Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
J Periodontal Res. 2017 Dec;52(6):965-974. doi: 10.1111/jre.12477. Epub 2017 Jun 21.
The periodontal ligament (PDL) connects the tooth root and alveolar bone. It is an aligned fibrous network that is interposed between, and anchored to, both mineralized surfaces. Periodontal disease is common and reduces the ability of the PDL to act as a shock absorber, a barrier for pathogens and a sensor of mastication. Although disease progression can be stopped, current therapies do not primarily focus on tissue regeneration. Functional regeneration of PDL may be achieved using innovative techniques, such as tissue engineering. However, the complex fibrillar architecture of the PDL, essential to withstand high forces, makes PDL tissue engineering very challenging. This challenge may be met by studying PDL anatomy and development. Understanding PDL anatomy, development and maintenance provides clues regarding the specific events that need to be mimicked for the formation of this intricate tissue. Owing to the specific composition of the PDL, which develops by self-organization, a different approach than the typical combination of biomaterials, growth factors and regenerative cells is necessary for functional PDL engineering. Most specifically, the architecture of the new PDL to be formed does not need to be dictated by textured biomaterials but can emerge from the local mechanical loading conditions. Elastic hydrogels are optimal to fill the space properly between tooth and bone, may house cells and growth factors to enhance regeneration and allow self-optimization by the alignment to local stresses. We suggest that cells and materials should be placed in a proper mechanical environment to initiate a process of self-organization resulting in a functional architecture of the PDL.
牙周韧带 (PDL) 将牙根和牙槽骨连接起来。它是一种排列整齐的纤维网络，夹在矿化表面之间，并固定在矿化表面上。牙周病很常见，会降低 PDL 作为减震器、病原体屏障和咀嚼传感器的能力。虽然可以阻止疾病的进展，但目前的治疗方法主要不是关注组织再生。使用创新技术，如组织工程，可以实现 PDL 的功能性再生。然而，PDL 复杂的纤维状结构对于承受高压力至关重要，这使得 PDL 组织工程极具挑战性。通过研究 PDL 的解剖结构和发育，可以应对这一挑战。了解 PDL 的解剖结构、发育和维持为形成这种复杂组织需要模拟的特定事件提供了线索。由于 PDL 的特定组成部分是通过自我组织发育的，因此需要一种不同于典型的生物材料、生长因子和再生细胞组合的方法来进行功能性 PDL 工程。具体来说，形成的新 PDL 的结构不需要由具有纹理的生物材料来决定，而是可以从局部机械加载条件中出现。弹性水凝胶是在牙齿和骨骼之间适当填充空间的理想选择，它们可以容纳细胞和生长因子来增强再生，并通过与局部应力的对齐来实现自我优化。我们建议将细胞和材料置于适当的机械环境中，以启动自我组织过程，从而形成功能性 PDL 结构。
