Periodontal tissue regeneration method by regenerative medicine with stem cells-multi-center study for practical use

牙周病是一种影响牙齿支撑组织的传染病。但目前，对牙周病的有效治疗还没有。另一方面，很少有再生医学应用于实际用途。本研究将再生医学技术应用于牙周病的治疗。我们使用PRP作为提供信号分子的自体支架，与体外扩增的间充质干细胞（MSCs）结合，并将这种方法称为“可注射组织工程骨（T.E.B.）”。作为基础研究，我们研究了T.E.B.再生对犬下颌骨牙周组织再生能力的影响。结果表明，与对照组（皮瓣手术）相比，te.b组（dogMSCs/PRP）和te.b + GTR法的上皮组织下降较少，te.b组的MSCs再生的新骨质与天然骨质相同。其次，在临床前，我们通过细胞表面抗体、支原体感染、内毒素、基因突变、肿瘤形成试验等对MSCs的特性和安全性进行了研究，未发现异常情况。研究方案经学校伦理委员会批准后，我们多中心讨论手术方法和适应案例，并申请临床途径。术前1个半月行骨髓活检，术前1天准备。培养过程在无菌条件下进行，以供实际使用。术前进行菌斑控制及牙周初始治疗。从动物实验的结果来看，我们在临床应用中没有使用GTR方法的膜。临床应用结果发表于《中华口腔医学杂志》，26,363-369,2006。术后处理良好，显示了MSCs对牙周炎的真正牙周再生能力。在未来，我们希望通过转化研究理念，建立一种微创的牙周组织再生新方法，为提高患者的生活质量做出贡献。少

Periodontal disease is an infectious disease affecting tooth-supporting tissues. But in this present, effective treatment for the periodontal disease is not. On the other hand, little regenerative medicine is applied for practical use. In this study, the regenerative medicine technology is applied for periodontal disease. We used PRP as an autologous scaffold-which provides signal molecules-with in vitro-expanded mesenchymal stem cells (MSCs), and called this method 'injectable tissue engineerd bone (T.E.B.)'. As basic research we investigated about the ability of periodontal tissue regeneration by T.E.B. regeneration in a dog mandible periodontal model. The results showed that epithelial tissue down growth is few in T.E.B. (dogMSCs/PRP) and T.E.B. and GTR method compared to control (flap operation) in histological, histomorphometric observations, and that the MSCs in the T.E.B. regenerated new cementum the same as a natural cementum. Secondaly before clinical approach we investigated … More the characteristic and safety of the MSCs by cell surface antibody with FACS, mycoplasma infection, endtoxin, gene mutation, tumor formation test and did not find abnormal condition. After the research protocol was approved by the University Ethics Committee, we discussed about the operation method and adaptation case by multi-center and applied for clinical approach. It did bone marrow biopsy 1 month and half, and prepared 1 day before operation. The culture process did under sterile condition for practice use. Before operation the patient did plaque control and periodontal initial treatment. From the result of animal experiment we did not use membrane using by GTR method in this clinical application. The result in clinical application published in Int J Periodont Rest, 26, 363-369, 2006. The post-operation process is good and it showed the ability of true periodontal regeneration for periodontitis by MSCs. In the future, we would like to establish novel periodontal tissue regeneration method with minimal invasiveness by translational research concept and contribute improvement in quality of life (QOL) for the patients. Less