Category:

Growth Factors and Periodontal Regeneration

Learning Objectives

After completing this course you’ll be able to:

  1. Define the difference between repair and regeneration.
  2. Discuss the potential for periodontal tissues to undergo repair versus regeneration.
  3. Discuss the concepts of oral wound healing in periodontics.
  4. Understand the role of growth and differentiation factors in periodontal regeneration.
  5. Discuss the principles of the biology of wound healing.
  6. Understand the molecular and cell biology of cementum.
  7. Discuss the role of cementum in periodontal wound healing and regeneration.
  8. Understand the role of growth factors as indicators of periodontal disease activity.
  9. Discuss the methods available to deliver growth factors to sites of periodontal disease.
  10. Discuss the future use of gene therapy to target growth factors to periodontal tissues.
  11. Discuss how human derived dental stem cells might have potential use in the future.
  12. Discuss the use of stem cells in periodontal regeneration.
  13. Discuss the impact of growth factors and cytokines on the differentiation of osteoblasts.
  14. Discuss the regulation and interaction of growth factor pathways.

Course Contents

1. Potential for Repair of Periodontal Tissues

  • Gingiva
  • Response of Bone to Wounding
  • Alveolar Process, Periodontal Ligament and Cementum
  • Interaction Between Cells of Periodontal Tissues

2. Biology of Periodontal Wound Healing

  • General Concepts of Wound Healing
    • Regeneration and Repair
    • Cells: Labile, Table, and Permanent
    • Healing Process
  • Healing in the Periodontium
    • Healing of the Supracrestal Gingival Tissue Involved in Gingivitis
    • Healing of the Aupracrestal and Aubcrestal Periodontal Tissues Involved in Periodontitis
    • The Fibrin Clot and Inflammatory Cells
    • Re-Epithelialization of Wounds
    • Matrix Degradation and the Wound-Cleaning Process
    • Granulation Tissue and Contraction of the Wound
    • Angiogenesis of wounds
  • Treatments for Periodontal Tissue Regeneration Based on the Concepts of Wound Healing in Periodontology
  • Applied Clinical Aspects and Future Approaches to Enhance Wound Healing
  • Conclusion

3. Potential Role of Growth and Differentiation Factors in Periodontal Regeneration

  • Review of Growth and Differentiation Factors (GDFs)
  • Growth and Differentiation Factors in Wound Healing of Periodontal Soft Tissues
  • Platelet-Derived Growth Factor-AA,-AB,-BB
  • Transforming Growth Factor-β (TGF-β1)
  • Basic Fibroblast Growth Factor (bFGF)
  • Epidermal Growth Factor (EGF)
  • Insulin-Like Growth Factors (IGF-I and -II)
  • Cementum-Derived Growth Factor (CGF)
  • Bone Morphogenetic Proteins (BMPs)
  • Effects of Growth and Differentiation Factors on Bone and Cementum Regeneration
  • Platelet-Derived Growth Factor (PDGF)
  • Transforming Growth Factor-β (TGF-β1)
  • Fibroblast Growth Factors (a- and b-FGF)
  • Insulin-Like Growth Factors (IGF-I and IGF-II)
  • Parathyroid Hormone-Related Protein (PTHrP)
  • Bone Morphogenetic Proteins (BMPs)
  • Preclinical and Clinical Studies on Periodontal Regeneration
    • Growth Factors
    • Bone Morphogenetic Proteins (BMPs)
  • Future Perspectives

4. Molecular and Cell Biology of Cementum

  • Regulation of Cementogenesis
    • Overview: Events, Cells and Factors Associated with Cementum
    • Factor-Mediated Cell Activities
    • Receptor Tyrosine Kinases
    • G-Protein-Coupled Receptors
    • Serine-Threonine Receptor Kinases
    • Integrins
    • Regenerative Therapies and Cementogenesis in Vivo
    • Therapies Based on Platelet-Derived Growth Factor and Insulin-Like Growth Factor
    • Transforming Growth Factor-Beta Family Members: (Bone Morphogenetic Proteins) BMP 2, BMP 3 (Osteogenin), BMP 4, and BMP 7 (OP-1)
    • Enamel Matrix Derivative
    • Delivery Systems
    • Models to Study Cementogenesis
    • In Vitro Models
    • In Vivo: Genetically Engineered Animals
    • Cell Applications: Regional Gene Therapy
    • Future Directions: Unknowns

5. Cementum, Periodontal Wound Healing and Regeneration

  • Wound-Healing Events
  • Factors that Determine Whether Wounds Heal by Regeneration or Repair
  • Regulation by the Local Environment
  • Local Factors in Periodontal Healing
  • Biology of Cementum
  • Possible Role of Cementum in Periodontal Regeneration
  • Models of Cementoblastic Cells and Their Potential Application for Developing New Strategies for Periodontal Regeneration

6. Growth Factors as Indicators of Periodontal Disease Activity

7. Treatment of Periodontal Disease with Growth Factors

  • Platelet-Derived Growth Factor for Gene Delivery
  • Subantimicrobial Dose Doxycycline and Transforming Growth Factor-Beta 1
  • Growth Factor Delivery to Re-Engineer Periodontal Tissues
    • Periodontal Diseases
    • Growth Factor Delivery For Tissue Engineering
    • Growth Factors: Biological Properties and Applications for Periodontal Tissue Regeneration
    • Platelet-Derived Growth Factor
    • Insulin-Like Growth Factors (IGFS)
    • Fibroblast Growth Factors (FGFS)
    • Transforming Growth Factor Beta Family Members and Bone Morphogenetic Proteins (BMPS)
    • Enamel Matrix Proteins
    • Future Considerations: Gene Therapy to Target Growth Factors to Periodontal Tissues

8. Stem Cells and Periodontal Regeneration

  • Identification of Stem Cells in the Periodontium
  • Growth Potential in Periodontal Ligament Stem Cells
  • Characterization and Origin of Periodontal Stem Cells
  • Differentiation Potential of Periodontal Ligament Stem Cells
  • Periodontal Therapies for Periodontal Regeneration
  • Cell Seeding and Tissue Engineering
  • Potential Clinical Applications for Human Ddental Stem Cells

9. Influence of Growth Factors, Cytokines, and Osteoblast Differentiation

  • Osteoblast Lineage and Function
    • The Osteoblast Phenotype
    • The Osteoblast Lineage
  • The Effects of Growth Factors on Osteoblast Differentiation
    • Transforming Growth Factor-β
    • Bone Morphogenetic Proteins
    • Fibroblast Growth Factor
    • Platelet-Derived Growth Factor
    • Insulin-Like Growth Factors
    • Wnt Signaling
    • Other Growth Factors
    • Enamel Matrix Derivatives
  • Effects of Inflammatory Cytokines on Osteoblast Differentiation
    • Interleukin-1
    • Regulation of Osteoclastogenesis and Bone Resorption by the Osteoblast
    • Other Inflammatory Cytokines
  • Regulation and Interaction of Growth Factor Pathways
    • Therapeutic Application of Growth Factors for Bone Regeneration
    • Platelet-Derived Growth Factor and Periodontal Regeneration
    • Other Growth Factors
    • Conclusion

10. Growth Factors and Pro- and Anti-Inflammatory Properties in Platelet-Rich Plasma

11. Summary

  • Referencs
  • Appendix
    • Definitions
    • Table and Figures