Effect of enamel matrix derivative in soft tissue healing on post‐extraction sockets: Histological evaluation in humans

BACKGROUND: The use of enamel matrix derivative (EMD) has the potential to stimulate soft tissue healing and reduce inflammatory response. Our aim was to evaluate histological and immunohistochemical soft tissue healing with the use of EMD in post-extraction sockets. METHODS: A total of 20 single-rooted teeth with indication of extraction were selected for the study. The patients were randomly assigned to two treatment groups: control group atraumatic extraction filled with a collagenic hemostat cone and left to heal for 4 weeks (SC group) or test group atraumatic extraction filling the socket with a collagenic hemostat cone embedded with enamel matrix derivative and left to heal for 4 weeks (EMD group). A lingual or palatal flap was elevated and displaced to obtain primary closure. Soft tissue samples were obtained during second stage surgery (implant placement) at 4 weeks to be processed for the histological assessment and statistical analysis. RESULTS: The EMD group showed a significant increase in epithelial thickness as well as greater thickness of the lamina propria compared with the control group. The EMD group had significantly higher values for blood vessel area and the total H-score for vascular endothelial growth factor (VEGF) immunostaining intensity than the control group. CONCLUSIONS: The use of EMD enhances early stages in soft tissue healing by stimulating angiogenesis and soft tissue characteristics. PLAIN LANGUAGE SUMMARY: This study looked at whether adding a biologically active material called enamel matrix derivative (EMD) could improve the healing of gum tissue after tooth extraction. Twenty patients who needed a single tooth removed were randomly assigned to one of two groups. In both groups, the tooth was carefully extracted, and the socket was filled with a collagen sponge. In the test group, the sponge was combined with EMD, while in the control group it was used alone. After 4 weeks, samples of the healing tissue were collected during implant placement and examined under a microscope. The results showed that sites treated with EMD developed thicker epithelial and connective tissue compared to the control group. They also had a greater number of blood vessels and higher levels of a protein linked to new blood vessel formation.