Tissue-engineered ligament: implant constructs for tooth replacement.
OBJECTIVE
A tissue-engineered periodontal ligament (PDL) around implants would represent an important new therapeutic tool to replace lost teeth. The PDL is the key to tooth anchoring; it connects tooth root and alveolar bone, and it sustains bone formation.


METHODS
Cells were isolated from PDL and cultured in a bioreactor on titanium pins. After the formation of multiple cellular layers, pins were implanted in enlarged dental alveolae.


METHODS
Cell-covered implants integrated without adverse effects, and induced bone in their vicinity.


RESULTS
A histological examination of a dog model revealed that cells were arranged in a typical ligament-like fashion. In human patients, product safety was ascertained for 6-60 months. Probing and motility assessments suggested that the implants were well integrated with mechanical properties similar to those of teeth. Radiographs demonstrated the regeneration of deficient alveolar bone, the development of a lamina dura adjacent to a mineral-devoid space around the implant and implant migration in an intact bone structure.


CONCLUSIONS
New tissue consistent with PDL developed on the surface of dental implants after implantation. This proof-of-principal investigation demonstrates the application of ligament-anchored implants, which have potential advantages over osseointegrated oral implants.
Gault
Philippe
P
Natural Implant, 38 rue Jim Sevellec, Brest, France.
Black
Annie
A
Romette
Jean-Louis
JL
Fuente
Fabien
F
Schroeder
Klaus
K
Thillou
Fabienne
F
Brune
Thierry
T
Berdal
Ariane
A
Wurtz
Tilmann
T
D000328:Adult; D000368:Aged; D000818:Animals; D001861:Bone Regeneration; D002478:Cells, Cultured; D025021:Cementogenesis; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D004285:Dogs; D017886:Durapatite; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008819:Mice, Nude; D008875:Middle Aged; D010513:Periodontal Ligament / Q000166:cytology* / Q000637:transplantation; D033581:Stem Cell Transplantation / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D014025:Titanium
D015921:Dental Implants; D017886:Durapatite; D014025:Titanium