Dilek BİNGÖL, Erkan Işıl Saygun Sağlık Bilimleri Üniversitesi, Gülhane Diş Hekimliği Fakültesi, Periodontoloji Anabilim Dalı, ÖZCAN, Işıl SAYGUN

Periodontal tedavide kök hücre uygulamaları

Periodontal tedavinin amacı inflamasyonu ortadan kaldırmak, doku yıkımını durdurmak, kaybedilen kemik desteği ve yumuşak dokuyu tekrar kazanmak ve kalan dişlerin stabilitesini korumak veya tekrar sağlamaktır. Geleneksel periodontal tedaviler ile kaybolan periodontal dokularda morfolojik ve fizyolojik olarak istenilen düzeyde rejenerasyon elde edilmesinde birçok zorluklar bulunmaktadır. Kök hücreler sert ve yumuşak dokuları oluşturan çoklu hücre tiplerine diferansiye olabilme ve kendi kendilerini yenileyebilme özellikleriyle tıp ve diş hekimliğinde rejeneratif tedavilerde endojen hücre kaynakları olarak ümit vaat etmektedir. Bu nedenle periodontal dokuların yara iyileşme süreçlerine doğrudan rehberlik ettiğine inanılan kök hücre uygulamalarına yönelik araştırmalar her geçen gün artmaktadır. Bu derlemede, güncel literatür taranarak kök hücrelerin tanı kriterleri ve sınıflandırılması özetlenmiştir. Dental pulpal kök hücreler, periodontal ligament kök hücreleri, gingival mezenkimal kök hücreler, eksfoliye olan süt dişlerinden elde edilen kök hücreler, dental folikül kaynaklı kök hücreler, adipoz doku kök hücreleri, umbilikal kord kök hücreleri ile ilgili klinik ve deneysel çalışmalara genel bir bakış sunulmaktadır. Doku rejenerasyonu için kök hücrelerin kullanımına ilişkin araştırmalar, gelecekteki periodontal tedavi stratejilerini önemli ölçüde etkileme potansiyeline sahiptir. Anahtar Kelimeler: Periodontitis, rejenerasyon, kök hücre

Anahtar Kelimeler:

Periodontitis, rejenerasyon, kök hücre

Periodontal tedavide kök hücre uygulamaları

Keywords:

Periodontitis, rejenerasyon, kök hücre,

PDF

___

1. Newman, Michael G, Henry, H Takei, Perry R, Klokkevold, Fermin A Carranza. Carranza's clinical periodontology. 13th. 2019. p. 89
2. G Polimeni, A V Xiropaidis, U. M. E. Wikesjö. Biology and principles of periodontal wound healing/regeneration. Periodontology 2000. 2006;41:30–47
3. A Bongso and M Richards. History and perspective of stem cell research. Best Practice and Research: Clinical Obstetrics and Gynaecology. 2004;18:827–842
4. J A Thomson. Embryonic stem cell lines derived from human blastocysts. Science. 1998;282:145–1147. doi: 10.1126/science.282.5391.1145.
5. X Duan et al. Application of induced pluripotent stem (iPS) cells in periodontal tissue regeneration. J Cell Physiol. 2011;226:150–157. doi: 10.1002/jcp.22316.
6. J Dulak, K Szade, A Szade, W Nowak et al. Adult stem cells: Hopes and hypes of regenerative medicine. Acta Biochimica Polonica. 2015;62:329–337. doi: 10.18388/abp.2015_1023.
7. M Dominici et al.. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006;8:315–317. doi: 10.1080/14653240600855905.
8. P Bianco, P G Robey, and PJ Simmons. Mesenchymal Stem Cells: Revisiting History, Concepts, and Assays. Cell Stem Cell. 2008;2:313–319. doi: 10.1016/j.stem.2008.03.002.
9. J Li et al. Treatment of gingival defects with gingival mesenchymal stem cells derived from human fetal gingival tissue in a rat model. Stem Cell Res. Ther. 2018;9:1–8. doi: 10.1186/s13287-017-0751-7.
10. S S Hakki et al. Comparison of Different Sources of Mesenchymal Stem Cells: Palatal versus Lipoaspirated Adipose Tissue. Cells Tissues Organs. 2017;204:228–240. doi: 10.1159/000478998.
11. N Wei et al. Auto-transplanted mesenchymal stromal cell fate in periodontal tissue of beagle dogs. Cytotherapy. 2010;12:514–521. doi: 10.3109/14653241003709702.
12. S Gronthos, M Mankani, J Brahim, P G Robey, S Shi. Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo. Proc Natl Acad Sci U S A. 2000;97:13625–13630. doi: 10.1073/pnas.240309797.
13. A Queiroz, E Albuquerque-Souza, L M Gasparoni. World J Stem Cells. Therapeutic potential of periodontal ligament stem cells. 2021;13:605-618
14. M Miura et al. SHED: Stem cells from human exfoliated deciduous teeth. Proc Natl Acad Sci U S A. 2003;100:5807–5812, doi: 10.1073/pnas.0937635100.
15. W Guo et al. Dental follicle cells and treated dentin matrix scaffold for tissue engineering the tooth root. Biomaterials. 2012;33:1291–1302. doi: 10.1016/j.biomaterials.2011.09.068.
16. M Oshima et al. Functional tooth restoration by next-generation bio-hybrid implant as a bio-hybrid artificial organ replacement therapy. Sci Rep. 2014;4:1–10. doi: 10.1038/srep06044.
17. E Özcan, S Atuğ Özcan. Periodontal Rejenerasyonda Kök Hücrenin Yeri. J Dent Fac Atatürk Uni. 2010;20:123-130L
18. Tomasello et al. Mesenchymal stem cells derived from inflamed dental pulpal and gingival tissue: A potential application for bone formation. Stem Cell Res Ther. 2017;1:179 doi: 10.1186/s13287-017-0633-z.
19. M Tobita, C A Uysal, X Guo, H Hyakusoku, H Mizuno. Periodontal tissue regeneration by combined implantation of adipose tissue-derived stem cells and platelet-rich plasma in a canine model. Cytotherapy. 2013;15:1517–1526. doi: 10.1016/j.jcyt.2013.05.007.
20. D Akita et al. Use of rat mature adipocyte-derived dedifferentiated fat cells as a cell source for periodontal tissue regeneration. Front Physiol. 2016;7:50 doi: 10.3389/fphys.2016.00050.
21. L Lu, Y Liu, X Zhang, J Lin. The therapeutic role of bone marrow stem cell local injection in rat experimental periodontitis. J Oral Rehabil. 2020;1:73-82 doi: 10.1111/joor.12843.
22. K Ito, Y Yamada, S Nakamura, M Ueda. Osteogenic potential of effective bone engineering using dental pulp stem cells, bone marrow stem cells, and periosteal cells for osseointegration of dental implants. Int. J Oral Maxillofac Implants. 2011;26:947–54
23. F Asutay, S Polat, M Gül, C Subaşi, S A Kahraman, E Karaöz. The effects of dental pulp stem cells on bone regeneration in rat calvarial defect model: Micro-computed tomography and histomorphometric analysis. Arch Oral Biol. 2015;60:1729–1735. doi: 10.1016/j.archoralbio.2015.09.002.
24. Y Cao et al. Adenovirus-mediated transfer of hepatocyte growth factor gene to human dental pulp stem cells under good manufacturing practice improves their potential for periodontal regeneration in swine. Stem Cell Res Ther. 2015;6:249. doi: 10.1186/s13287-015-0244-5.
25. J Hu et al. Periodontal regeneration in swine after cell injection and cell sheet transplantation of human dental pulp stem cells following good manufacturing practice. Stem Cell Res Ther. 2016;7:1–11. doi: 10.1186/s13287-016-0362-8.
26. D Menicanin et al. Periodontal-ligament-derived stem cells exhibit the capacity for long-term survival, self-renewal, and regeneration of multiple tissue types in vivo. Stem Cells Dev. 2014;23:1001–1011. doi: 10.1089/scd.2013.0490.
27. F Shang et al. Human umbilical cord mscs as new cell sources for promoting periodontal regeneration in inflammatory periodontal defect. Theranostics. 2017;7:4370. doi: 10.7150/thno.19888.
28. H Shi, W Zong, X Xu, and J Chen. Improved biphasic calcium phosphate combined with periodontal ligament stem cells may serve as a promising method for periodontal regeneration. Am J Transl Res. 2020;10:4030–4041.
29. L Winning, I A El Karim, F Lundy. A Comparative Analysis of the Osteogenic Potential of Dental Mesenchymal Stem Cells. Stem Cells Dev. 2019;28:1050–1058. doi: 10.1089/scd.2019.0023.
30. A Jahanbin et al. Success of Maxillary Alveolar Defect Repair in Rats Using Osteoblast-Differentiated Human Deciduous Dental Pulp Stem Cells. J. Oral Maxillofac Surg. 2016;74:829. doi: 10.1016/j.joms.2015.11.033.
31. K M Fawzy El-Sayed et al. Periodontal regeneration employing gingival margin-derived stem/progenitor cells in conjunction with IL-1ra-hydrogel synthetic extracellular matrix. J Clin Periodontol. 2015;42:448–457. doi: 10.1111/jcpe.12401.
32. S Baba et al. Phase I/II Trial of Autologous Bone Marrow Stem Cell Transplantation with a Three-Dimensional Woven-Fabric Scaffold for Periodontitis. Stem Cells Int. 2016;2016:6205910 doi: 10.1155/2016/6205910.
33. Y Yamada et al. Injectable bone tissue engineering using expanded mesenchymal stem cells. Stem Cells. 2013;31:572–580. doi: 10.1002/stem.1300.
34. S C L Corrêa et al. Use of bone allograft with or without bone marrow aspirate concentrate in appositional reconstructions: A tomographic and histomorphometric study. Implant Dent. 2017;26:915–921. doi: 10.1097/ID.0000000000000669.
35. F Du et al. Bone Marrow Mononuclear Cells Combined with Beta-Tricalcium Phosphate Granules for Alveolar Cleft Repair: A 12-Month Clinical Study. Sci Rep 2017;7. doi: 10.1038/s41598-017-12602-1.
36. R D Aquino et al. Human mandible bone defect repair by the grafting of dental pulp stem/progenitor cells and collagen sponge biocomplexes. Eur Cells Mater. 2009;2:75–83. doi: 10.22203/eCM.v018a07.
37. A Giuliani et al. Three Years After Transplants in Human Mandibles, Histological and In-Line Holotomography Revealed That Stem Cells Regenerated a Compact Rather Than a Spongy Bone: Biological and Clinical Implications. Stem Cells Transl Med. 2013;2:316–324. doi: 10.5966/sctm.2012-0136.
38. M Monti et al. In Vitro and In Vivo Differentiation of Progenitor Stem Cells Obtained After Mechanical Digestion of Human Dental Pulp J Cell Physiol. 2017;232:548–555. doi: 10.1002/jcp.25452.
39. F Ferrarotti et al. Human intrabony defect regeneration with micrografts containing dental pulp stem cells: A randomized controlled clinical trial. J Clin Periodontol. 2018;45:841–850. doi: 10.1111/jcpe.12931.
40. Y Li et al. Repair of human periodontal bone defects by autologous grafting stem cells derived from inflammatory dental pulp tissues. Stem Cell Res Ther. 2016;7:141. doi: 10.1186/s13287-016-0404-2.
41. F Feng et al. Utility of PDL progenitors for in vivo tissue regeneration: A report of 3 cases. Oral Dis. 2010;16:20–28. doi: 10.1111/j.1601-0825.2009.01593.x.
42. F M Chen et al. Treatment of periodontal intrabony defects using autologous periodontal ligament stem cells: a randomized clinical trial. Stem Cell Res Ther. 2016;7:33. doi: 10.1186/s13287-016-0288-1.
43. N Sánchez et al. Periodontal regeneration using a xenogeneic bone substitute seeded with autologous periodontal ligament‐derived mesenchymal stem cells: A 12‐month quasi‐randomized controlled pilot clinical trial. J Clin Periodontol. 2020;47:1391–1402. doi: 10.1111/jcpe.13368.
44. K Zanwar, K Kumar Ganji, M L Bhongade. Efficacy of Human Umbilical Stem Cells Cultured on Polylactic/ Polyglycolic Acid Membrane in the Treatment of Multiple Gingival Recession Defects: a Randomized Controlled Clinical Study. J Dent. 2020;18:95–103.
45. K Mesimäki et al. Novel maxillary reconstruction with ectopic bone formation by GMP adipose stem cells. Int J Oral Maxillofac Surg. 2009;38:201–209. doi: 10.1016/j.ijom.2009.01.001.
46. A A Kulakov et al. Clinical study of the efficiency of combined cell transplant on the basis of multipotent mesenchymal stromal adipose tissue cells in patients with pronounced deficit of the maxillary and mandibulary bone tissue. Bull Exp Biol Med. 2008;146:522-5. doi: 10.1007/s10517-009-0322-8.