Development of Tissue-Engineered Periodontal Regeneration Using Platelet-Rich Plasma and Periodontal Ligament Cells

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Platelet-Rich Plasma(PRP) contained high levels of PDGF and TGF-β. PRP stimulated osteoblastic DNA synthesis and cell division, but suppressed epithelial cell division. PRP also stimulated DNA synthesis in gingival fibroblasts and periodontal ligament cells. Fibrin in combination with growth factors present in PRP might effectively promote wound healing at sites of injury in periodontal tissue. As a next stage, randomized controlled clinical trial was to compare PRP+hydroxyapatite(HA), with the mixture of HA and saline in the treatment of human intrabony defects. PRP+HA led to a significantly more favorable clinical improvement. In addition to in vitro data, PRP enhanced alkaline phosphatase(ALP) activity, but neither TGF-β nor PDGF replicated this effect. As stimulation of ATP often accompanies promotion of mineralization in a variety of tissues, the ability of PRP to stimulate mineralization in PDL cell cultures was examined. PRP substantially up-regulated expression of several osteoblastic markers such as Cbfa1,BSP, and OCN, and concomitantly stimulated mineralization in PDL cells cultured on PC-coated plates. TEM findings demonstrated that mineralized spicules were deposited onto platelet aggregates but not on or within matrix vesicle-like structures. Therefore, PRP promotes in vitro mineralization both by stimulating cellular ALP activity and by providing a nucleus for mineralization in culture.Human cultured gingival epithelial sheets were used as an autografting material for regenerating gingival tissue for treatment of chronic desquamative gingivitis. Six months post-surgery in treated sites, there were gains in healthy keratinized gingiva.In the "cultured bone" project, we succeeded incorporating periodontal ligament cells to porous hydroxyapatite block by modifying the rotary culture method.