Establishment and clinical application ofperiodontal regeneration by using autologous periodontal cells

目前的牙周治疗仅限于抑制疾病的进展，并且仍然难以实现被破坏的牙周组织的再生。牙周组织再生的研究成果分为三个阶段：第一阶段是引导组织再生技术。其概念是通过使用膜封闭被破坏的缺损来诱导牙周再生，并期望周围组织的细胞增殖。第二步是通过在被破坏的缺损内应用生长因子来加速再生。我们的研究小组报告使用BMP-2成功地获得牙周再生（Kawanami，et.（见上文），GDF-5（Izumi，et.（见上文）和FGF-2（Murakami，et.（见上文）第三步是通过将自体牙周细胞应用于缺损处进行再生。我们的小组通过使用来自骨髓的间充质干细胞（Kurihar）研究了牙周再生的机制。 关于我们 a，et.等人），人培养骨膜（Yoshie，et.等人），人牙髓细胞（Gomi，et.等人），Hertwig上皮根鞘细胞（Ohishi，et.等人），和来自牙周韧带的增殖组织（Ota，et.等）。石川等.等人使用人牙周膜细胞片进行牙周再生。细胞片层由Okano等人开发的温度响应皿产生。将人牙周膜细胞片移植到牙周缺损处后，牙骨质和Sharpey纤维几乎完全再生。为了将该方法应用于人类，Watanabe，et.本课题组不仅进行了牙周组织再生的临床研究，还进行了牙周组织再生的基础研究。Ogata，et.揭示了骨唾液酸蛋白在矿化过程中的转录机制。Nishihara等人等提出肝素通过RANKL抑制骨细胞的分化和功能，这些研究成果在公开论坛上发表了两次，我们充分讨论了如何正确地完成成功的再生治疗。少

The current status for periodontal therapy is limited to inhibit the progression of the disease and is still believed difficult to achieve the regeneration of destroyed periodontal tissues. The research accomplishment for periodontal regeneration is considered as 3 steps.First step is the guided tissue regeneration technique. The concept is to induce periodontal regeneration by sealing the destroyed defect using membrane blocking the epithelial invasion and expect the cell proliferation from surrounding tissues.Second step is an accelerating regeneration by growth factor application within the destroyed defects. Our groups reported to obtain successfully the periodontal regeneration using BMP-2 (Kawanami, et. al.) , GDF-5 (Izumi, et. al.) , and FGF-2 (Murakami, et. al.) .Third step is the regeneration by applying the autologous periodontal cells to the defects. Our groups investigated the mechanism of periodontal regeneration by using mesenchymal stem cells from bone marrow (Kurihar … More a, et. al.), human cultured periosteum (Yoshie, et. al.), human dental pulp cells (Gomi, et. al.), Hertwig's epithelial root sheath cells (Ohishi, et. al.), and proliferating tissue derived from periodontal ligament (Ota, et. al.).Ishikawa, et. al. approached the periodontal regeneration using the human periodontal ligament cell sheets. The cell sheets were produced by the temperature-responsive dishes developed by Okano, et. al. After the transplantation of human periodontal ligament cell sheet into the periodontal defect, cementum and Sharpey's fiber were almost completely regenerated. To apply the method to human, Watanabe, et. al. constructed Cell Processing Center.Our groups conducted not only clinical studies of periodontal regeneration, but also basic studies. Ogata, et. al. revealed the transcription mechanisms of bone sialoprotein in mineralization. Nishihara, et. al. suggested that heparin inhibits osteoclastic differentiation and function through RANKL.These research achievements were presented in open forum twice and we discussed fully how successful regeneration therapy could be accomplished properly. Less