全脱位再植牙牙周组织再生的研究进展

Research progress on periodontal regeneration of replanted teeth after complete avulsion

全脱位牙是牙外伤中最严重的一种,目前临床首选的治疗方法是牙再植术。由于患牙通常不能及时就诊,导致牙根表面牙周膜坏死,牙再植成功率大大降低。如何利用种子细胞、相关调节因子以及支架材料的应用促进牙周组织再生,提高再植牙的牙周膜愈合,实现全脱位牙成功再植是当下急需解决的难题。牙周膜干细胞(periodontal ligament stem cells,PDLSCs)表达干细胞标记物,具有多细胞分化潜能,在牙周组织再生修复方面有重要的应用价值;成纤维细胞生长因子-2(fibroblast growth factor-2,FGF-2)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)、溶血磷脂酸(lysobisphosphatidic acids,LPA)等相关调节因子对牙周组织再生具有促进作用。种子细胞结合支架材料,能更好地促进牙周组织再生,修复牙周组织缺损。目前研究已经表明PDLSCs等种子细胞具有牙周组织再生潜能,在牙周炎与牙周骨缺损的实验动物模型中也有了广泛的研究,但是在全脱位再植牙的应用中报道较少且机制尚不明确,本文就全脱位再植牙牙周组织再生的研究进展作一综述,以期将牙周组织再生的研究应用于全脱位牙再植中,实现全脱位再植牙的牙周膜愈合,为今后的临床工作提供理论依据。

Complete avulsion of teeth are one of the most serious traumatic dental injuries.The preferred treatment is tooth replantation.When teeth usually cannot be treated in time,the periodontal membrane on the root surface becomes necrotic,and the success rate of replantation is greatly reduced.How to use seed cells,growth factors and scaffold materials to promote periodontal tissue regeneration,improve periodontal membrane healing of replanted teeth,and achieve successful replantation of completely dislocated teeth is an urgent problem.Periodontal ligament stem cells(PDLSCs)express stem cell markers,have the potential to undergo multicellular differentiation and have important application value in periodontal tissue regeneration and repair.Fibroblast growth factor-2(FGF-2),basic fibroblast growth factor(bFGF),lysobisphosphatidic acids(LPA)and other related regulatory factors promote periodontal tissue regeneration.Seed cells combined with scaffold materials can promote periodontal tissue regeneration and repair periodontal tissue defects.At present,studies have shown that PDLSCs and other seed cells have the potential for periodontal tissue regeneration and have been widely studied in experimental animal models of periodontitis and bone defects.However,there are few reports on the application of replanted teeth after complete avulsion,and its mechanism is not clear.In this paper,the research progress of periodontal tissue regeneration after total dislocation replantation is reviewed.We expect to apply periodontal tissue regeneration research to the replantation of fully dislocated teeth to achieve periodontal membrane healing of fully dislocated replanted teeth to provide a theoretical basis for future clinical work.