Background: Expanded polytetrafluoroethylene (ePTFE) barrier membranes have
been widely used for guided tissue regeneration (GTR) of the human periodo
ntal ligament (PL). However, the precise cellular and molecular events invo
lved in the re-growth of the new tissue are still unclear.
Methods: Retrieved membranes and the newly -regenerated soft tissue (RT) un
derlying the membranes were used to examine the cells associated with GTR c
ompared with normal human PL and gingival cells. Flow cytometry (FCM) was u
sed, for the first time, to analyze the spindle-shaped fibroblast-like cell
s which were adherent to these membranes and the cells which grew out of th
e RT.
Results: The results showed that the membrane-associated (M) cells had the
lowest rate of proliferation and appeared to be larger and more granular th
an the other types of cell. Moreover, both the M- and RT-derived cells were
found to express higher levels of the extracellular matrix (ECM) proteins
Collagen type I, fibronectin, tenascin, and decorin. In addition, evidence
based on FCM profiles identified distinct sub-populations of GTR cells in w
hich fibronectin expression was markedly up-regulated compared with normal
PL cells and which also differed in size and granularity.
Conclusions: The results of this study show that cells associated with GTR
barrier membranes and with the underlying tissue appear to have distinct ph
enotypic and functional activities consistent with the production of new pe
riodontal connective tissue and periodontal regeneration.