Tissue Engineering for Periodontal Regeneration

Periodontology 2000, 2000

Periodontology 2000, 1995

Journal of Membrane and Separation Technology, 2013

Periodontal regeneration is the restoration of lost periodontium or supporting tissues and includes the formation of new alveolar bone, new cementum and new periodontal ligament. The concept of GTR is based on the exclusion of gingival connective tissue cells and prevention of epithelial down growth into the wound, thereby allowing cells with regenerative potential (PDL and bone cells) to enter the wound first. GTR consists of placing barriers of different types to cover the bone and periodontal ligament thus temporarily separating them from gingival epithelium. Excluding the epithelium and gingival connective tissue from the root surface during the post-surgical healing phase not only prevent epithelial migration into the wound but also favors repopulation of the area by cells from the periodontal ligament and bone. Purpose and Scope-This review discusses the rationale for using guided tissue regeneration therapy. The review not only attempts to clarify the concept of selective tissue regeneration using non-resorbable and resorbable barriers, but to discuss differences in healing events after treatment with the two types of barriers together with their significance in periodontal therapy. At present, barrier membranes have potential clinical use in promoting periodontal tissue regeneration if patients to be so treated are selected appropriately. Research is still necessary to determine the critical period for guiding the ingrowth of new attachment forming cells and also to further clarify the concept of GTR involving the "wrong cell type" which inhibits periodontal tissue regeneration.

Periodontology 2000, 2012

Reconstructive therapies to promote the regeneration of lost periodontal support have been investigated through both preclinical and clinical studies. Advanced regenerative technologies using new barrier-membrane techniques, cell-growth-stimulating proteins or gene-delivery applications have entered the clinical arena. Wound-healing approaches using growth factors to target the restoration of tooth-supporting bone, periodontal ligament and cementum are shown to significantly advance the field of periodontal-regenerative medicine. Topical delivery of growth factors, such as platelet-derived growth factor, fibroblast growth factor or bone morphogenetic proteins, to periodontal wounds has demonstrated promising results. Future directions in the delivery of growth factors or other signaling models involve the development of innovative scaffolding matrices, cell therapy and gene transfer, and these issues are discussed in this paper.

Journal of Endodontics, 2009

Guided tissue regeneration (GTR) is effective in halting tissue and bone destruction and promoting new tissue and bone formation. Although the goal of complete and predictable regeneration still remains elusive, many techniques and materials have been developed that show good clinical and histologic outcomes. The most commonly used materials in GTR include bone replacement grafts from numerous sources, nonresorbable and bioabsorbable membranes, and recently growth hormones/cytokines and other host modulating factors. This article reviews the biologic rationale behind current techniques used for tissue/bone regeneration, reviews the most common materials and techniques, and attempts to explain the factors that influence the outcomes of these therapies. (J Endod 2009;35:321-328)

Regenerative treatment of periodontal defects with an agent, or procedure, requires that each functional stage of reconstruction be grounded in a biologically directed process. With this paradigm, we contended the way of periodontal regeneration through the application of current knowledge in the fields of molecular and cell biology, developmental biology and tissue engineering principles as applicable to tissue engineering. Through a combination of transplanted biomaterials containing appropriately selected and primed cells, together with an appropriate mix of regulatory factors to allow growth and specialization of the cells and matrix, we envision a new vista for periodontal regeneration becoming possible.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 2010

Periodontitis affects around 15 per cent of human adult populations. While periodontal treatment aimed at removing the bacterial cause of the disease is generally very successful, the ability predictably to regenerate the damaged tissues remains a major unmet objective for new treatment strategies. Existing treatments include the use of space-maintaining barrier membranes (guided tissue regeneration), use of graft materials, and application of bioactive molecules to induce regeneration, but their overall effects are relatively modest and restricted in application. The periodontal ligament is rich in mesenchymal stem cells, and the understanding of the signalling molecules that may regulate their differentation has increased enormously in recent years. Applying these principles for the development of new tissue engineering strategies for periodontal regeneration will require further work to determine the efficacy of current experimental preclinical treatments, including pharmacologic...

2016

Periodontal regeneration has become one of the primary objectives of periodontal therapy. The resulting scientific endeavours have elucidated modes of periodontal wound healing, the growth of periodontal cells and their association with the surrounding matrix, and growth-promoting factors. The periodontal regeneration industry is producing better and more expensive devices, but the criteria for evaluating their success have not progressed to the same extent. Although clinical measurements of attachment level and probing depths, along with radiography, are good methods of evaluating tooth survival and prognosis, they do not indicate true biological regeneration. The goals of periodontal therapy include not only the arrest of periodontal disease progression, but also the regeneration of structures lost to disease, where appropriate. Conventional surgical approaches (e.g., flap debridement) continue to offer time-tested and reliable methods to access root surfaces, reduce periodontal p...

Journal of Oral Health and Community Dentistry, 2010

The management of periodontal defects has been an ongoing challenge in clinical periodontics. In the recent past, attention has been focused more on regenerative and reconstructive therapies i.e. bone grafts, guided tissue regeneration, root conditioning, polypeptide growth factors, rather than on respective therapies. These therapeutic measures are shown to be limited in the predictability of healing and regenerative response in the modern clinical practice because oral environment presents several complicating factors that border regeneration. The 21st century appears to represent a time in history when there is a convergence between clinical dentistry and medicine, human genetics, developmental and molecular biology, biotechnology, bioengineering, and bioinformatics, resulting in the emergence of novel regenerative therapeutic approaches viz. tissue engineering, gene therapy and RNA interference. The focus of this review paper is to furnish and update the current knowledge of per...

2015

Periodontitis is an infectious disease that causes destruction of the attachment apparatus of the tooth. Regeneration has been defined as the reproduction or reconstitution of lost or injured part of the body in a way that the function and architecture of the lost tissue is restored. In terms of periodontal regeneration, the structure and function of the gingiva, alveolar bone, root cementum and periodontal ligament must be restored. There are a broad range of treatment options which bring about regeneration, bone grafts, root biomodification, guided tissue regeneration to name a few. This review paper gives an insight to the various options available for periodontal regeneration and the clinical effectiveness of each of them.