Abstract
Current periodontal regenerative therapies aim at restitution ad integrum of the periodontal attachment apparatus, which involves periodontal ligament, root cementum, and alveolar bone. Guided tissue regeneration, bioactive agents and bone replacement grafts have been utilized in an attempt to fully restore the lost periodontal tissues. But their predictability has been limited and dependent on patient- and defect-related factors. Consequently, the treatment of most periodontal defects still lacks satisfactory and predictable outcomes. Cell therapies, based on the use of mesenchymal stem cells (MSCs), represent a promising therapeutic strategy in light of recently available published preclinical investigations and clinical studies. The application of MSCs in humans is being performed by two different strategies: (1) the ex vivo culture of undifferentiated MSCs from autologous or allogeneic sources, subjected to specific cell expansion and characterization/differentiation tests to obtain the required cell counts for transplantation; and (2) the use of autologous tissue grafts and micrografts, which apart from MSCs, contain other biologically active cell populations and their extracellular matrix. This review evaluates the current status of MSCs therapy applied for periodontal regeneration, describing not only their mechanism of action, but also their efficacy and safety according to the published evidence.
Highlights
Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus induced by the alteration of the homeostasis between the subgingival microbiota and the host immune response[1].According to a systematic review with data from 37 countries, aimed at consolidating the epidemiologic records about the most destructive forms of periodontal disease, severe periodontitis was the sixth most prevalent medical condition in world, with a prevalence of 11.2%
The aim of this review is to summarize the current status of cell therapy in periodontal regeneration, presenting the particular characteristics and potentials of stem cells and the most recent evidence regarding the application of different modalities of cell therapy for the regeneration of the tooth-supporting structures both in the preclinical and in the clinical field
The scientific evidence from preclinical and clinical research has proven that the application of mesenchymal stem cells (MSCs) used in periodontal regenerative interventions is safe
Summary
According to a systematic review with data from 37 countries, aimed at consolidating the epidemiologic records about the most destructive forms of periodontal disease, severe periodontitis was the sixth most prevalent medical condition in world, with a prevalence of 11.2%. It shows a significant increase with age and a peak incidence at 38 years old[2]. Severe periodontitis is widely distributed throughout the world and remains a public health concern[3]. The control of the disease may influence the long-term general health of periodontitis patients[3]
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