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Journal of Periodontology Jun 2018To date there is a paucity of documentation regarding definitions of periodontal health. This review considers the histological and clinical determinants of periodontal... (Review)
Review
OBJECTIVES
To date there is a paucity of documentation regarding definitions of periodontal health. This review considers the histological and clinical determinants of periodontal health for both intact and reduced periodontium and seeks to propose appropriate definitions according to treatment outcomes.
IMPORTANCE
Defining periodontal health is can serve as a vital common reference point for assessing disease and determining meaningful treatment outcomes.
FINDINGS
The multifactorial nature of periodontitis is accepted, and it is recognized that restoration of periodontal health will be defined by an individual's response to treatment, taking into account allostatic conditions.
CONCLUSIONS
It is proposed that there are 4 levels of periodontal health, depending on the state of the periodontium (structurally and clinically sound or reduced) and the relative treatment outcomes: (1) pristine periodontal health, with a structurally sound and uninflamed periodontium; (2) well-maintained clinical periodontal health, with a structurally and clinically sound (intact) periodontium; (3) periodontal disease stability, with a reduced periodontium, and (4) periodontal disease remission/control, with a reduced periodontium.
Topics: Gingiva; Humans; Periodontal Diseases; Periodontal Ligament; Periodontitis; Periodontium
PubMed: 29926938
DOI: 10.1002/JPER.16-0517 -
International Journal of Oral Science Jun 2021Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated.... (Review)
Review
Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.
Topics: Humans; Osteoblasts; Osteoclasts; Periodontal Ligament; Periodontium; Root Resorption; Tooth Movement Techniques
PubMed: 34183652
DOI: 10.1038/s41368-021-00125-5 -
Dental Clinics of North America Oct 2022As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore,... (Review)
Review
As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore, regeneration of damaged/lost periodontal tissues has been a major subject in periodontal research. During periodontal tissue regeneration, biomaterials play pivotal roles in improving the outcome of the periodontal therapy. With the advancement of biomaterial science and engineering in recent years, new biomimetic materials and scaffolding fabrication technologies have been proposed for periodontal tissue regeneration. This article summarizes recent progress in periodontal tissue regeneration from a biomaterial perspective. First, various guide tissue regeneration/guide bone regeneration membranes and grafting biomaterials for periodontal tissue regeneration are overviewed. Next, the recent development of multifunctional scaffolding biomaterials for alveolar bone/periodontal ligament/cementum regeneration is summarized. Finally, clinical care points and perspectives on the use of biomimetic scaffolding materials to reconstruct the hierarchical periodontal tissues are provided.
Topics: Biocompatible Materials; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Ligament; Periodontium; Tissue Engineering
PubMed: 36216452
DOI: 10.1016/j.cden.2022.05.011 -
Periodontology 2000 2006
Review
Topics: Alveolar Process; Cementogenesis; Connective Tissue; Dental Cementum; Epithelial Attachment; Humans; Periodontal Diseases; Periodontal Ligament; Periodontium; Regeneration; Wound Healing
PubMed: 16398683
DOI: 10.1111/j.1600-0757.2005.00141.x -
Journal of Clinical Periodontology Jun 2018To date there is a paucity of documentation regarding definitions of periodontal health. This review considers the histological and clinical determinants of periodontal... (Review)
Review
OBJECTIVES
To date there is a paucity of documentation regarding definitions of periodontal health. This review considers the histological and clinical determinants of periodontal health for both intact and reduced periodontium and seeks to propose appropriate definitions according to treatment outcomes.
IMPORTANCE
Defining periodontal health is can serve as a vital common reference point for assessing disease and determining meaningful treatment outcomes.
FINDINGS
The multifactorial nature of periodontitis is accepted, and it is recognized that restoration of periodontal health will be defined by an individual's response to treatment, taking into account allostatic conditions.
CONCLUSIONS
It is proposed that there are 4 levels of periodontal health, depending on the state of the periodontium (structurally and clinically sound or reduced) and the relative treatment outcomes: (1) pristine periodontal health, with a structurally sound and uninflamed periodontium; (2) well-maintained clinical periodontal health, with a structurally and clinically sound (intact) periodontium; (3) periodontal disease stability, with a reduced periodontium, and (4) periodontal disease remission/control, with a reduced periodontium.
Topics: Gingiva; Humans; Periodontal Diseases; Periodontal Ligament; Periodontitis; Periodontium
PubMed: 29926485
DOI: 10.1111/jcpe.12936 -
Tissue Engineering. Part C, Methods Aug 2022Periodontitis is a chronic infectious oral disease with a high prevalence rate in the world, and is a major cause of tooth loss. Nowadays, people have realized that the... (Review)
Review
Periodontitis is a chronic infectious oral disease with a high prevalence rate in the world, and is a major cause of tooth loss. Nowadays, people have realized that the local microenvironment that includes proteins, cytokines, and extracellular matrix has a key influence on the functions of host immune cells and periodontal ligament (PDL) stem cells during a chronic infectious disease such as periodontitis. The above pathological process of periodontitis will lead to a defect of periodontal tissues. Through the application of biomaterials, biological agents, and stem cell therapy, guided tissue regeneration (GTR) makes it possible to reconstruct healthy PDL tissue after local inflammation control. To date, substantial advances have been made in periodontal GTR. However, the process of periodontal remodeling experiences complex microenvironment changes, and currently periodontium regeneration still remains to be a challenging feat. In this review, we summarized the main challenges in each stage of periodontal regeneration, and try to put forward appropriate biomaterial treatment mechanisms or potential tissue engineering strategies that provide a theoretical basis for periodontal tissue engineering regeneration research.
Topics: Biocompatible Materials; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Ligament; Periodontitis; Periodontium; Tissue Engineering
PubMed: 35838120
DOI: 10.1089/ten.TEC.2022.0106 -
Stem Cells Translational Medicine Apr 2019Periodontitis is a widespread disease characterized by inflammation-induced progressive damage to the tooth-supporting structures until tooth loss occurs. The... (Review)
Review
Periodontitis is a widespread disease characterized by inflammation-induced progressive damage to the tooth-supporting structures until tooth loss occurs. The regeneration of lost/damaged support tissue in the periodontium, including the alveolar bone, periodontal ligament, and cementum, is an ambitious purpose of periodontal regenerative therapy and might effectively reduce periodontitis-caused tooth loss. The use of stem cells for periodontal regeneration is a hot field in translational research and an emerging potential treatment for periodontitis. This concise review summarizes the regenerative approaches using either culture-expanded or host-mobilized stem cells that are currently being investigated in the laboratory and with preclinical models for periodontal tissue regeneration and highlights the most recent evidence supporting their translational potential toward a widespread use in the clinic for combating highly prevalent periodontal disease. We conclude that in addition to in vitro cell-biomaterial design and transplantation, the engineering of biomaterial devices to encourage the innate regenerative capabilities of the periodontium warrants further investigation. In comparison to cell-based therapies, the use of biomaterials is comparatively simple and sufficiently reliable to support high levels of endogenous tissue regeneration. Thus, endogenous regenerative technology is a more economical and effective as well as safer method for the treatment of clinical patients. Stem Cells Translational Medicine 2019;8:392-403.
Topics: Animals; Biocompatible Materials; Humans; Periodontal Ligament; Periodontitis; Periodontium; Regeneration; Stem Cells; Tissue Engineering; Wound Healing
PubMed: 30585445
DOI: 10.1002/sctm.18-0181 -
Journal of the American Dental... Oct 1991Current techniques can benefit patients with advanced periodontal disease and oral injuries. Future technology offers even greater promise for regenerating periodontal... (Review)
Review
Current techniques can benefit patients with advanced periodontal disease and oral injuries. Future technology offers even greater promise for regenerating periodontal tissue.
Topics: Biocompatible Materials; Bone Morphogenetic Protein 3; Bone Morphogenetic Proteins; Bone Transplantation; Dental Cementum; Growth Substances; Guided Tissue Regeneration, Periodontal; Humans; Osteogenesis; Periodontal Diseases; Periodontal Ligament; Polytetrafluoroethylene; Proteins
PubMed: 1744346
DOI: 10.14219/jada.archive.1991.0288 -
Journal of Periodontal Research Dec 2017The periodontal ligament (PDL) connects the tooth root and alveolar bone. It is an aligned fibrous network that is interposed between, and anchored to, both mineralized... (Review)
Review
The periodontal ligament (PDL) connects the tooth root and alveolar bone. It is an aligned fibrous network that is interposed between, and anchored to, both mineralized surfaces. Periodontal disease is common and reduces the ability of the PDL to act as a shock absorber, a barrier for pathogens and a sensor of mastication. Although disease progression can be stopped, current therapies do not primarily focus on tissue regeneration. Functional regeneration of PDL may be achieved using innovative techniques, such as tissue engineering. However, the complex fibrillar architecture of the PDL, essential to withstand high forces, makes PDL tissue engineering very challenging. This challenge may be met by studying PDL anatomy and development. Understanding PDL anatomy, development and maintenance provides clues regarding the specific events that need to be mimicked for the formation of this intricate tissue. Owing to the specific composition of the PDL, which develops by self-organization, a different approach than the typical combination of biomaterials, growth factors and regenerative cells is necessary for functional PDL engineering. Most specifically, the architecture of the new PDL to be formed does not need to be dictated by textured biomaterials but can emerge from the local mechanical loading conditions. Elastic hydrogels are optimal to fill the space properly between tooth and bone, may house cells and growth factors to enhance regeneration and allow self-optimization by the alignment to local stresses. We suggest that cells and materials should be placed in a proper mechanical environment to initiate a process of self-organization resulting in a functional architecture of the PDL.
Topics: Alveolar Process; Animals; Guided Tissue Regeneration, Periodontal; Humans; Odontogenesis; Periodontal Ligament; Tooth Root
PubMed: 28635007
DOI: 10.1111/jre.12477 -
Journal of Medical Microbiology Apr 2022Periodontitis is initiated by hyper-inflammatory responses in the periodontal tissues that generate dysbiotic ecological changes within the microbial communities. As a... (Review)
Review
Periodontitis is initiated by hyper-inflammatory responses in the periodontal tissues that generate dysbiotic ecological changes within the microbial communities. As a result, supportive tissues of the tooth are damaged and periodontal attachment is lost. Gingival recession, formation of periodontal pockets with the presence of bleeding, and often suppuration and/or tooth mobility are evident upon clinical examination. These changes may ultimately lead to tooth loss. Mesenchymal stem cells (MSCs) are implicated in controlling periodontal disease progression and have been shown to play a key role in periodontal tissue homeostasis and regeneration. Evidence shows that MSCs interact with subgingival microorganisms and their by-products and modulate the activity of immune cells by either paracrine mechanisms or direct cell-to-cell contact. The aim of this review is to reveal the interactions that take place between microbes and in particular periodontal pathogens and MSCs in order to understand the factors and mechanisms that modulate the regenerative capacity of periodontal tissues and the ability of the host to defend against putative pathogens. The clinical implications of these interactions in terms of anti-inflammatory and paracrine responses of MSCs, anti-microbial properties and alterations in function including their regenerative potential are critically discussed based on literature findings. In addition, future directions to design periodontal research models and study the microbial-stem cell interactions are introduced.
Topics: Cell Communication; Humans; Mesenchymal Stem Cells; Periodontal Ligament; Periodontitis; Stem Cells
PubMed: 35451943
DOI: 10.1099/jmm.0.001503