牙源性干细胞在牙周组织再生中的作用

The Role of Odontogenic Stem Cells in Periodontal Tissue Regeneration

摘要: 牙周炎，又称破坏性牙周病，其病因在于牙菌斑中的细菌对牙周组织的侵袭，从而引发一种慢性炎症反应。这一病理过程可能导致牙周支持组织(包括牙根、牙周膜、牙槽骨和牙骨质)遭受破坏，进一步引发牙周袋的形成，并伴随着炎症的加重、附着丧失以及牙槽骨的吸收。尽管通过规范的基础治疗可以有效地将炎症控制在最低水平，并通过手术治疗清除病变组织，但牙周组织的修复与再生仍然是当前治疗的难点所在。20世纪80年代，提出了引导性组织再生术，但引导性组织再生术治疗的把握性及预期性不佳。临床还常用骨粉植入促进牙槽骨生成，虽然可以修复牙周炎造成的牙槽骨缺损，但自体骨取材创伤大且再生效果不易预测；异体骨很难兼具骨引导、骨诱导和植入安全性。因此，牙周组织的再生在临床中面临着巨大的挑战。目前，干细胞因其卓越的自我更新与分化潜能，在牙周疾病的治疗中得到了广泛应用。在特定条件下，干细胞能够分化为成骨细胞，与生物材料和生长因子相结合，共同促进牙周组织的再生。此外，自体细胞移植不仅具有较高的安全性，而且在实际操作中展现出了显著的可行性。这种治疗策略为牙周疾病的康复提供了新的可能性。本文就牙源性间充质干细胞(DSCs)在牙周组织再生中的应用展开综述，聚焦于DSCs在牙周组织再生中的研究进展，总结DSCs的供体来源、如何高效保存及应用效率的研究现状及局限，为DSCs的前期研究和精准有效的临床应用提供思路。

Abstract: Periodontitis, also known as destructive periodontal disease, is caused by the invasion of bacteria in dental plaque into periodontal tissue, leading to a chronic inflammatory response. This pathological process may lead to the destruction of periodontal support tissues (including roots, periodontal membranes, alveolar bone, and cementum), further triggering the formation of periodontal pockets, accompanied by worsening inflammation, loss of attachment, and absorption of alveolar bone. Although standardized basic treatment can effectively control inflammation to the lowest level and remove diseased tissue through surgical treatment, the repair and regeneration of periodontal tissue remains the current challenge in treatment. In the 1980s, guided tissue regeneration surgery was proposed, but its treatment accuracy and predictability were poor. Bone powder implantation is commonly used in clinical practice to promote alveolar bone formation. Although it can repair alveolar bone defects caused by periodontitis, autologous bone extraction has significant trauma and the regeneration effect is difficult to predict; allogeneic bone is difficult to achieve both bone guidance, bone induction, and implant safety. Therefore, the regeneration of periodontal tissue faces significant challenges in clinical practice. At present, stem cells have been widely used in the treatment of periodontal diseases due to their excellent self-renewal and differentiation potential. Under specific conditions, stem cells can differentiate into osteoblasts and combine with biomaterials and growth factors to promote periodontal tissue regeneration. In addition, autologous cell transplantation not only has high safety, but also demonstrates significant feasibility in practical operations. This treatment strategy provides new possibilities for the rehabilitation of periodontal diseases. This article provides a review of the application of dental derived mesenchymal stem cells (DSCs) in periodontal tissue regeneration, focusing on the research progress of DSCs in periodontal tissue regeneration. It summarizes the research status and limitations of donor sources, efficient preservation, and application efficiency of DSCs, providing ideas for the preliminary research and precise and effective clinical application of DSCs.