Department of Biologic and Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Genesis. 2022 Sep;60(8-9):e23499. doi: 10.1002/dvg.23499. Epub 2022 Sep 10.
The periodontal complex involves the hard and soft tissues which support dentition, comprised of cementum, bone, and the periodontal ligament (PDL). Periodontitis, a prevalent infectious disease of the periodontium, threatens the integrity of these tissues and causes irreversible damage. Periodontal therapy aims to repair and ultimately regenerate these tissues toward preserving native dentition and improving the physiologic integration of dental implants. The PDL contains multipotent stem cells, which have a robust capacity to differentiate into various types of cells to form the PDL, cementum, and alveolar bone. Selection of appropriate growth factors and biomaterial matrices to facilitate periodontal regeneration are critical to recapitulate the physiologic organization and function of the periodontal complex. Herein, we discuss the current state of clinical periodontal regeneration including a review of FDA-approved growth factors. We will highlight advances in preclinical research toward identifying additional growth factors capable of robust repair and biomaterial matrices to augment regeneration similarly and synergistically, ultimately improving periodontal regeneration's predictability and long-term efficacy. This review should improve the readers' understanding of the molecular and cellular processes involving periodontal regeneration essential for designing comprehensive therapeutic approaches.
牙周复合体包括支持牙列的硬组织和软组织,由牙骨质、骨和牙周韧带 (PDL) 组成。牙周炎是一种常见的牙周疾病,威胁着这些组织的完整性,并导致不可逆转的损伤。牙周病治疗旨在修复和最终再生这些组织,以保留天然牙列并改善牙种植体的生理整合。牙周韧带含有多能干细胞,具有很强的分化为各种类型细胞的能力,形成牙周韧带、牙骨质和牙槽骨。选择合适的生长因子和生物材料基质来促进牙周再生对于复制牙周复合体的生理组织和功能至关重要。本文讨论了临床牙周再生的现状,包括对 FDA 批准的生长因子的综述。我们将重点介绍临床前研究的进展,以确定能够进行强大修复的其他生长因子和生物材料基质,以同样和协同的方式增强再生,最终提高牙周再生的可预测性和长期疗效。这篇综述应该提高读者对牙周再生所涉及的分子和细胞过程的理解,这对于设计全面的治疗方法至关重要。