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持组织的传染病。但在目前，牙周病的有效治疗还不是很多。另一方面，再生医学很少被应用于实际应用。本研究将再生医学技术应用于牙周病的治疗。我们使用PRP作为体外扩增间充质干细胞(MSCs)的自体支架，为信号分子提供信号分子，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，我们在犬下颌骨牙周模型上研究了T.E.B.再生牙周组织的能力。结果表明，在组织学、组织形态计量学观察中，T.E.B.(DogMSCs/PRP)、T.E.B.和GTR法与对照组(翻瓣术)相比，上皮组织向下生长较少，T.E.B.中的MSCs与天然牙骨质一样再生出新的牙骨质。第二，在临床应用之前，我们对…进行了调查多经细胞表面抗体FACS、支原体感染、内毒素、基因突变、成瘤试验等检测，未发现异常情况。研究方案经大学伦理委员会批准后，由多中心讨论操作方法和适应案例，并应用于临床。术后1个半月行骨髓活检，术前1天取材。该培养过程是在无菌条件下进行的，便于实际使用。术前患者进行菌斑控制和牙周基础治疗。从动物实验结果来看，我们在临床应用中没有使用GTR法使用的膜。临床应用结果发表在Int J Perodont Rest，26,363-369,2006年。术后过程良好，显示了MSCs对牙周炎牙周组织的真实再生能力。在未来，我们希望通过翻译研究的理念，建立一种新的、创伤最小的牙周组织再生方法，为提高患者的生活质量做出贡献。较少

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