Concise Review: Periodontal Tissue Regeneration Using Stem Cells: Strategies and Translational Considerations

Xu, Xinyue; Li, Xuan; Wang, Jia; He, Xiao-Tao; Sun, Hao; Chen, Fa‐Ming

doi:10.1002/sctm.18-0181

Cited by 159 publications

(149 citation statements)

References 89 publications

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“…Regenerative medicine in skeletal system always attracts clinicians and researchers [1,2]. Fortunately, recent decades witness the conceptual progress of bone biology, which in turn contributes to new therapeutic strategies managing bone loss diseases [3,4].…”

Section: Introductionmentioning

confidence: 99%

Synergistic Application of Platelet-Rich Fibrin and 1% Alendronate in Periodontal Bone Regeneration: A Meta-Analysis

Jiang

Pan

et al. 2019

BioMed Research International

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Periodontal bone regeneration relies on coupled and cooperative bone formation and resorption. Accordingly a novel strategy on concurrent use of platelet-rich fibrin (PRF) (anabolic agent) and 1% alendronate (ALN) (anticatabolic agent) was proposed recently in regenerative periodontal treatment. It was supposed to enhance bone formation and reduce bone resorption simultaneously. However, there is a lack of evidence-based studies to answer whether this concurrent application was superior to single application until now. Besides, concerns on ALN lead to some reservation on this synergistic way. ALN may impair new bone formation and necrotize jaws. Thus, in order to compare the clinical efficacy between PRF plus 1%ALN and PRF alone on periodontal bone regeneration, we performed present systematic review and meta-analysis. Because it is the prerequisite for measuring the combined efficacy of PRF plus 1%ALN, firstly we evaluated the effectiveness of 1%ALN. Our data indicated that adjunctive 1%ALN was effective in promoting periodontal bone repair. Further, PRF plus 1%ALN showed a greater capacity for periodontal regeneration than PRF alone with statistical significance. The findings of this study revealed the promising prospects on synergistic application of bone anabolic agents (PRF) and antiresorption medications (1%ALN) in regenerative periodontal treatment.

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Section: Introductionmentioning

confidence: 99%

Synergistic Application of Platelet-Rich Fibrin and 1% Alendronate in Periodontal Bone Regeneration: A Meta-Analysis

Jiang

Pan

et al. 2019

BioMed Research International

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“…All different types of stem cells have been tested with several approaches (e.g., different isolation processes, different implantation methods, etc.) with promising results in terms of regeneration of bone and dental supporting tissues (PL and root cementum) [62,63] . Although promising, from all these studies, no clear clinical protocol can be ultimately validated due to the heterogeneity of the investigation designs and because we still do not have a complete understanding of how these cells interact in the healing and regenerative processes [Tables 1 and 2].…”

Section: Animal Studiesmentioning

confidence: 99%

Stem cells and periodontal regeneration: present and future

Citterio¹,

Gualini²,

Fierravanti³

et al. 2020

Plast Aesthet Res

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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.

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“…Currently, the overall prevalence of periodontitis is as high as 45 to 50%, making it the sixth most common human disease and a substantial public health burden worldwide [2]. Periodontitis is also considered to be associated with the occurrence and prognosis of many systemic diseases [3]. Therefore, effective and safe periodontal therapy methods are urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Stem cell therapies for periodontal tissue regeneration: a network meta-analysis of preclinical studies

Yang

et al. 2020

Stem Cell Res Ther

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Background Periodontal tissue regeneration (PTR) is the ultimate goal of periodontal therapy. Currently, stem cell therapy is considered a promising strategy for achieving PTR. However, there is still no conclusive comparison that distinguishes clear hierarchies among different kinds of stem cells. Methods A systematic review and network meta-analysis (NMA) was performed using MEDLINE (via PubMed), EMBASE, and Web of Science up to February 2020. Preclinical studies assessing five types of stem cells for PTR were included; the five types of stem cells included periodontal ligament-derived stem cells (PDLSCs), bone marrow-derived stem cells (BMSCs), adipose tissue-derived stem cells (ADSCs), dental pulp-derived stem cells (DPSCs), and gingival-derived stem cells (GMSCs). The primary outcomes were three histological indicators with continuous variables: newly formed alveolar bone (NB), newly formed cementum (NC), and newly formed periodontal ligament (NPDL). We performed pairwise meta-analyses using a random-effects model and then performed a random-effects NMA using a multivariate meta-analysis model. Results Sixty preclinical studies assessing five different stem cell-based therapies were identified. The NMA showed that in terms of NB, PDLSCs (standardized mean difference 1.87, 95% credible interval 1.24 to 2.51), BMSCs (1.88, 1.17 to 2.59), and DPSCs (1.69, 0.64 to 2.75) were statistically more efficacious than cell carriers (CCs). In addition, PDLSCs were superior to GMSCs (1.49, 0.04 to 2.94). For NC, PDLSCs (2.18, 1.48 to 2.87), BMSCs (2.11, 1.28 to 2.94), and ADSCs (1.55, 0.18 to 2.91) were superior to CCs. For NPDL, PDLSCs (1.69, 0.92 to 2.47) and BMSCs (1.41, 0.56 to 2.26) were more efficacious than CCs, and PDLSCs (1.26, 0.11 to 2.42) were superior to GMSCs. The results of treatment hierarchies also demonstrated that the two highest-ranked interventions were PDLSCs and BMSCs. Conclusion PDLSCs and BMSCs were the most effective and well-documented stem cells for PTR among the five kinds of stem cells evaluated in this study, and there was no statistical significance between them. To translate the stem cell therapies for PTR successfully in the clinic, future studies should utilize robust experimental designs and reports.

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Concise Review: Periodontal Tissue Regeneration Using Stem Cells: Strategies and Translational Considerations

Cited by 159 publications

References 89 publications

Synergistic Application of Platelet-Rich Fibrin and 1% Alendronate in Periodontal Bone Regeneration: A Meta-Analysis

Synergistic Application of Platelet-Rich Fibrin and 1% Alendronate in Periodontal Bone Regeneration: A Meta-Analysis

Stem cells and periodontal regeneration: present and future

Stem cell therapies for periodontal tissue regeneration: a network meta-analysis of preclinical studies

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