Abstract
The periodontal complex consisting of alveolar bone, cementum, and periodontal ligaments (PDL) supports human teeth through the systematic orchestration of mineralized tissues and fibrous tissues. Importantly, cementum, the outermost mineralized layer of dental roots, plays an essential role by bridging the inner ligaments from the dental root to the alveolar bone. When the periodontal complex is damaged, the regeneration of each component of the periodontal complex is necessary; however, it is still challenging to achieve complete functional regeneration. In this study, we tried to control the regeneration of cementum and PDL by using a human PDL stem cell (hPDLSC) sheet engineering technology with the pretreatment of recombinant human BMP-2 (rhBMP-2). Isolated hPDLSCs obtained from extracted human teeth were pretreated with rhBMP-2 for in vitro osteogenic differentiation and grafted on the micro/macro-porous biphasic calcium phosphate (MBCP) blocks, which represent dental roots. The MBCPs with hPDLSC sheets were implanted in the subcutaneous layer of immune-compromised mice, and rhBMP-2 pretreated hPDLSC sheets showed higher mineralization and collagen ligament deposition than the no-pretreatment group. Therefore, the rhBMP-2-hPDLSC sheet technique could be an effective strategy for the synchronized regeneration of two different tissues: mineralized tissue and fibrous tissues in periodontal complexes.
Highlights
Human teeth are embedded inside the jawbone, inside the subarea of the jaw called alveolar bone
The immunoregulatory property is another characteristic of mesenchymal stem cells (MSCs) [22,23], and the human PDL stem cell (hPDLSC) clones inhibited lymphocyte proliferation shown in the in vitro immunosuppression assay (Figure 1C)
These data show that the hPDLSC clones in this study were MSCs that were suitable for the development of cell sheets
Summary
Human teeth are embedded inside the jawbone, inside the subarea of the jaw called alveolar bone. The anchored collagenous tissue fibers (Sharpey’s fibers) in cementum sprout toward adjacent alveolar bone in several different directions [4]. In this way, the periodontal complex, which consists of cementum, PDL, and alveolar bone, provides significant support to tooth structures and prevents tooth damage in occlusal or masticatory loading environments [5]. The clinical symptoms of periodontitis are gum bleeding, bad oral odor, alveolar bone destruction, and inflammation of periodontal ligaments, which results in tooth mobility and loss of teeth. Chronic periodontitis is prevalent in adults and seniors worldwide, a definitive method to regenerate each element of the periodontal complex has not been identified, especially how to regenerate cementum, including the embedded functional PDLs
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