Total regeneration of periodontal tissue was and still the dream of every periodontist, inspite the inherent regeneration ability of the periodontium.
In 1976 Melcher and his colleagues posted the concept of guided tissue regeneration, which postulated that the rapidly growing gingival epithelial tissue and connective tissue, fill in the periodontal defects before the slow growing periodontal tissue and bone, this fact hinder the regeneration of the periodontium, and cause repair of the defect with long junction epithelium.
Conventional periodontal therapy most often results in repair with granulation tissue and long junction epithelium, Melcher suggested the guided tissue regeneration, which depends on using a barrier membrane, to hinder the in growth of the gingival tissue in the periodontal defect to give more time for the regeneration process to take place.
In 2009 Zhang and his colleagues could isolate and characterize stem cells in the gingival tissue. Later Tomar and his colleagues did a comparison of this cells to bone marrow stem cells, they found many advantages in many respects. Such multipotent cells existance in the gingival connective tissue means that GTR technique deprive the periodontal defect from an important regenerative source and urges an essential modification in guided tissue regeneration (GTR) membrane,in the sight of its occlusive nature.
In 2018 Al Bahrawy and his colleagues proofed that gingival stem cells could migrate through 0.4,3,and 8 microns perforated membranes in the existence of chemo-tactic agent and perforated membranes were occlusive to cells migration in the absence of chemo-tactic agent.
Cell migration through micro perforated membranes might help in managing the periodontal defect isolation from the surrounding regenerative elements, a problem caused by guided tissue regeneration using occlusive membrane.
In this study Human Gingival mesenchymal stem cells (GMSCs) were seeded on the upper chambers of collagen-coated polytetrafluoroethylene (PTFE) transwells with readymade pore diameters of 0.4 and 3 microns and polycarbonic acid transwells with readymade pore diameter of 8 microns. Fetal Bovine Serum (FBS) was added to the culturing media in the lower chambers versus plain media in the control group. Migrating cells were counted in the lower compartment. Scanning electron microscopic imaging of the lower surface of the perforated transwell membranes was obtained.
The results of this study demonstrated that membrane microperforations of 0.4, 3, and 8 microns are suitable pore diameters for Human gingival mesenchymal stem cell migration to chemotactic media and are occlusive for cell migration in negative control, without affecting membrane mechanical or occlusive properties, which can be used to develop GTR membrane to have selective cell migration ability, which means allow certain cells to migrate through it, the stem cells, and be occlusive to unwanted cell lines, the epithelium and connective tissue, this study would open the doors for a new generation of the barrier membranes of the GTR technique.
The study link:
https://www.sciforschenonline.org/journals/dentistry/IJDOH-4-272.php
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