Periodontal Regeneration- The right way forward
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PERIODONTAL REGENERATION WHICH WAY IS THE CORRECT WAY?
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Periodontal Regeneration- The right way forward
- 1. PERIODONTAL REGENERATION WHICH WAY IS THE CORRECT WAY?
- 2. Alpiste-Illueca FM et al. Periodontal regeneration in clinical practice. Med Oral Pathol Oral Cir Bucal 2006;11:E382-92.
- 3. DEVICES
- 4. DEVICES
- 5. PERIODONTAL REGENERATION TISSUE ENGINEERING*** refers to the practice of combining scaffolds, cells, and biologically active molecules into functional tissues. PERIODONTAL TISSUE ENGINEERING AND BONE REGENERATION (PTEBR)* promotes reconstitution of damaged and lost tissues through the use of growth factors and signaling molecules, scaffolds, cells and gene therapy. TISSUE ENGINEERING AND REGENERATIVE MEDICINE (TE/RM)** combines materials science, biomechanics, cell biology, and medical sciences to realize repair or reconstruction. BONE TISSUE ENGINEERING (BTE)*** is an emerging field that aims to combat the limitations of conventional treatments of bone disease. Galli M et al. Plast Aesthet Res 2021*/ Brouwer KM et al. Wound Repair Regen 2015** /Yuan et al. Comprehensive Biomaterials II, 2017*** DEVICES
- 7. J.M. Kanczler et al. Principles of Tissue Engineering (Fifth Edition) 2020, Pages 917-935, ISBN 9780128184226.
- 8. “Thus, if the ambition is to regenerate the periodontal ligament and the alveolar bone that have been lost due to periodontitis, it should aim at reestablishing a new cementum and neighboring cells” Lars Hammarström. The 1998 Jens Waerhaug Lecture in Periodontology. Scandinavian Society of Periodontology. CONCEPTS
- 9. Abdulghani S, Mitchell GR. Biomolecules. 2019 Nov 19;9(11):750/ *Mathew A et al. Nanomedicine and Tissue Engineering, 2016/ **Wang et al. Stem Cells International, 2020/***Vaquette C et al. Adv Healthc Mater, 2018 MICROGRAFTS*** (Non-stem cell delivery) STEM CELLS** PDLSC, DFSC, SCAP, SHED, GMSC, DSSC, iPDLSC, DPSC TRANSPLANTS* AutoAlloXenogeneic SCAFFOLDS Alloplastic PRF CONCEPTS
- 10. Ikada Y. Challenges in tissue engineering. J R Soc Interface. 2006 Oct 22;3(10):589-601. Brion & Rammal. Handbook of Biomaterials Biocompatibility, 2020. STEM CELLS** PDLSC, DFSC, SCAP, SHED, GMSC, DSSC, iPDLSC, DPSC MICROGRAFTS*** (Non-stem cell delivery) CONCEPTS
- 11. Tissue Regeneration WITHOUT Stem Cell Transplantation Any gels or scaffolds to effect repair or regeneration. Facchin F et al. Stem Cells International. Volume 2018, Article ID 7412035 CONCEPTS Titanium granules based bone-graft Stevia rebaudiana bertoni gel
- 12. Egusa H, Sonoyama W, Nishimura M, Atsuta I, Akiyama K. J Prosthodont Res. 2012 Oct;56(4):229-48. REGENERATIVE PERIODONTAL-BONE THERAPIES MATERIALS
- 13. TISSUE ENGINEERING *Mathew A et al. Nanomedicine and Tissue Engineering, 2016/ **Wang et al. Stem Cells International, 2020/****Brion & Rammal. Handbook of Biomaterials Biocompatibility, 2020. TRANSPLANTS* AutoAlloXenogeneic SCAFFOLDS* Alloplastic STEM CELLS** PDLSC, DFSC, SCAP, SHED, GMSC, DSSC, iPDLSC, DPSC MICROGRAFTS*** (Non-stem cell delivery) TYPES**** Mitogenic, Angiogenic, Chemotactic, Osteoinductive MATERIALS
- 14. MATERIALS Roy S. Functionally graded coatings on biomaterials: a critical review. 2020;18100375; Upadhyay RK. Adv Tissue Eng Regen Med Open Access. 2017;2(1):121-135 BIOLOGICAL or INJECTABLE
- 15. MANUFACTURING Annamalai, Ramkumar & Armant, David & Matthew, Howard. (2014). PloS one. 9. e84287. 10.1371/journal.pone.0084287. FGF2+Collagen RAW MATERIAL SCAFFOLD GF
- 17. Annamalai, Ramkumar & Armant, David & Matthew, Howard. (2014). PloS one. 9. e84287. 10.1371/journal.pone.0084287. SCAFFOLD MANUFACTURING
- 18. Annamalai, Ramkumar & Armant, David & Matthew, Howard. (2014). PloS one. 9. e84287. 10.1371/journal.pone.0084287. MANUFACTURING COLLAGEN SCAFFOLD After Fibroblast Impregnation MICROGRAFT after mincing it into small pieces
- 19. APPROACHES Ausenda F. Materials 2019, 12, 2197; doi:10.3390/ma12132197
- 20. APPROACHES Ausenda F. Materials 2019, 12, 2197; doi:10.3390/ma12132197
- 21. APPROACHES/HTR ENTIRE PAPILLA PRESERVATION Aslan S et al. Int J Periodontics Restorative Dent 2017:37, 227–233.
- 22. Non-Incised Papillae Surgical Approach Rodriguez JA, Caffesse RG. Int J Periodontics Restorative Dent 2018;38(Suppl):s105-s111. APPROACHES/HTR
- 23. Connective Tissue Graft Wall Technique Zucchelli G et al. Int J Periodontics Restorative Dent. 2017 Sep/Oct;37(5):673-681. APPROACHES/HTR
- 24. Interproximal tissue maintenance Murphy KG. Int J Periodontics Restorative Dent. 1996 Oct;16(5):463-77. APPROACHES/HTR
- 25. APPROACHES/STR Open Membrane Concepts Engler-Hamm D et al. Periodontol. 2011;82(3):377-387. Any membrane whose tensile stress >10 Mpa and a porosity of less than 0.2µ.
- 26. Membranes/Grafts + Conventional Techniques + + ? “LAB IN YOUR CLINICS approach” Xiaochen R et al. Frontiers in Bioengineering and Biotechnology, 2020.
Editor's Notes
- the influence diagram for the data published on the factors related with the treatment of periodontal bone defects. The complexity involved in trying to include all the different circumstances related with the results when making decisions on treatment. However, primary factors have been identified (primary line of globus, bacterial contamination, innate healing potential, local characteristics and surgical technique) whose influence on treatment of intrabony defects seems clear
- Bioengineering: The use of artificial tissues, organs, or organ components to replace damaged or absent parts of the body. Stress is placed on the use of grafts/scaffolds Regenerative Medicine is the promise of regenerating damaged tissues and organs in the body by replacing damaged tissue and/or by stimulating the body's own repair mechanisms to heal previously irreparable tissues or organs. The term regenerative medicine is often used synonymously with tissue engineering, although those involved in regenerative medicine place more emphasis on the use of stem cells to produce tissues.
- Periodontal regeneration is defined as the restoration of lost periodontium or supporting tissues and includes formation of new alveolar bone, new cementum, and new periodontal ligament.
- in situ | Business English ... in the original place Cell-based therapies for example with respect to spinal cord injuries provide conflicting results and it is now thought that the injection of stem cells does not lead on to differentiation but rather the release of secreting factors, the paracrine effect that promotes the preservation and activity of other cells. The most widely studied tissue engineering technique employs a top-down approach in which the cells are collected, and seeded on or within a porous biodegradable scaffold, with the desired size and shape, and conditioned in an in vitro bioreactor for several weeks where it is exposed to cues including biochemical signals and mechanical stimulation which serve to guide the formation of appropriate tissue type and architecture and ensure fast matrix production. A "top-down" approach is where an executive decision maker or other top person makes the decisions of how something should be done.
- regenerative medicine replaces or regenerates human cells, tissue or organs, to restore or establish normal function.
- Progress in regenerative periodontal/bone therapies. Regenerative periodontal/bone therapies are broadly categorized as material-based therapies (first-generation biomaterial scaffold-based approach and second-generation growth-factor-based approach) and stem-cell-based therapies (third-generation MSC/osteoprogenitor cell-based approach, fourth-generation stem-cell construction-based approach, and fifth-generation physiologically analogous tissue/organ-replacement approach). Technologies from the first to the fourth generation have already reached the clinic
- A transplant can be classified or defined in many ways; for example, it can be based on the relationship between the recipient and the donor, its location in a recipient, and so on. Different types of transplants include autograft (from one part of the body to other within one individual), isograft (within genetically identical species like identical twins), allograft (from different individuals of same species), and xenograft (from members of different species). The different populations of dental mesenchymal stem cells and their distribution. PDLSCs: periodontal ligament stem cells; DFSCs: dental follicle stem cells; DPSCs: dental pulp-derived stem cells; SCAPs: stem cells from apical papilla; SHEDs: stem cells from exfoliated deciduous teeth; GMSCs: gingival mesenchymal stem cells; DSSCs: dental socket-derived stem cells; iPDLSCs: PDLSCs derived from infected tissue; iDPSCs: DPSCs derived from infected tissue. The micrografting technique was conceived by Cicero Parker Meek at the University of South Carolina Aiken in 1958.34 Micrografting is based on the concept that by increasing the superficial area of a skin graft by cutting the graft into smaller “micrografts,” it is possible to cover a wound larger than the original donor site. Micrografting was first applied to the treatment of burns because of a lack of available donor sites for skin grafting.
- Bottom-up vs. top-down approaches in tissue engineering. The traditional, top-down approach (right) involves seeding cells into full sized porous scaffolds to form tissue constructs. This approach poses many limitations such as slow vascularization, diffusion limitations, low cell density and non-uniform cell distribution. In contrast, the modular or bottom-up approach (left) involves assembling small, non-diffusion limited, cell- laden modules to form larger structures and has the potential to eliminate the shortcomings of the traditional approach. doi:10.1371/journal.pone.0084287.g001 Source publication