Attachment formation after transplantation of teeth cultured with enamel matrix derivative in dogs.

Background: Implantation of cultured cells may be applied for periodontal regeneration in the future. However, a donor is essential in each case and tooth extraction is required to obtain the periodontal ligament-derived cell. We developed a novel regenerative technique combining tissue culture and transplantation of teeth. The purpose of this study is to evaluate the effect of enamel matrix derivative (EMD) on periodontal healing using this technique in dogs. Methods: A total of 32 incisors from seven beagle dogs were used. The periodontal ligament and cementum 5 mm from the coronal part of the roots were removed, whereas those in the apical part were preserved. Teeth were transplanted after the following treatments: 1) culture with application of EMD to the root surface for 6 weeks (n = 11); 2) culture without application of EMD for 6 weeks (n = 11); and 3) immediately transplanted without culture as control (n = 10). Eight weeks after transplantation, periodontal healing was analyzed. Results: The downgrowth of junctional epithelium on the roots of the EMD and culture groups was significantly smaller than that in the control group (P < 0.01). Most of the root-planed surfaces in the EMD group were covered with new cementum (72.2% +/- 8.6%). This was significantly greater than that in the culture (29.1% +/- 22.9%) and control groups (0.3% +/- 1.1%). Conclusions: Transplantation of tissue-cultured teeth decreased epithelial downgrowth and increased connective tissue attachment on the root-planed surface. Furthermore, EMD could remarkably increase the new connective tissue attachment in this periodontal regenerative technique. J Periodontol 2011; 82: 1462-1468.