Efficacy of stem cells on periodontal regeneration: Systematic review of pre‐clinical studies

Abstract

This systematic review aims to evaluate mesenchymal stem cells (MSC) periodontal regenerative potential in animal models. MEDLINE, EMBASE and LILACS databases were searched for quantitative pre-clinical controlled animal model studies that evaluated the effect of local administration of MSC on periodontal regeneration. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Twenty-two studies met the inclusion criteria. Periodontal defects were surgically created in all studies. In seven studies, periodontal inflammation was experimentally induced following surgical defect creation. Differences in defect morphology were identified among the studies. Autogenous, alogenous and xenogenous MSC were used to promote periodontal regeneration. These included bone marrow-derived MSC, periodontal ligament (PDL)-derived MSC, dental pulp-derived MSC, gingival margin-derived MSC, foreskin-derived induced pluripotent stem cells, adipose tissue-derived MSC, cementum-derived MSC, periapical follicular MSC and alveolar periosteal cells. Meta-analysis was not possible due to heterogeneities in study designs. In most of the studies, local MSC implantation was not associated with adverse effects. The use of bone marrow-derived MSC for periodontal regeneration yielded conflicting results. In contrast, PDL-MSC consistently promoted increased PDL and cementum regeneration. Finally, the adjunct use of MSC improved the regenerative outcomes of periodontal defects treated with membranes or bone substitutes. Despite the quality level of the existing evidence, the current data indicate that the use of MSC may provide beneficial effects on periodontal regeneration. The various degrees of success of MSC in periodontal regeneration are likely to be related to the use of heterogeneous cells. Thus, future studies need to identify phenotypic profiles of highly regenerative MSC populations.

Circular RNA CDR1as regulates osteoblastic differentiation of periodontal ligament stem cells via the miR-7/GDF5/SMAD and p38 MAPK signaling pathway

“…PDLSCs are an excellent cell source with potential for multilineage differentiation, and are considered ideal candidates for use in periodontal tissue and bone regenerative applications [3, 31]. Therefore, it is essential to understand the mechanisms underlying their multilineage differentiation potential.…”

Reduction of Gingival Black Triangles with Dental Pulp or Gingival Stem Cell Injection Therapy: Clinical and Outcomes Research Gaps

“…Evidence to support the use of stem cell therapy for this purpose, while available, remains limited [18][19][20][21]. Many small studies and case series have been published but as the technology and application are new, there is not yet evidence confirming the long-term persistence of the procedure.…”

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

“…These studies indicated the extensive potential of stem cells in dental tissue regeneration. In order to increase the value of animal experimental work as a proof‐of‐concept preparatory evidence for clinical trials, some systematic reviews and meta‐analyses of preclinical studies have already been published with promising results, although not all tissues seem to regenerate equally and this could be influenced by the type of stem cells used . As a consequence of these successful animal studies, the clinical application of stem cells for the regeneration of periodontal tissue has begun, but no previous attempts to systematically review the literature have been made.…”