Human intrabony defect regeneration with micrografts containing dental pulp stem cells: A randomized controlled clinical trial

Ferrarotti, Francesco; Romano, Federica; Gamba, Mara Noemi; Quirico, Andrea; Giraudi, Marta; Audagna, Martina; Aimetti, Mario

doi:10.1111/jcpe.12931

Cited by 142 publications

(181 citation statements)

References 53 publications

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“…Only one study provided data for plaque index with the full‐mouth plaque score. The MD between test and control groups was −1.60% (95% CI [−4.23; 1.03]).…”

Section: Resultsmentioning

confidence: 99%

Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta‐analysis

Novello

Debouche

Marie

et al. 2019

J of Periodontal Research

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Objective To evaluate the potential efficacy of mesenchymal stem cells (MSCs) in periodontal regeneration in humans on the following main outcomes: clinical attachment level (CAL), probing depth (PD), and gingival recession (GR). Background The clinical application of stem cells in periodontal regeneration has begun in recent years, but clinical practices are not yet standardized and no recommendations are available at this time. Methods Electronic database searches and hand searches were conducted. All types of studies, case series, and case reports were qualitatively described. Double‐blind randomized controlled trials (RCTs) evaluating MSCs in periodontal regeneration were included in a meta‐analysis if they compared administration of MSCs vs application of stem cell‐free therapy in the control group, in healthy patients with periodontal defects, with a minimum of three mo of follow‐up. Results Fifteen reports were included in qualitative analysis, involving 123 patients and 158 periodontal defects. Only two small RCTs at high risk of bias, with a total of 59 patients and 70 periodontal defects, were included in the meta‐analysis. A small but significant difference between test and control groups was found for CAL at three mo (−0.90 mm, 95% CI [−1.51; −0.29]), but not for PD and GR. Conclusion Low‐quality evidence suggests that MSC‐based therapy may have a small impact on periodontal regeneration. However, due to the monocentric character, the small sample size, and potential heterogeneity across the two included RCTs, these results must not be considered as definitive. High‐quality RCTs are needed before any clinical use of MSCs in periodontal regeneration.

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“…Only one study provided data for plaque index with the full‐mouth plaque score. The MD between test and control groups was −1.60% (95% CI [−4.23; 1.03]).…”

Section: Resultsmentioning

confidence: 99%

Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta‐analysis

Novello

Debouche

Marie

et al. 2019

J of Periodontal Research

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“…After assessment of the full papers, a further 56 records were excluded. Therefore, a total of 18 publications corresponding to 16 original studies were included for qualitative analysis. One of the included studies reported follow‐up data from a previously published study , whereas another one was a correction of a previous report .…”

Section: Resultsmentioning

confidence: 99%

“…There was a total of 11 randomized controlled trials (RCTs) and 5 non‐randomized controlled original trials included for qualitative analysis. All RCTs incorporated a parallel design, whereas CCTs included reports with either a parallel or a “split mouth” design.…”

Section: Resultsmentioning

confidence: 99%

“…We identified cell‐based therapies according to the type of MSCs harvested and the donor tissue. Seven studies reported the use of bone marrow stem cells (BMSCs) harvested from posterior iliac crest aspiration , two studies investigated the performance of dental pulp stem cells (DPSCs) harvested from the dental pulp of extracted teeth , five of the included publications involved the harvesting of periosteum‐derived stem cells (PdSCs) from gingival connective tissue samples , one report produced periodontal ligament‐derived stem cells (PdlSCs) “cell sheets,” and another publication used the adipose‐stromal vascular fraction from adipose tissue samples obtained via lipo‐aspiration . In line with the definition from the European Medicines Agency Regulation (EC) no 1394/2007 , we further subcategorized the techniques in another two groups: (a) “minimal manipulation” of tissues/cells or (b) “substantial manipulation” otherwise (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…For studies aiming to achieve periodontal regeneration, one of the RCTs did not report clinical measurements beyond 3 months and did not report the standard deviations of the differences in radiographic bone fill at 12 months postop . For this reason, two studies assessing CAL, PD, REC, and BF 12 months after surgery were included in separate meta‐analysis. The combined estimate for the two studies showed significant benefits of using cell therapy for periodontal regeneration in terms of CAL (1.33 mm; 95% CI, 0.47, 2.19; I 2 = 0.0%) and radiographic BF (2 mm; 95% CI, 1.41, 2.58; I 2 = 0.3%) with no observed heterogeneity and a nonsignificant improvement in PD (0.91 mm; 95% CI, −0.05, 1.88; I 2 = 50.2%), and REC (0.36 mm; 95% CI, −0.30, 1.02; I 2 = 18.1%).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Cell-Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review

Moreno

Leira

Orlandi

et al. 2019

Stem Cells Translational Medicine

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Current regenerative strategies for alveolar bone and periodontal tissues are effective and well adopted. These are mainly based on the use of a combination of synthetic/natural scaffolds and bioactive agents, obviating the incorporation of cells. However, there are some inherent limitations associated with traditional techniques, and we hypothesized that the use of cell-based therapies as part of comprehensive regenerative protocols may help overcome these hurdles to enhance clinical outcomes. We conducted a systematic review of human controlled clinical trials investigating the clinical and/or histological effect of the use of cellbased therapies for alveolar bone and periodontal regeneration and explored the translational potential of the different cell-based strategies identified in the included trials. A total of 16 studies (11 randomized controlled trials, 5 controlled clinical trials) were included for data synthesis and qualitative analysis with meta-analyses performed when appropriate. The results suggest a clinical benefit from the use of cell therapy. Improved outcomes were shown for alveolar ridge preservation, lateral ridge augmentation, and periodontal regeneration. However, there was insufficient evidence to identify best-performing treatment modalities amongst the different cell-based techniques. In light of the clinical and histological outcomes, we identify extraction socket and challenging lateral and vertical bone defects requiring bone block grafts as strong candidates for the adjuvant application of mesenchymal stem cells. Given the complexity, invasiveness, and costs associated with techniques that include "substantial manipulation" of tissues and cells, their additional clinical benefit when compared with "minimal manipulation" must be elucidated in future trials. STEM CELLS Cell-based therapies have the potential to improve outcomes of regenerative treatment in the oral cavity. Extraction sockets and challenging lateral/vertical bone defects requiring bone block grafts are ideal candidates for the adjuvant application of mesenchymal stem cells. The present review showed that there is insufficient evidence to identify best-performing treatment modalities among the different cell-based techniques. Given the complexity, invasiveness, and costs associated with the "substantial manipulation" of tissues and cells, the clinical benefit of these techniques when compared with "minimal manipulation" must be elucidated. Further research evaluating the effectiveness of simple, fast, and economical methods for cell harvesting and processing is warranted.

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Drug Delivery (Nano)Platforms for Oral and Dental Applications: Tissue Regeneration, Infection Control, and Cancer Management

et al. 2021

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The oral cavity and oropharynx are complex environments that are susceptible to physical, chemical, and microbiological insults. They are also common sites for pathological and cancerous changes. The effectiveness of conventional locally-administered medications against diseases affecting these oral milieus may be compromised by constant salivary flow. For systemically-administered medications, drug resistance and adverse side-effects are issues that need to be resolved. New strategies for drug delivery have been investigated over the last decade to overcome these obstacles. Synthesis of nanoparticle-containing agents that promote healing represents a quantum leap in ensuring safe, efficient drug delivery to the affected tissues. Micro/nanoencapsulants with unique structures and properties function as more favorable drug-release platforms than conventional treatment approaches. The present review provides an overview of newly-developed nanocarriers and discusses their potential applications and limitations in various fields of dentistry and oral medicine.

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Human intrabony defect regeneration with micrografts containing dental pulp stem cells: A randomized controlled clinical trial

Abstract: Application of DPSCs significantly improved clinical parameters of periodontal regeneration 1 year after treatment.

Cited by 142 publications

References 53 publications

Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta‐analysis

Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta‐analysis

Cell-Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review

Drug Delivery (Nano)Platforms for Oral and Dental Applications: Tissue Regeneration, Infection Control, and Cancer Management

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