Kao Richard T, Conte Greg, Nishimine Dee, Dault Scott
Department of Periodontology, University of the Pacific, Arthur A. Dugoni School of Dentistry, USA.
J Calif Dent Assoc. 2005 Mar;33(3):205-15.
As a result of periodontal regeneration research, a series of clinical techniques have emerged that permit tissue engineering to be performed for more efficient regeneration and repair of periodontal defects and improved implant site development. Historically, periodontal regeneration research has focused on a quest for "magic filler" material. This search has led to the development of techniques utilizing autologous bone and bone marrow, allografts, xenografts, and various man-made bone substitutes. Though these techniques have had limited success, the desire for a more effective regenerative approach has resulted in the development of tissue engineering techniques. Tissue engineering is a relatively new field of reconstructive biology which utilizes mechanical, cellular, or biologic mediators to facilitate reconstruction/regeneration of a particular tissue. In periodontology, the concept of tissue engineering had its beginnings with guided tissue regeneration, a mechanical approach utilizing nonresorbable membranes to obtain regeneration in defects. In dental implantology, guided bone regeneration membranes +/- mechanical support are used for bone augmentation of proposed implant placement sites. With the availability of partially purified protein mixture from developing teeth and growth factors from recombinant technology, a new era of tissue engineering whereby biologic mediators can be used for periodontal regeneration. The advantage of recombinant growth factors is this tissue engineering device is consistent in its regenerative capacity, and variations in regenerative response are due to individual healing response and/or poor surgical techniques. In this article, the authors review how tissue engineering has advanced and discuss its impact on the clinical management of both periodontal and osseous defects in preparation for implant placement. An understanding of these new tissue engineering techniques is essential for comprehending today's ever-expanding oral plastic surgery procedures.
由于牙周再生研究的开展，一系列临床技术应运而生，这些技术使得组织工程能够用于更有效地再生和修复牙周缺损，并改善种植位点的发育。从历史上看，牙周再生研究一直专注于寻找“神奇填充物”材料。这一探索导致了利用自体骨和骨髓、同种异体移植物、异种移植物以及各种人工骨替代物的技术的发展。尽管这些技术取得的成功有限，但对更有效的再生方法的需求促使了组织工程技术的发展。组织工程是重建生物学中一个相对较新的领域，它利用机械、细胞或生物介质来促进特定组织的重建/再生。在牙周病学中，组织工程的概念始于引导组织再生，这是一种利用不可吸收膜在缺损处实现再生的机械方法。在牙种植学中，引导骨再生膜±机械支撑用于拟种植位点的骨增量。随着从发育中的牙齿中获得部分纯化的蛋白质混合物以及重组技术生产的生长因子的出现，组织工程进入了一个新时代，即生物介质可用于牙周再生。重组生长因子在这种组织工程手段中的优势在于其再生能力具有一致性，再生反应的差异是由于个体愈合反应和/或手术技术欠佳所致。在本文中，作者回顾了组织工程的进展，并讨论了其对牙周和骨缺损临床管理的影响，为种植体植入做准备。了解这些新的组织工程技术对于理解当今不断扩展的口腔整形手术程序至关重要。
