Stem cells and periodontal regeneration: present and future

Filippo Citterio,Giacomo Gualini,Mario Aimetti,Ludovica Fierravanti

doi:10.20517/2347-9264.2020.29

Abstract

The ultimate goal of periodontal regeneration is to restore the damaged alveolar bone proper, root cementum, and periodontal ligament with collagen fibers inserted into the root surface. The search for new regenerative strategies is a challenging field of periodontal research, and tissue engineering, using stem cells, has recently been shown as a promising approach. This paper aims at reviewing the current available literature on the use of stem cells for the treatment of periodontitis. Up to now, different mesenchymal stem cells (MSCs) have shown potential for periodontal regeneration in animal studies. The most investigated MSCs for periodontal regeneration are bone marrow MSCs (BMMSCs), periodontal ligament stem cells (PDLSCs), and dental pulp stem cells (DPSCs), which have shown very promising results in animal models. Few studies on humans are available but BMMSCs, PDLSCs, and DPSCs have been proven safe and effective. Clinical trials are sparse, but tend to support the efficacy of MSCs for periodontal regeneration. In the future, more human studies will be required to support the use of MSCs in daily clinical practice, especially in order to identify the best protocol to harvest, process, and graft MSCs. Future perspectives include trans-differentiation of somatic cells to generate induced pluripotent stem cells, homing procedures, the use of exogenous stem cells, and 3D-printed scaffolds.

Highlights

The results showed a statistically significant greater PD reduction, CAL gain, and radiographic bone defect fill in the group treated with dental pulp stem cells (DPSCs) on a scaffold, compared to the scaffold alone
Even if some studies reported conflicting results and irregular outcomes, the available evidence in animal models supports the applicability of stem cells in periodontal tissue regeneration
Histological evidence of periodontal regeneration is still lacking and the power of studies is hampered by major limitations

Summary

Introduction

Stem cells and tissue engineering have recently been introduced into the field of periodontology and they have shown encouraging potential in the treatment of periodontitis, which is a complex immune-www.parjournal.net. Stem cells and tissue engineering have recently been introduced into the field of periodontology and they have shown encouraging potential in the treatment of periodontitis, which is a complex immune-. Periodontitis affects the majority of the adult population[1,2], may cause edentulism, and has been listed as a risk factor for major systemic diseases, such as atherosclerosis, cardiovascular diseases[3], diabetes[4], and rheumatoid arthritis[5,6] This may directly influence the general health, social life, and nutritional state of affected individuals, jeopardizing their overall quality of life[7,8,9,10]. The treatment of advanced forms of periodontitis is expensive, with a direct impact on Western countries’ productivity, making periodontitis a threat for public health[11]

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