggest that collagen products adsorb a TGF-β receptor I kinase-dependent activity of EMD and make it available for potential target cells.
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Affiliation(s)
- Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern
| | - Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern.,Department of Oral Biology, Medical University of Vienna, Vienna, Austria
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Bertl K, Pifl M, Hirtler L, Rendl B, Nürnberger S, Stavropoulos A, Ulm C. Relative Composition of Fibrous Connective and Fatty/Glandular Tissue in Connective Tissue Grafts Depends on the Harvesting Technique but not the Donor Site of the Hard Palate. J Periodontol 2015; 86:1331-9. [DOI: 10.1902/jop.2015.150346] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Kuramitsu-Fujimoto S, Ariyoshi W, Saito N, Okinaga T, Kamo M, Ishisaki A, Takata T, Yamaguchi K, Nishihara T. Novel biological activity of ameloblastin in enamel matrix derivative. J Appl Oral Sci 2015; 23:49-55. [PMID: 25760267 PMCID: PMC4349119 DOI: 10.1590/1678-775720140291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/27/2014] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Enamel matrix derivative (EMD) is used clinically to promote periodontal tissue regeneration. However, the effects of EMD on gingival epithelial cells during regeneration of periodontal tissues are unclear. In this in vitro study, we purified ameloblastin from EMD and investigated its biological effects on epithelial cells. MATERIAL AND METHODS Bioactive fractions were purified from EMD by reversed-phase high-performance liquid chromatography using hydrophobic support with a C18 column. The mouse gingival epithelial cell line GE-1 and human oral squamous cell carcinoma line SCC-25 were treated with purified EMD fraction, and cell survival was assessed with a WST-1 assay. To identify the proteins in bioactive fractions of EMD, we used proteome analysis with two-dimensional gel electrophoresis followed by identification with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. RESULTS Purified fractions from EMD suppressed proliferation of GE-1 and SCC-25. LC-MS/MS revealed that ameloblastin in EMD is the component responsible for inhibiting epithelial cell proliferation. The inhibitory effect of ameloblastin on the proliferation of GE-1 and SCC-25 was confirmed using recombinant protein. CONCLUSION The inhibitory effects of EMD on epithelial cell proliferation are caused by the biological activities of ameloblastin, which suggests that ameloblastin is involved in regulating epithelial downgrowth in periodontal tissues.
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Affiliation(s)
- Sachiko Kuramitsu-Fujimoto
- Division of Orofacial Functions and Orthodontics, Department of Growth Development of Functions, Kyushu Dental University, Fukuoka, Japan
| | - Wataru Ariyoshi
- Division of Infections and Molecular Biology, Department of Health Promotion, Kyushu Dental University, Fukuoka, Japan
| | - Noriko Saito
- Division of Pulp Biology, Operative Dentistry and Endodontics, Department of Cariology and Periodontology, Kyushu Dental University, Fukuoka, Japan
| | - Toshinori Okinaga
- Division of Infections and Molecular Biology, Department of Health Promotion, Kyushu Dental University, Fukuoka, Japan
| | - Masaharu Kamo
- Division of Cellular Biosignal Sciences, Department of Biochemistry, Iwate Medical University, Iwate, Japan
| | - Akira Ishisaki
- Division of Cellular Biosignal Sciences, Department of Biochemistry, Iwate Medical University, Iwate, Japan
| | - Takashi Takata
- Department of Oral and Maxillofacial Pathobiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yamaguchi
- Division of Orofacial Functions and Orthodontics, Department of Growth Development of Functions, Kyushu Dental University, Fukuoka, Japan
| | - Tatsuji Nishihara
- Division of Infections and Molecular Biology, Department of Health Promotion, Kyushu Dental University, Fukuoka, Japan
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Stähli A, Bosshardt D, Sculean A, Gruber R. Emdogain-regulated gene expression in palatal fibroblasts requires TGF-βRI kinase signaling. PLoS One 2014; 9:e105672. [PMID: 25197981 PMCID: PMC4157743 DOI: 10.1371/journal.pone.0105672] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/25/2014] [Indexed: 12/11/2022] Open
Abstract
Genome-wide microarrays have suggested that Emdogain regulates TGF-β target genes in gingival and palatal fibroblasts. However, definitive support for this contention and the extent to which TGF-β signaling contributes to the effects of Emdogain has remained elusive. We therefore studied the role of the TGF-β receptor I (TGF-βRI) kinase to mediate the effect of Emdogain on palatal fibroblasts. Palatal fibroblasts were exposed to Emdogain with and without the inhibitor for TGF-βRI kinase, SB431542. Emdogain caused 39 coding genes to be differentially expressed in palatal fibroblasts by microarray analysis (p<0.05; >10-fold). Importantly, in the presence of the TGF-βRI kinase inhibitor SB431542, Emdogain failed to cause any significant changes in gene expression. Consistent with this mechanism, three independent TGF-βRI kinase inhibitors and a TGF-β neutralizing antibody abrogated the increased expression of IL-11, a selected Emdogain target gene. The MAPK inhibitors SB203580 and U0126 lowered the impact of Emdogain on IL-11 expression. The data support that TGF-βRI kinase activity is necessary to mediate the effects of Emdogain on gene expression in vitro.
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Affiliation(s)
- Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Dieter Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland
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