Biomedical Engineering Reference
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chips contain not only living cells, but bone precursor cells and SCs depending
from where in the alveolar bone the material is taken (Tobiasch, unpublished).
In addition, pre-treatment of the patient with antibiotics, as is common anyway,
reduces the contamination of the material to levels found in other tissues as well.
Thus, this material is a good and autologous source for stem and precursor cells to
stabilize implants without additional surgical interventions.
Even modern approaches such as guided tissue regeneration, bioactive proteins
alone or loaded on scaffolds, and replacement materials with or without cells, are
only moderately successful. Depending on which of the questions given above
should be addressed, specific lineage-committed SCs and innovative scaffolds
must be developed, in addition considering clinical handling and surgical proce-
dures for an implementation in clinical periodontology and dental surgery in the
future.
6 Future Developments
Great hopes have arisen in the last couple of years for SC-derived new therapies
for various diseases of genetic or degenerative or even infectious origin. The
question is whether this hype has an underlying hope and what can be expected in
the future.
The authors are reminded of a comparable hype 20 years ago: gene therapy.
There, a similar excitement suddenly vanished when the death of a patient, Jesse
Gelsinger, in a clinical trial caused the cessation of clinical trials worldwide,
followed by a huge general decline in interest and therefore also in money for
scientific research in this field. What was the cause? Big promises had been made
that this technique could, for the first time, lead not only to the treatment of genetic
diseases but also their cure. This statement, although true in general, was followed
by enormous excitement and hope in the population, which led to more money for
this research, but also to more pressure for fast results. But results cannot be forced
in science and the delay in positive outcomes of trials ultimately led to a disap-
pointment. A similar story can be seen at present in SC research. A lot of effort and
money is spent and the population expects visible effects soon. More than 3,000
clinical trials, mainly in phase I or II, are being performed at the moment for the
use of SCs to treat various diseases. Most of them are for cancer ([2,500) but all
kinds of illnesses such as cardiovascular diseases, diabetes, stroke, multiple
sclerosis, amyotrophic lateral sclerosis (ALS), and others are addressed as well.
In general, they mostly show a clinical improvement, often with an early onset of
positive progress, but more often than not these positive results are only short-term
and even when they lead to a prolongation of life they do not show the long-term
effects which scientists have been hoping for. A closer look at the effects reveals
that the SCs mainly have a diffuse stimulatory effect on the neighboring cells,
whose underlying mechanism(s) cannot be pinpointed exactly at the moment.
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