The presence of mesenchymal stem cells (MSCs) in human periodontal ligament (PDL) were first described by Seo et al. in 2004. These cells are capable of plastic adherence, colony forming and differentiation into various cell types when cultivated in appropriate cell culture conditions. PDL stem cells are investigated by high number of scientists nowadays because of their high potency for tissue regeneration. However, little is known about the effects of various active molecules and growth factors on their stem cell properties. There is limited number of reports revealing the activity of these cells when applied in clinical studies. The purpose of the current review is to highlight the stem cell properties of human PDL MSCs and to briefly systematize the data from various sources.

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but serious pathology associated with the use of bisphosphonates (BPs) and antiresorptive drugs in patients with bone metastases, multiple myeloma and osteoporosis. Various cases of patients with jaw bone necrosis due to BPs have recently been reported in the literature. Anti-angiogenic drugs are novel anticancer agents prescribed to patients with renal carcinoma, lung carcinoma, soft tissue metastases, etc. Anti-angiogenic drugs target the vascular endothelial growth factor’s (VEGF) signaling pathways via different mechanisms and thus inhibit tumor cell proliferation, neoangiogenesis and tumor growth. Several reports have suggested a higher incidence of MRONJ in patients treated with BPs in combination with anti-angiogenic drugs. However, there is currently no sufficient data in the literature about the risk of ONJ in patients taking anti-angiogenic drugs or cancer chemotherapy alone. We present two clinical cases of osteonecrosis of the jaw in patients treated with chemotherapy, but no history of BPs. In the first case the necrosis is related to the anti-angiogenic agent sunitinib in a patient with lung metastases and in the second case- to complex chemotherapy in a patient with acute myeloid leukemia. We recommend conservative treatment with antibiotics in both cases, together with antiseptics and surgical removal of the necrotic bone following total demarcation of the sequesters.

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Growth factors (GFs) are bioactive molecules participating in organ development, tissue regeneration and repair. They are protein molecules with a relatively low molecular weight and are released by activated platelets. Platelet-derived growth factor (PDGF) is one of the GFs of highest amount in human platelets. It is known to stimulate cell proliferation and extracellular matrix synthesis, as well as angiogenesis in healthy tissues and neoplasms. However, most of the studies in the literature demonstrate the influence of PDGF on tissue regeneration without revealing its intimate mechanisms of action on different cell types. In the current review we emphasis on the effects of PDGF in order to stimulate various biological processes in wide number of pre-clinical and clinical studies.

We report a case of osteonecrosis of the jaw (ONJ) associated with denosumab therapy in a 69-year-old female patient being treated for osteoporosis. The patient was admitted in Oral and maxillofacial surgery clinic twice because of nonhealing extraction wounds and inflammatory complications. We recommend conservative therapeutic approach and avoidance of extensive surgery in patients with ONJ.