Efficacy of Periodontal Stem Cell Transplantation in the Treatment of Advanced Periodontitis

Abstract

Periodontitis is the most common cause for tooth loss in adults and advanced types affect 10-15% of adults worldwide. The attempts to save tooth and regenerate the periodontal apparatus including cementum, periodontal ligament, and alveolar bone reach to the dental tissue-derived stem cell therapy. Although there have been several periodontitis models suggested, the apical involvement of tooth root is especially challenging to be regenerated and dental stem cell therapy for the state has never been investigated. Three kinds of dental tissue-derived adult stem cells (aDSCs) were obtained from the extracted immature molars of beagle dogs (n = 8), and ex vivo expanded periodontal ligament stem cells (PDLSCs), dental pulp stem cells (DPSCs), and periapical follicular stem cells (PAFSCs) were transplanted into the apical involvement defect. As for the lack of cementum-specific markers, anti-human cementum protein 1 (rhCEMP1) antibody was fabricated and the aDSCs and the regenerated tissues were immunostained with anti-CEMP1 antibody. Autologous PDLSCs showed the best regenerating capacity of periodontal ligament, alveolar bone, and cementum as well as peripheral nerve and blood vessel, which were evaluated by conventional and immune histology, 3D micro-CT, and clinical index. The rhCEMP1 was expressed strongest in PDLSCs and in the regenerated periodontal ligament space. We suggest here the PDLSCs as the most favorable candidate for the clinical application among the three dental stem cells and can be used for treatment of advanced periodontitis where tooth removal was indicated in the clinical cases.

Neural crest stem cells: discovery, properties and potential for therapy

“…More recently, both allogeneic and autologous transplanation of PDLSCs in a swine model for periodontitis resulted in the regeneration of the periodontal tissue [82,95]. Similar experiments in a dog model of periodontitis have compared the regenerative capacity of three different types of dental MSCs in autologous transplantation and demonstrated that PDLSCs have the best regeneration capacity over DPSCs and DFPCs [96]. DFPCs comprise another type of dental MSCs that were identified in the dental follicle [83].…”

Growth and Osteogenic Differentiation of CD117+ Dental Pulp and Periodontal Ligament Cells

“…(13) In an in vivo study, dental tissue-derived adult stem cells, including DPSC and PDLSC were autologous transplanted into the apical involvement defect. (14) PDLSCs showed the best regenerating capacity of periodontal ligament, alveolar bone, and cementum as well as peripheral nerve and blood vessel, which were evaluated by conventional immunohistology, 3D micro-CT and clinical index. (14) PDLSC is suggested as a favorable candidate for the clinical application, that can be used for treatment of advanced periodontitis where tooth removal was indicated in the clinical cases.…”

Periodontal Ligament Stem Cells

“…Furthermore, human PDLSCs that were transplanted into surgically created defects at the periodontal area of mandibular molars in immunocompromised rats were integrated into the PDL tissue, resulting in homing on the surfaces of alveolar bone and tooth root (Seo, et al, 2004). Swine or canine PDLSCs have also been reported to regenerate PDL tissues when transplanted into surgically created periodontal defect areas in swine or canine models (Liu et al, 2008;Park et al, 2010). Immunomodulatory property is also known to be one of the characteristics of MSCs (Bartholomew et al, 2002).…”