Lin Zhao, Rios Hector F, Cochran David L
Department of Periodontics, Virginia Commonwealth University School of Dentistry, Richmond, VA.
J Periodontol. 2015 Feb;86(2 Suppl):S134-52. doi: 10.1902/jop.2015.130689.
More than 30 years have passed since the first successful application of regenerative therapy for treatment of periodontal diseases. Despite being feasible, periodontal regeneration still faces numerous challenges, and complete restoration of structure and function of the diseased periodontium is often considered an unpredictable task. This review highlights developing basic science and technologies for potential application to achieve reconstruction of the periodontium. A comprehensive search of the electronic bibliographic database PubMed was conducted to identify different emerging therapeutic approaches reported to influence either biologic pathways and/or tissues involved in periodontal regeneration. Each citation was assessed based on its abstract, and the full text of potentially eligible reports was retrieved. Based on the review of the full papers, their suitability for inclusion in this report was determined. In principle, only reports from scientifically well-designed studies that presented preclinical in vivo (animal studies) or clinical (human studies) evidence for successful periodontal regeneration were included. Hence, in vitro studies, namely those conducted in laboratories without any live animals, were excluded. In case of especially recent and relevant reviews with a narrow focus on specific regenerative approaches, they were identified as such, and thereby the option of referring to them to summarize the status of a specific approach, in addition to or instead of listing each separately, was preserved. Admittedly, the presence of subjectivity in the selection of studies to include in this overview cannot be excluded. However, it is believed that the contemporary approaches described in this review collectively represent the current efforts that have reported preclinical or clinical methods to successfully enhance regeneration of the periodontium. Today's challenges facing periodontal regenerative therapy continue to stimulate important research and clinical development, which, in turn, shapes the current concept of periodontal tissue engineering. Emerging technologies--such as stem cell therapy, bone anabolic agents, genetic approaches, and nanomaterials--also offer unique opportunities to enhance the predictability of current regenerative surgical approaches and inspire development of novel treatment strategies.
自再生疗法首次成功应用于牙周疾病治疗以来，已过去30多年。尽管牙周再生可行，但仍面临众多挑战，患病牙周组织的结构和功能完全恢复通常被认为是一项不可预测的任务。本综述重点介绍了为实现牙周组织重建而开发的基础科学和技术，这些技术有可能得到应用。我们对电子文献数据库PubMed进行了全面检索，以确定已报道的影响牙周再生相关生物学途径和/或组织的不同新兴治疗方法。根据每篇文献的摘要进行评估，并检索潜在符合条件报告的全文。基于对全文的审查，确定其是否适合纳入本报告。原则上，仅纳入来自科学设计良好的研究报告，这些报告提供了临床前体内（动物研究）或临床（人体研究）成功实现牙周再生的证据。因此，排除了体外研究，即在没有任何活体动物的实验室中进行的研究。对于特别近期且专注于特定再生方法的相关综述，将其识别出来，因此保留了除单独列出每种方法外，还可参考这些综述来总结特定方法现状的选项。诚然，在选择纳入本综述的研究时，主观性的存在无法排除。然而，人们认为本综述中描述的当代方法共同代表了目前已报道的成功增强牙周组织再生的临床前或临床方法所做的努力。牙周再生治疗目前面临的挑战继续刺激着重要的研究和临床发展，这反过来又塑造了当前牙周组织工程的概念。新兴技术，如干细胞疗法、骨合成代谢剂、基因方法和纳米材料，也为提高当前再生手术方法的可预测性提供了独特机会，并激发了新治疗策略的发展。
