Department of Periodontology and Oral Medicine, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi, PR China.
Biomaterials. 2012 Sep;33(27):6320-44. doi: 10.1016/j.biomaterials.2012.05.048. Epub 2012 Jun 12.
Periodontitis, an inflammatory disease, is the most common cause of tooth loss in adults. Attempts to regenerate the complex system of tooth-supporting apparatus (i.e., the periodontal ligament, alveolar bone and root cementum) after loss/damage due to periodontitis have made some progress recently and provide a useful experimental model for the evaluation of future regenerative therapies. Concentrated efforts have now moved from the use of guided tissue/bone regeneration technology, a variety of growth factors and various bone grafts/substitutes toward the design and practice of endogenous regenerative technology by recruitment of host cells (cell homing) or stem cell-based therapeutics by transplantation of outside cells to enhance periodontal tissue regeneration and its biomechanical integration. This shift is driven by the general inability of conventional therapies to deliver satisfactory outcomes, particularly in cases where the disease has caused large tissue defects in the periodontium. Cell homing and cell transplantation are both scientifically meritorious approaches that show promise to completely and reliably reconstitute all tissue and connections damaged through periodontal disease, and hence research into both directions should continue. In view of periodontal regeneration by paradigms that unlock the body's innate regenerative potential has been reviewed elsewhere, this paper specifically explores and analyses the stem cell types and cell delivery strategies that have been or have the potential to be used as therapeutics in periodontal regenerative medicine, with particular emphasis placed on the efficacy and safety concerns of current stem cell-based periodontal therapies that may eventually enter into the clinic.
牙周炎是一种炎症性疾病，是成年人牙齿丧失的最常见原因。最近，人们试图在牙周炎导致的牙齿支持装置（即牙周韧带、牙槽骨和牙根牙骨质）丧失/损伤后再生这一复杂系统，这方面取得了一些进展，并为评估未来的再生疗法提供了一个有用的实验模型。目前，人们的努力重点已经从使用引导组织/骨再生技术、各种生长因子和各种骨移植物/替代品，转向通过募集宿主细胞（细胞归巢）或通过移植外细胞进行基于干细胞的治疗来设计和实践内源性再生技术，以增强牙周组织再生及其生物力学整合。这种转变的驱动力是常规疗法普遍无法提供满意的结果，尤其是在疾病导致牙周组织出现大的组织缺损的情况下。细胞归巢和细胞移植都是具有科学价值的方法，它们有可能完全可靠地重建所有通过牙周病受损的组织和连接，因此这两个方向的研究都应该继续进行。鉴于其他地方已经回顾了通过释放身体固有再生潜能的范式进行牙周再生，本文特别探讨和分析了已经或有可能作为牙周再生医学治疗方法使用的干细胞类型和细胞输送策略，特别强调了当前基于干细胞的牙周治疗的疗效和安全性问题，这些问题最终可能会进入临床应用。
