Dental Follicle Stem Cells as a Biomaterial for Periodontal Regeneration A proof-of-concept study

Abstract

The goal of periodontal therapy is to regenerate the periodontal structures: cement, periodontal ligament and alveolar bone. Stem cell-based tissue engineering raised novel therapeutic strategies for periodontal repair. In vivo dental follicle stem (DFSC) cells give rise to cementoblasts, osteoblasts and fibroblasts. Based on this idea, we have assessed DFSC potential to regenerate the periodontal structures, and by that to elaborate a new biomaterial. An experimental study was performed on male Wistar rats which were subjected to a procedure of periodontitis induction through placing silk thread ligatures around the lower incisors, under general anesthesia. Clinically, the changes of the periodontal tissue (bleeding on probing, dental mobility, dental plaque, presence of pus) induced by the periodontitis progression were daily assessed. The subjects were divided in two groups: a control and a study group. After 7 days from placing silk thread ligatures, subjects from the study group received an injection in the gingival sulcus. The injected biomaterial contained dental follicle stem cells seeded on fibrinogen. Bleeding on probing at the end of the treatment period was significantly reduced in the study group (study vs control group - 0% vs 100%, p=0.01.). In terms of dental mobility statistical significant results were obtained (p=0.04): for 20% from the subjects from the study group dental mobility was absent, while in the control group all subjects presented different degrees of mobility (33.3% degree II- v-o/m-d, 66.6% degree III-v-o/m-d/ax). In the control group pus was present in 66.7% from the subjects, and absent in the study group (p=0.10). Dental plaque was present in 40% of the subjects from the study group and in 100% in the control group. The clinical and histological results of our study demonstrate that dental follicle stem cells are a valuable cell source for tissue engineering the periodontal tissue.