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Title: Cellular and molecular basis of periodontal regeneration
Author: Kuru, Leyla
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 1998
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Guided tissue regeneration (GTR) is based on the insertion of a barrier membrane to physically prevent downgrowth of the gingival epithelium and to enable cells with regenerative capability to re-populate the root surface and re-build the lost periodontium. Although many clinical studies have been carried out, little is known about the cellular and molecular mechanisms underlying GTR. The aims of this study were therefore to investigate the phenotypes, functions and extracellular environment of the cells involved in periodontal regeneration. Periodontal defects of subjects were treated by GTR using expanded polytetrafluoroethylene membranes or conventional flap (CF) surgery. Clinical measurements were recorded and retrieved membranes, underlying regenerated tissue (RT), periodontal ligament (PL) and gingival tissues, gingival crevicular fluid (GCF) and serum samples obtained. The cells associated with the retrieved membranes (M cells) and those derived from the RT (RT cells) were obtained and cultured in vitro. They were found to have a fibroblast-like morphology similar to the PL and gingival cells, and flow cytometry analysis showed that they also produce higher levels of collagen type I, fibronectin and tenascin. In addition, cultures of M cells formed mineralised nodules, characteristic of osteoblasts. The RT cells expressed high levels of bone-associated proteins osteonectin, osteocalcin, bone sialoprotein, osteopontin and alkaline phosphatase activity. Moreover, expression of the receptors for transforming growth factor-β (TGF-β) and platelet-derived growth factor (PDGF) were also found to be up-regulated in the RT tissue, and analysis of GCF showed that TGF-β was significantly higher in GTR test samples compared with CF samples after surgery. The results of this study have demonstrated that GTR-associated cells have a fibroblast-like morphology, produce certain key connective tissue proteins, have osteoblast-like characteristics and express high levels of growth factor receptors which are likely to be involved in periodontal regeneration.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available