Comprehensive study of root surface treatment and regeneration in periodontal disease

本研究旨在探索一种新的获得结缔组织附着的根面处理方法及其在牙周手术后的临床应用。本课题通过多种方法研究牙周膜细胞的动态变化与新型根面处理的关系。获得了以下结果。(1)牙周膜中细胞增殖和分化的机制（高田）。(2)牙周组织再生过程中神经的参与（Maeda）。(3)牙周组织的再生和稳态机制（Shimono）。(4)上皮附着和结缔组织附着之间的相关性（桥本）。(5)牙周组织的再生变化通过生长因子的应用（Sugaya）。(6)通过釉质基质蛋白（Yamada）获得结缔组织附着。(7)微循环参与再附着 ...更多信息 牙周膜表面附近较浅的亚群增殖活性较高。另一方面，碱性磷酸酶（ALP）和钙化的活性较高，在更深的亚群接近根表面。有趣的是，PDL亚群在根表面表现出高活性的ALP和增殖。这里建立的实验模型可能是一个很好的工具，讨论新的再生疗法使用生长因子。在退变过程中，终末雪旺细胞迁移到牙齿相关部分，在完整韧带中很少观察到Ruffini终末。在牙周Ruffini终末再生之前，它们移动到与牙槽相关的部分。提示终末雪旺细胞在牙周膜Ruffini终末再生中起重要作用。Malassez上皮剩余或残余在牙周膜的维护中的重要性被指出。在长连接上皮的内层中，指示整合素和层粘连蛋白-5，并且其提示对于上皮附着是重要的。rhPDGF-BB组蛋白浓度和细胞数显著增加，rhBMP-2组ALP活性显著增加。因此，rhPDGF-BB和rhBMP-2应用于EDTA脱矿牙本质表面，分别促进牙周膜细胞的反应，ulibration将促进牙周再生。柠檬酸在牙本质上的应用可以作为牙骨质形成的积极因素。柠檬酸处理的表层脱钙牙本质基质具有诱导牙骨质形成的能力。少

The aim of this comprehensive study is development of new root surface treatment method to acquire the connective tissue attachment, and it's clinical application in which after periodontal surgery. In this project, relationship between the dynamics of periodontal ligament cells and the new root surface treatment was clarified by various methods. Followings results were obtained.(1) The mechanism of cell proliferation and differentiation in the periodontal ligament (Takata).(2) The involvement of the nerve in the regeneration process of the periodontal tissue (Maeda).(3) The mechanism of regeneration and homeostasis of the periodontal tissue (Shimono).(4) The correlation between epithelial attachment and connective tissue attachment (Hashimoto).(5) The regenerative change of the periodontal tissue by Growth factor application (Sugaya).(6) The acquisition of connective tissue attachment by the enamel substrate protein (Yamada).(7) The involvement of the microcirculation in the reattachm … More ent of the periodontal tissue (Sekiguchi).Proliferation activities were higher in the shallower subpopulations near the PDL surface. On the other hand, activities of alkaline phosphatase (ALP) and calcification were higher in the deeper subpopulations close to the root surface. Interestingly, the PDL subpopulation on the root surface showed the high activities both in ALP and proliferation. The experimental model established here could be an excellent tool for the discussion of new regenerative therapies using growth factors. The terminal Schwann cells migrated into tooth-related part, where the Ruffini endings were rarely observed in intact ligament, during degeneration process. Prior to regeneration of periodontal Ruffini endings, they moved to alveolus-related part. These data suggested that terminal Schwann cells play important roles in regeneration of periodontal Ruffini endings. The importance of Malassez epithelial rest or remnant in the maintenance of the periodontal ligament was indicated. In the internal lamina of the long-junctional epithelium, Integrin and Laminin-5 were indicated, and it suggested to be important for epithelial attachment. A significant increase of protein concentration and cell number in rhPDGF-BB groups and a significant increase of ALP activity in rhBMP-2 groups was observed. Thus, rhPDGF-BB and rhBMP-2 application to EDTA demineralized dentin surfaces promote the periodontal ligament cell responses respectively which ulimately would enhance periodontal regeneration. The application of the citric acid on the dentin can act as positive factor for cementum formation. The superficially decalcified dentin matrix treated with citric acid has the ability toinduce cementogenesis. Less