Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Adelaide, SA, Australia.
School of Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
J Periodontal Res. 2016 Feb;51(1):1-15. doi: 10.1111/jre.12275. Epub 2015 Apr 21.
Attainment of periodontal regeneration is a significant clinical goal in the management of advanced periodontal defects arising from periodontitis. Over the past 30 years numerous techniques and materials have been introduced and evaluated clinically and have included guided tissue regeneration, bone grafting materials, growth and other biological factors and gene therapy. With the exception of gene therapy, all have undergone evaluation in humans. All of the products have shown efficacy in promoting periodontal regeneration in animal models but the results in humans remain variable and equivocal concerning attaining complete biological regeneration of damaged periodontal structures. In the early 2000s, the concept of tissue engineering was proposed as a new paradigm for periodontal regeneration based on molecular and cell biology. At this time, tissue engineering was a new and emerging field. Now, 14 years later we revisit the concept of tissue engineering for the periodontium and assess how far we have come, where we are currently situated and what needs to be done in the future to make this concept a reality. In this review, we cover some of the precursor products, which led to our current position in periodontal tissue engineering. The basic concepts of tissue engineering with special emphasis on periodontal tissue engineering products is discussed including the use of mesenchymal stem cells in bioscaffolds and the emerging field of cell sheet technology. Finally, we look into the future to consider what CAD/CAM technology and nanotechnology will have to offer.
牙周再生的实现是治疗牙周炎引起的晚期牙周缺损的重要临床目标。在过去的 30 年中，已经引入并临床评估了许多技术和材料，包括引导组织再生、骨移植材料、生长因子和其他生物因子以及基因治疗。除了基因治疗外，所有这些方法都已经在人体中进行了评估。所有这些产品在动物模型中都显示出促进牙周再生的功效，但在人体中，关于受损牙周结构的完全生物学再生的结果仍然存在差异和不确定性。在 21 世纪初，基于分子和细胞生物学，组织工程被提出作为牙周再生的一个新范例。当时，组织工程是一个新兴的领域。14 年后的今天，我们重新审视了牙周组织工程的概念，评估了我们已经走了多远，目前的位置以及未来需要做些什么才能使这一概念成为现实。在这篇综述中，我们介绍了一些先驱产品，这些产品使我们目前在牙周组织工程中的地位成为可能。讨论了组织工程的基本概念，特别强调了牙周组织工程产品，包括间充质干细胞在生物支架中的应用和细胞片技术这一新兴领域。最后，我们展望未来，考虑 CAD/CAM 技术和纳米技术将提供什么。
