줄기세포 기반의 치주조직재생
Stem cel based periodontal regeneration
박재욱, 박주철,
소속 상세정보
박재욱 ( Park Jae-Wok ) - 서울대학교 치의학대학원 치의학과
박주철 ( Park Ju-Cheol ) - 서울대학교 치의학대학원 구강조직 및 발생생물학교실
KMID : 0355820140350010051
Abstract
Periodontium is complex tisue composed of cementum, periodontal ligament and alveolar bone which holds the toth in the bone. periodontitis is main cause of toth los leads to los of atachment of connective tisue and ireversible bony destruction. So periodontitis has ben one of the main concern to dentist, patient and oral health system. For recent years the main purpose of periodontics is regene?ration of damaged peroidontium on shape, structure and function. In periodontal regeneration, new connective tisue fibers should be inserted in the cementum and bone, and construct the complex cementum-ligament-bone interfaces and provide a functional connection betwen a toth and the surounding jaw. Recently, many surgical, nonsurgical therapies and bone substitutes are using, but the clinical outcomes are stil limiting. Bone transplantation or bone substitutes like guided bone regeneration, guided tisue regeneration don't have the capacity to regenerate destructed connective tisue. With cel based therapy, numerous growth factors and modulating agents have
used but it made limited suces. Stem cel based therapy is the most active researching field in medical and dental area. However, when diseased periodontal condition, tisue repair does not ocur naturaly because of the lack of sound stem
cels. So exogenous regenerative tols such as ex vivo expanded/manipulated stem cels wil be neded to replenish the host cel niche and facililtate tisue regeneration. As the increasing suces of regenerating other tissues (skin, cartilage, bone, cardiovascular component, pancreas), stem cell based periodontal regeneration with tissue enginee?ring approach can be new field of treatment. Comparing stem cells from other sites of adult body, dental stem cells have advantage that is easy access to gaining site and have characteristics like proliferation, differentiation, and flexiblity. Some kind of reviewed stem cells, dental pulp stem cells (DPSCs), Stem cells from exfoliated deciduous teeth (SHED), PDL stem cells (PDLSCs),
Stem cells from apical papilla, apical papilla stem cells (SCAP), Dental follicle cells (DFCs), and MSCs are most actively studied for stem cell based periodontal regeneration. However, safety problems are not completely examined, and the difficulty of ex vivo proliferation is still recognized to limiatation of stem cells. With effective stem cell delivery strategy, research to overcome these limitations should be continued. With recent advancement of stem cell based periodontal tissue engineering and periodontal regeneration, next step of research should be concentrated to clinical application of this advanced therapeutic method. Accordingly, further studies are required to develop new methods to identify and maintain multipotent stem cells in vitro and to determine the long term safety and efficacy of ex vivo expanded stem cells to repair periodontal defects in large animal models. With partial regeneration of tooth, whole tooth regeneration has
been actively studied. When whole tooth regeneration succeed, regene?rating periodontal ligament and contact of tooth-periodontium are needed to transplant regenerated tooth. So periodontal regeneration is essential step to achieve whole tooth regeneration and replantation.
키워드
dental stem cell; periodontal regeneration; dental pulp stem cells; Stem cells from exfoliated deciduous teeth; PDL stem cells; stem cells from apical papilla; dental follicle cells; bone marrow-derived mesenchymal stem cells; adipose-derived stem cells; embryonic stem cells
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