体性幹細胞を用いた顎顔面骨の再生医療

Recently it pays attention to regenerative medicine by the discovery of embryonic stem cells(ES cells)and induced pluripotent stem(iPS)cells. The regenerative medicine aims at restoration of lost healthy tissue by increasing and applying viable cells, and tissues are reconstructed with 3 elements(stem cells, scaffolds, and growth factors), among which‘stem cells’are considered to play the most important role.<br>Although the current gold standard of bone formation and regeneration for severe alveolar bone atrophy associated with tumor resection and trauma is still autologous bone transplantation, it requires injuring a healthy region, giving stress to the patient. Moreover, the amount of tissue sampling is limited, and absorption of grafted bone occurs. To reduce the patient’s burden and consider the aesthetic issue, we attempted to develop a less invasive tissue regeneration method, and have contributed to patients by applying it for alveolar bone regeneration in clinical cases. Since this method uses autologous stem cells and platelets, it can be regarded as a tailor-made medical care. We expanded the indication from alveolar bone regeneration for implant placement to periodontal disease, residual bone defect, and distraction osteogenesis in more than 50 cases including a case in which 6.5 years have passed after treatment. These cases showed that osteogenesis before bone regeneration occurred early.Therefore, alveolar bone regeneration has become a satisfactory treatment method. In addition, regarding anesthetic improvement we succeeded in interdental papillary regeneration for black triangle using stem cells. This treatment is simply applied by infusion, requiring no incision, and repeated application is possible using preserved(bank)cells. Here we will introduce the protocol of clinical application, indications, and outcome of regenerative medicine including the long-term outcomes of the clinical applications, and propose early realization and spread of its practical use based on these clinical outcomes showing the efficacy. Next we also paid attention to milk teeth, which have been discarded as medical waste, as a new source of stem cells, the promising key factor of regenerative medicine. Stem cells collected from milk teeth have potent proliferative ability, compared to those of bone marrow-derived and permanent tooth pulp stem cells, suggesting a possibility of allograft.<br>The possibility of bone regeneration using new stem cells will also be discussed. The development of regenerative medicine for the maxillofacial region represents a social contribution by the dentistry field, and may lead to paradigm shift to the new treatment method.