Abstract
The current review aims to systematically assess the osteogenic capacity of gingiva-derived mesenchymal stem cells (GMSCs) in preclinical studies. A comprehensive electronic search of PubMed, Embase, Web of Science, and Scopus databases, as well as a manual search of relevant references, was performed in June 2020 without date or language restrictions. Eligibility criteria were the following: studies that compared mesenchymal stem cells (MSCs) derived from the gingiva with other MSC sources (in vitro or in vivo) or cell-free scaffold (in vivo) and studies that reported at least one of the following outcomes: osteogenic potential and new bone formation for in vitro and in vivo, respectively. Moreover, the assessment of included studies was conducted using appropriate guidelines. From 646 initial retrieved studies, 35 full-text articles were subjected to further screening and 26 studies were selected (20 in vitro studies and 6 in vivo studies). GMSCs showed great proliferation capacity and expressed recognized mesenchymal stem cell markers, particularly CD90. In vitro, MSC sources including GMSCs were capable of undergoing osteogenic differentiation with less ability in GMSCs, while most in vivo studies confirmed the capacity of GMSCs to regenerate bony defects. Concerning the assessment of methodological quality, in vitro studies met the relevant guideline except in five areas: the sample size calculation, randomization, allocation concealment, implementation, and blinding, and in vivo publications had probably low risk of bias in most domains except in three areas: allocation concealment, attrition, and blinding items.
Highlights
From autogeneic grafts to NanoBone materials, various therapeutic strategies to promote bone regeneration have been established over the past years
In vivo studies should consider the bone as a targeting area, and bone defects were induced in animals either by surgery or by disease regardless of species, age, and sex, as well as in vitro culture studies that compared mesenchymal stem cells (MSCs) derived from the gingiva and other MSC sources, in vivo studies that compared MSCs derived from the healthy gingiva and cell-free scaffold or other MSC sources, and studies that reported at least one of the following outcomes: new bone formation and osteogenic potential
In terms of in vivo studies, more newly formed bone areas in gingiva-derived mesenchymal stem cells (GMSCs) groups were detected by Hematoxylin and Eosin (H&E) staining [48, 52, 67,68,69] with the exception of one article indicating that GMSCs had lower new bone formation in comparison to periodontal ligament stem cells (PDLSCs) and bone marrow mesenchymal stem cells (BMSCs) [66]
Summary
From autogeneic grafts to NanoBone materials, various therapeutic strategies to promote bone regeneration have been established over the past years. Autogeneic, allogeneic, and xenogeneic bone grafts, different forms of natural or synthetic bone graft substitutes, bioactive molecule-augmented bone graft substitutes, cell-based bone graft substitutes, and NanoBone materials have been reported in preclinical and clinical fields [1]. Their implantation in bone regeneration has been associated with different complications. Allogeneic grafting combined with the absence of osteogenic potential, risk of viral contamination, and lack of biological and mechanical properties due to the irradiation process required for antimicrobial purposes was reported. The disadvantages of xenografts were the lack of osteogenic ability and risk of immune rejection [2]
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