Department of Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Periodontal Res. 2020 Jun;55(3):441-452. doi: 10.1111/jre.12728. Epub 2020 Feb 21.
Defective cellular elements constitute an important challenge to achieve predictable periodontal regeneration. In an attempt to improve the cellularity of periodontal defects, gingival fibroblasts were implanted without their associated extracellular elements in periodontal defects to expose them to periodontal tissue mediators. In order to investigate the regenerative potential of gingival fibroblasts translocated into periodontal defects, the present study was designed to clinically and biochemically investigate the use of gingival fibroblasts (GF) and their associated mesenchymal stem cells (GMSC) in the treatment of intrabony periodontal defects.
A total of 20 subjects were randomly divided into two groups (n = 20). Group I: ten patients were included with ten intrabony periodontal defects that received β-calcium triphosphate (β-TCP) followed by collagen membrane defect coverage, while group II: (10 patients) ten periodontal defects received cultured gingival fibroblasts (GF) on the β-TCP scaffold and covered by a collagen membrane. The clinical evaluation was carried out at the beginning and at 6 months. Gingival crevicular fluid (GCF) samples were collected directly from the test sites for the quantitative measurement of PDGF-BB and BMP-2 using the ELISA kit at 1, 7, 14, and 21 days after surgery.
Group II reported a significantly greater reduction in vertical pocket depth (VPD) and CAL gain compared with group I after 6 months. Radiographic bone gain was statistically higher in group II compared with group I. A significantly higher concentration of PDGF-BB was observed in group II on days 1, 3, and 7 compared with group I.
Translocation of gingival fibroblasts from gingival tissue to periodontal defects could be a promising option that increases cellular elements with regeneration potential. The concept of total isolation of gingival fibroblasts using occlusive membranes must be re-evaluated.
有缺陷的细胞成分是实现可预测牙周再生的一个重要挑战。为了提高牙周缺损的细胞密度，将牙龈成纤维细胞植入牙周缺损部位，使其与细胞外基质分离，从而暴露于牙周组织介质中。为了研究转位至牙周缺损部位的牙龈成纤维细胞的再生潜力，本研究旨在临床和生化方面研究牙龈成纤维细胞（GF）及其相关间充质干细胞（GMSC）在治疗骨内牙周缺损中的应用。
共 20 名受试者被随机分为两组（n=20）。I 组：10 名患者，10 个骨内牙周缺损，接受β-磷酸三钙（β-TCP）治疗，随后用胶原膜覆盖缺损；II 组：10 名患者，10 个牙周缺损接受培养的牙龈成纤维细胞（GF）在β-TCP 支架上，并覆盖胶原膜。在开始和 6 个月时进行临床评估。直接从试验部位采集龈沟液（GCF）样本，使用 ELISA 试剂盒在术后第 1、7、14 和 21 天定量测量 PDGF-BB 和 BMP-2。
6 个月后，II 组的垂直牙周袋深度（VPD）和 CAL 增加明显大于 I 组。与 I 组相比，II 组的放射状骨增加有统计学意义。与 I 组相比，II 组在第 1、3 和 7 天 PDGF-BB 的浓度显著升高。
将牙龈组织中的牙龈成纤维细胞转位至牙周缺损部位可能是一种有前途的选择，可以增加具有再生潜力的细胞成分。使用封闭膜对牙龈成纤维细胞进行完全隔离的概念必须重新评估。
