Periodontal Regenerative Materials and Their Applications: Mechanisms of Action
Una El-Shinnawi and Mena Soory
Affiliation: Periodontology, King’s College London Dental Institute, Denmark Hill, London SE5 9RW, UK.
Barrier membrane technology, gene delivery and stimulatory proteins for cell growth and metabolism are potential
methods for enhancing periodontal regeneration. Factors that contribute to growth and differentiation of connective
tissue and bone regulate diverse cells of periodontal origin. Although these agents have significant appeal in promoting
periodontal wound healing and bone regeneration, the outcome of current methods may be attenuated in an inflammatory
environment. Focused generation of required components for periodontal regeneration is a challenge in the context of molecular
redundancy associated with multiple isoforms. Epithelial / mesenchymal tissue interactions are closely modulated
by several pleiotropic actions of soluble molecular signals in mineralized and non-mineralized tissues. Significant advances
in regenerative tissue engineering rely on fine tuning of activity profiles of redundant isoforms of human osteogenic
proteins towards more streamlined activity. Accurate dissemination of active agents to connective tissue and
bone, underscores regenerative procedures. Targeted therapy comprising slow release devices, loaded scaffolds, fillers and
vehicular microcapsules, delivers stimulatory agents over critical temporal phases of wound healing. Techniques for tissue
engineering and gene therapy enhance expansion of cell populations and protein expression. Applications for growth
stimulatory factors delivered via barriers, scaffolds, cell sheets and other variants have been addressed alongside recent
patents in this context; which pave the way for future applications with more consistent outcome in the human subject.
Keywords: Barrier membranes, biological printing, biomaterials, cell sheets, gene therapy, growth factors, periodontal regeneration,
scaffolds, stem cells.
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