Periodontal Tissue Regeneration Therapy Using Stem Cells
Periodontal Tissue Regeneration Therapy Using Stem Cells
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DOI：
10.1007/s12015-022-10494-x
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发表时间：
2022-12
影响因子：
4.8
通讯作者：
Sachio Tsuchida;T. Nakayama
中科院分区：
文献类型：
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作者：
Sachio Tsuchida;T. Nakayama
牙周病是牙周组织疾病的总称，由牙龈、牙骨质、牙周膜和牙槽骨组成。随着牙周疾病的恶化，牙周组织被破坏，导致牙齿脱落和口腔功能障碍，这不仅影响口腔，还影响其他器官系统[1]。牙周治疗的目的是通过清除牙面上的菌斑、细菌及其代谢物来阻止疾病的发展。此外，应维护局部牙周环境，切除因炎症而破坏的牙周组织。通过改善局部牙周环境，使炎症破坏的牙周组织恢复到原来的健康状态。根据这一观点，牙周治疗需要检查、诊断和计划适当的行动方案。根据这一观点，牙周治疗包括患者的检查、诊断、治疗计划、患者依从性、基础牙周治疗、重新评估和治疗。应正确控制菌斑，并使用抗菌或抗炎化学品，如结垢和根面刨平，以化学或机械方式清洁牙根表面。这些方法的临床结果是减少了探诊深度和探诊附着水平。在临床环境中，可以减少探诊深度，减少探诊附着体水平的粘连，并加强牙本质。关于全身和牙周问题的研究已经在世界各地进行，许多论文着眼于全身疾病如何影响牙周组织。按照检查诊断、牙周基础治疗、再评估、维护的牙周治疗流程进行适当的牙根平整和刮治，可以阻止牙周病的进展，促进牙周组织的愈合。然而，在牙周疾病伴有广泛的牙槽骨吸收的情况下，牙周袋可能会在根管治疗后持续存在，或者即使他们这样做了，愈合过程也可能伴随着显著的牙龈退缩。即使采用传统的根治疗法或牙周手术，牙周组织随着新牙槽骨和牙骨质的形成而再生也是不可能的。因此，随着组织工程的引入，人们对牙周组织再生治疗的期望很高(图1)。近年来，在牙周膜中发现了能区分成骨细胞和成牙骨质细胞的间充质干细胞，通过显示其生物学功能诱导牙周组织再生是可能的。目前应用于临床的引导组织再生技术、釉质基质衍生物(Emdogain®凝胶)和碱性成纤维细胞生长因子-2(REGROTH®)都在积极利用牙周膜中的干细胞[2-4]。GTR方法使用GTR膜，从调节组成牙周组织的细胞的迁移来促进牙周组织再生的角度，对应于组织工程的三个主要因素的支架。Emdogain®凝胶包含一种可促进向成牙骨质细胞分化的蛋白质，Ligros是一种可促进血管生成、干细胞增殖和迁移的物质，是三个主要因素中的两个。间充质干细胞是正在积极研究临床应用的体细胞干细胞[5]。在口头上，…
Periodontal disease is a general term for diseases of the periodontal tissue, consisting of the gingiva, cementum, periodontal ligament, and alveolar bone. As periodontal disorders worsen, the periodontal tissue is destroyed, leading to tooth loss and oral dysfunction that not only affects the oral cavity but also other organ systems [1]. The purpose of periodontal treatment is to stop disease progression by eliminating plaque, bacteria, and their metabolites from the tooth surfaces. Furthermore, the local periodontal environment should be maintained, and periodontal tissues destroyed by inflammation should be removed. Periodontal tissues destroyed by inflammation should be restored to their original healthy state by improving the local periodontal environment. According to this perspective, periodontal treatment entails an inspection, diagnosis, and planning of the appropriate course of action. According to this viewpoint, periodontal treatment entails a patient's examination, diagnosis, treatment planning, patient compliance, basic periodontal therapy, reevaluation, and treatment. Plaque control should be carried out properly, and root surfaces are cleaned chemically or mechanically using antimicrobial or anti-inflammatory chemicals, such as scaling and root planing. The clinical result of these methods is a reduction in probing depth and probing attachment level. In the clinical setting, a decrease in probing depth, adhesion at the probing attachment level, and strengthening of the dentin can be accomplished. Studies on systemic and periodontal problems have been undertaken all around the world, and numerous papers have looked at how systemic conditions affect periodontal tissues. Periodontal disease progression can be stopped, and periodontal tissue healing can be improved if root planing and scaling therapies are properly conducted according to the periodontal treatment flow, which consists of examination and diagnosis, basic periodontal treatment, reevaluation, and maintenance. However, in cases of periodontal disorders accompanied by extensive alveolar bone resorption, periodontal pockets may persist following root canal therapy, or even if they do, the healing process may be accompanied by significant gingival recession. Even with conventional root-cause elimination therapy or periodontal surgery, periodontal tissue regeneration with the new alveolar bone and cementum formation cannot be expected. As a result, expectations for periodontal tissue regeneration therapy are great with the introduction of tissue engineering (Fig. 1). Recently, mesenchymal stem cells that can distinguish osteoblasts and cementoblasts were discovered in the periodontal ligament even after adulthood and inducing periodontal tissue regeneration by showing their biological functions is biologically possible. Currently used in actual clinical practice, the guided tissue regeneration (GTR) technique, enamel matrix derivatives (Emdogain® gel), and basic fibroblast growth factor FGF-2 (REGROTH®) all actively employ stem cells found in the periodontal ligament [2–4]. The GTR method, which uses the GTR membrane, corresponds to the scaffold of the three main factors of tissue engineering from the perspective of improving periodontal tissue regeneration by regulating the migration of the cells that make up the periodontal tissue. Emdogain® gel, which contains a protein that encourages differentiation into cementoblasts, and Ligros, a substance that encourages angiogenesis, stem cell proliferation, and migration, are two of the three main factors. Mesenchymal stem cells are somatic stem cells that are being actively studied for clinical applications [5]. In the oral …