Biomedical Engineering Reference
In-Depth Information
Chapter 2
The Cell-Multilayered Periosteal Sheet — A Promising
Osteogenic and Osteoinductive Grafting Material
Tomoyuki Kawase, Kazuhiro Okuda,
Masaki Nagata and Hiromasa Yoshie
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/58902
1. Introduction
The present is an exciting time in the field of regenerative biology in dental medicine. Many
basic and clinical studies have been performed to improve periodontal therapy and rehabili‐
tation therapy for morphological and functional recovery of the maxillofacial bones. Many
materials, e.g., hydroxyapatite, GTR membrane, enamel matrix derivative, and platelet-rich
plasma, have been applied to osseous defects to achieve significant outcomes. In contrast, cell
therapy, as an advanced tissue-engineering technology, using bone marrow stem cells,
periosteal cells, or periodontal ligament cells have just been started in several university
hospitals and institutes in Japan.
The periosteum has been recognized as a promising source of immature osteogenic progenitor
cells. Osteogenic cells are important components as a promoter of bone regenerative therapy
because their bioactivities are crucial to reconstituting an active site of controlled bone
formation. We demonstrated that implantation of cultured periosteal sheets into nude mice
could induce the formation of bone-like tissue [Kawase
et al
., 2009]. In addition, we established
regenerative surgery with autologous cultured periosteal sheets in combination with platelet-
rich plasma (PRP) and hydroxyapatite (HA) in periodontitis patients (Fig. 1) [Yamamiya
et
al
., 2008, Okuda
et al
.,2013]. Furthermore, we reported remarkable bone remodeling in reduced
alveolar bone from autologous bone grafting with cultured periosteal sheets [Nagata
et al
.,
2012].
In this chapter, we will introduce the characteristics of periosteal sheets and clinical outcome
by cell-based therapy in patients with periodontitis and alveolar jaw reduction. In addition,
future perspectives on regenerative therapy will be described.
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