Wound models for periodontal and bone regeneration: the role of biologic research.
Wound models for periodontal and bone regeneration: the role of biologic research.
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DOI：
10.1111/prd.12091
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发表时间：
2015-06
影响因子：
18.6
通讯作者：
Giannobile WV
中科院分区：
文献类型：
--
作者：
Sculean A;Chapple IL;Giannobile WV
牙周治疗的最终目标仍然是完全再生那些牙周组织失去了破坏性的炎症免疫反应，或创伤，具有相同的结构和功能的组织，并重建和维持健康促进生物膜从一个特征为生态失调。本卷讨论了在20世纪60年代后期到今天的过渡的多个方面，对再生疗法建立在正常结构和功能的生物生理学的更清楚的理解，而不是再生主义。本介绍性手稿概述了牙周创伤和骨修复的适当体外实验室模型（例如细胞培养）、临床前（即动物）模型和人体研究的要求。实验室研究可以为伤口修复和再生中涉及的基本机制提供有价值的基本见解，但也遭受一维和简单化的方法，该方法不能解释体内情况的复杂性，其中多种细胞类型和相互作用都有助于确定的结果。因此，此类实验室研究需要采用专门设计的临床前模型进行验证性研究，以证明概念验证功效、初步安全性和对人类疾病情景的适应性。小动物模型提供了最经济和后勤可行的初步方法，但结果不一定转化为较大的动物或人类模型。所有牙周再生模型的优点和局限性，需要仔细考虑时，规划调查，以确保采用最佳的设计来回答提出的具体研究问题。未来的挑战在于干细胞研究、支架设计、细胞递送和生长因子的选择等领域，沿着研究以确保适当的牙龈覆盖，以防止愈合阶段的牙龈退缩。
The ultimate goal of periodontal therapy remains the complete regeneration of those periodontal tissues lost to the destructive inflammatory-immune response, or to trauma, with tissues that possess the same structure and function, and to reestablish and sustain a heath promoting biofilm from one characterised by dysbiosis. This volume discusses the multiple facets of a transition during the late 1960’s to the present day, towards regenerative therapies founded upon a clearer understanding of the biophysiology of normal structure and function, rather than empiricism. This introductory manuscript provides an overview on the requirements of appropriate in-vitro laboratory models (e.g. cell culture), of pre-clinical (i.e. animal) models and human studies for periodontal wound and bone repair. Laboratory studies may provide valuable fundamental insights into basic mechanisms involved in wound repair and regeneration, but also suffer from a uni-dimensional and simplistic approach that does not account for the complexities of the in vivo situation, where multiple cell types and interactions all contribute to definitive outcomes. Therefore, such laboratory studies require validatory research employing preclinical models specifically designed to demonstrate proof-of-concept efficacy, preliminary safety and adaptation to human disease scenarios. Small animal models provide the most economic and logistically feasible preliminary approaches, but outcomes do not necessarily translate to larger animal or human models. The advantages and limitations of all periodontal regeneration models need to be carefully considered when planning investigations to ensure that the optimal design is adopted to answer the specific research question posed. Future challenges lie in the areas of stem cell research, scaffold designs, cell delivery and choice of growth factors, along with research to ensure appropriate gingival coverage in order to prevent gingival recession during the healing phase.
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