TISSUE ENGINEERING AND ANTI-AGING - Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine - page 728

ability to bind water increases. Our method was based on the
hypothesis that a long-lasting correction can be achieved with HA
combinedwithculturedhumanfibroblastscomparedwithHAalone.
Aging is a complex process having pathologic similarities to
skin wounds. 10 Fibroblasts play key roles in this process as they
interact with keratinocytes, fat cells, and mast cells. They are the
source of ECM proteins, glycoproteins, adhesive molecules, and
various cytokines. 11 By supplying these molecules and support-
ing cell-to-cell interactions, fibroblasts contribute to the fibroblast-
keratinocyte-endothelium complex that accelerates wound repair
and maintains skin integrity and youthfulness. Conventional treat-
ments of skin aging, such as laser and topical regimens, are mostly
based on increasing ECM synthesis via fibroblast activation. Wound
healing and skin rejuvenation from aging are a complex but orderly
process and are orchestrated via cytokines and growth factors.
These cytokines do not operate in isolation but rather interact with
a variety of cytokines, as well as other regulatory proteins. Five
major growth factor families have been studied with regards to the
wound-healing process: transforming growth factor (TGF), insulin-
like growth factor (IGF), platelet-derived growth factor (PDGF),
epithelialgrowthfactor(EGF),andfibroblastsgrowthfactor.Growth
factors released from platelets initiate this cascade, and continued
secretion of growth factors by inflammatory cells, fibroblasts, and
epithelial cells maintains this process. 12 The most significant skin
rejuvenation process for aging is collagen remodeling, and the cell
that is most important in the production of collagen remodeling
is the dermal fibroblast. Collagen synthesis by fibroblasts is stimu-
lated by a variety of growth factors, including IGF, EGF, interleukin-
1, and tumor necrosis factor-

α β

appears to be
the most potent stimulator. In summary, 13 , 14 it has been demon-
stratedthatfibroblastshaveanantiwrinkleeffect,anditisenhanced
by HA.

,but in vivo TGF-

35.4.2 Wrinkle Treatment in Dentistry
Dental implants have revolutionized the field of dentistry. Due to
their ability to preserve bone and provide proper emergence pro-
files, dental implants are usually the ideal treatment option in the