Stem Cells, Scaffolds and Gene Therapy for Periodontal Engineering

Abstract

The periodontium is continually exposed to a variety of challenges. Over the past decade, preclinical and clinical research has highlighted the complex modulatory role of the periodontal ligament (PDL) as a mediator of tissue repair and homeostasis. Experiments carried out in both human and animal models have highlighted the importance of the PDL as a protective structure. The unique properties of PDL cells endow this tissue with functional attributes that are not replicated by other biological systems. Furthermore, distinct PDL matricellular properties favor a synchronized molecular response to environmental challenges that supports normal dental and alveolar adaptation. Today, the mechanism by which periodontal integrity is restored and maintained is the focus of novel and innovative research. The ability to decipher the molecular mechanisms that support periodontal homeostasis, together with emerging science in biomaterials and stem cell biology, represents a unique opportunity to enhance the predictability of current regenerative surgical approaches and to develop novel treatment strategies for periodontal tissue engineering. This review will focus on the most recent available information concerning cells, gene delivery, and new scaffold technologies that are relevant in periodontal regeneration.

Advanced platelet‐rich fibrin and freeze‐dried bone allograft for ridge preservation: A randomized controlled clinical trial

“…Biologic agents are molecular mediators with typical osteoinductive properties to promote de novo bone formation . Matrix scaffolding materials and biologic agents can be used separately or together to achieve the desired surgical outcome . Of the available biomaterials, platelet‐rich fibrin (PRF) has become increasingly popular since its first introduction in 2001 .…”

“…7 Matrix scaffolding materials and biologic agents can be used separately or together to achieve the desired surgical outcome. 7,8 Of the available biomaterials, platelet-rich fibrin (PRF) has become increasingly popular since its first introduction in 2001. 9 PRF is a platelet concentrate made of an autologous bioscaffold of a dense fibrin matrix with naturally integrated growth factors which are released from the scaffold over a sustained period to promote healing of hard and soft tissues.…”

“Three-Dimensional Printing” – A New Vista for Periodontal Regeneration: A Review

“…These 3D scaffolding technologies can be used in combination with either biologics or cell therapies to create" bioactive scaffolding systems" for tissue repair. 47 A major hurdle in the usage of cell scaffolds in day-today practice is the difficult task of getting clearance from regulatory agencies as it involves cells and tissues.…”

Clinical Application of Mesenchymal Stem Cells and Novel Supportive Therapies for Oral Bone Regeneration

“…Because of this, stem cells have gained interest due to their capacities to differentiate to a variety of cell lineages, including hematopoietic, mesenchymal, and endothelial cells [ 10 ]. Stem cells can be found in different tissues, such as bone marrow, adipose tissue, and, in the oral cavity, periodontal tissue, dental pulp, and dental follicle [ 8 ] ( Table 1 ). However, due to the limited autogenous availability in some of those locations, only bone marrow and adipose-derived mesenchymal stromal/stem cells have been clinically applied to bone regeneration in the oral cavity.…”

“…These techniques present different drawbacks including the limited availability of autografts and their associated morbidity in addition to the absence of cell populations carried by allografts, xenografts, and alloplasts, which determine poor osteoinductive properties. To overcome these limitations, the use of growth factors incorporated in carriers, the stimulation of the selective production of growth factors using gene therapy, and the delivery of expanded cellular constructs are being used in different areas of maxillofacial reconstruction [ 8 ] ( Figure 1 ). Cell therapy approaches constitute one of the most promising instruments to enhance reconstruction of both hard and soft tissues.…”