Guided Tissue Regeneration.

219 Pages·2017·4.628 MB·English

by  Angelo Cintra, Luciano Tavares

CELL BIOLOGY RESEARCH PROGRESS

G T R
UIDED ISSUE EGENERATION

P , H E
ROCEDURES EALTH FFECTS
L -T O
AND ONG ERM UTCOMES
C B R P
ELL IOLOGY ESEARCH ROGRESS

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CELL BIOLOGY RESEARCH PROGRESS

G T R
UIDED ISSUE EGENERATION

P , H E
ROCEDURES EALTH FFECTS
L -T O
AND ONG ERM UTCOMES

LUCIANO TAVARES ANGELO CINTRA
EDITOR
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ISBN: (cid:28)(cid:26)(cid:27)(cid:16)(cid:20)(cid:16)(cid:24)(cid:22)(cid:25)(cid:20)(cid:20)(cid:16)(cid:25)(cid:24)(cid:27)(cid:16)(cid:27)(cid:3)(cid:11)(cid:72)(cid:37)(cid:82)(cid:82)(cid:78)(cid:12)

Published by Nova Science Publishers, Inc. † New York
CONTENTS

Preface vii
Chapter 1 Regeneration of the Pulp-Dentin Complex 1
João E. Gomes-Filho, Paulo C. T. Duarte,
Carolina S. Lodi, Gustavo Sivieri-Araújo,
Rogério de C. Jacinto, Elói Dezan-Júnior and
Luciano T. A. Cintra
Chapter 2 Growth Factors in Guided Tissue Regeneration 29
Renata O. Samuel, João E. Gomes-Filho, Gustavo
Sivieri-Araújo, Rogério de C. Jacinto,
Elói Dezan-Júnior and Luciano T. A. Cintra
Chapter 3 The Role of Platelet-Rich Plasma in
Guided Tissue Regeneration 49
Mariane M. Azuma, Luiz C. de O. Rocha,
Pedro F. E. Bernabé and Luciano T. A. Cintra
Chapter 4 Guided Tissue Regeneration in
Apical Microsurgery 71
Luciana L. Ferreira, Pedro F. E. Bernabé and
Luciano T. A. Cintra
vi Contents
Chapter 5 Guided Tissue Regeneration in Furcation Defects 105
Gustav Guimarães, Francine Benetti,
João E. Gomes-Filho, Gustavo Sivieri-Araújo,
Rogério de C. Jacinto, Elói Dezan-Júnior and
Luciano T. A. Cintra
Chapter 6 Guided Tissue Regeneration in Intrabony Defects 125
Cléverson O. Silva, André B. de Souza and
Vítor M. Sapata
Chapter 7 Guided Tissue Regeneration in
Maxillofacial Surgery 155
Francine Benetti, João E. Gomes-Filho,
Gustavo Sivieri-Araújo, Rogério de C. Jacinto,
Elói Dezan-Júnior and Luciano T. A. Cintra
Editor Contact Information 195
Index 197
PREFACE

Regeneration is the reproduction or reconstitution of a lost or damaged
tissue through the formation of a new one that can reproduce the form,
structure and function of original tissues. Tissue regeneration is a complex
process that needs a sequence of molecular events, such as cell adhesion,
migration, multiplication and differentiation.
Tissue engineering is an interdisciplinary science that applies the
principles of engineering and biological sciences in order to develop
biological substitutes for tissues and injured and/or lost organs. In the
medical field, these techniques are already used and are widely established.
However, they have been used most recently for concepts of tissue
engineeringin dentistry. The success of science depends on three basic
pillars: cell responsiveness (not necessarily stem cell-based); molecular
induction (protein structures that are capable of inducing cellular response)
and scaffolds (structures that mimic the extracellular matrix and serve as a
support for cell growth).
The Guided Tissue Regeneration (GTR) is a technique used in
dentistry that also aims at tissue and bone regeneration, or to repair
damaged tissue. It is based on the perception that tissues, for the most part,
are capable of self-reconstitution if appropriate conditions are provided.
GTR therapy, which was introduced in the 1980s, has been widely used to
regenerate lost tissues from periodontal disease, such as the periodontal
ligament and alveolar bone. GTR therapy has also been used in the apical
viii Luciano Tavares Angelo Cintra
surgeries as a concomitant treatment during the management of
endodontic-periodontal lesions. In addition, GTR are used in mandibular
defects, implants and intra-bony defects.
The main principle that supports the GTR is cellular selectivity; in
other words, a barrier is placed upon a bone defect, which can be
associated with bone graft, to hinder the cell penetration of epithelial and
connective tissues. This protection ensures the necessary time for the
periodontal ligament and alveolar bone cells to differentiate, proliferate
and migrate to the inner bone defect, promoting tissue repair.
Recently, the literature has shown many types of techniques that may
be employed to promote tissue regeneration. Among the main techniques,
the use of bone graft materials associated with GTR and, more recently, the
application of polypeptide growth factors (PGFs) are used in favor of
tissue regeneration. Previous studies have shown that the association
between osseous grafting and GTR promote more favorable results when
compared with any other techniques alone. It is believed that while a
barrier addresses the dynamics of cell migration, osseous grafts will play
an active role in promoting the formation of alveolar bone. The placement
of a physical barrier over an osseous defect may prevent the faster
proliferating oral epithelium and gingival connective tissues from growing
into the bone defect, allowing the cells of the periodontal ligament and
endosteum to colonize the blood clot and regenerate the lost tissue.
In summary, the use of the GTR technique for the treatment of
periodontal lesions, including furcations of more complex lesions, apical
lesions, and large bone loss, is now a reality, as it is evidenced by the
regeneration capacity of the periodontal tissues.