Periodontal tissue regeneration by transplantation of autologous adipose tissue-derived multi-lineage progenitor cells

Abstract

Periodontitis is a chronic inflammatory disease that destroys tooth-supporting periodontal tissue. Current periodontal regenerative therapies have unsatisfactory efficacy; therefore, periodontal tissue engineering might be established by developing new cell-based therapies. In this study, we evaluated the safety and efficacy of adipose tissue-derived multi-lineage progenitor cells (ADMPC) autologous transplantation for periodontal tissue regeneration in humans. We conducted an open-label, single-arm exploratory phase I clinical study in which 12 periodontitis patients were transplanted with autologous ADMPCs isolated from subcutaneous adipose tissue. Each patient underwent flap surgery during which autologous ADMPCs were transplanted into the bone defect with a fibrin carrier material. Up to 36 weeks after transplantation, we performed a variety of clinical examinations including periodontal tissue inspection and standardized dental radiographic analysis. A 36-week follow-up demonstrated no severe transplantation-related adverse events in any cases. ADMPC transplantation reduced the probing pocket depth, improved the clinical attachment level, and induced neogenesis of alveolar bone. Therapeutic efficiency was observed in 2- or 3-walled vertical bone defects as well as more severe periodontal bone defects. These results suggest that autologous ADMPC transplantation might be an applicable therapy for severe periodontitis by inducing periodontal regeneration.

Recent Clinical Treatment and Basic Research on the Alveolar Bone

“…Takedachi et al evaluated the safety and efficacy of periodontal tissue regeneration using adipose tissue-derived multilineage progenitor cell (ADMPC) autologous transplantation [ 139 ]. Twelve patients with periodontitis enrolled in an open-label, single-arm, exploratory phase I clinical trial in which ADMPC isolated from subcutaneous adipose tissues were autologously transplanted [ 139 ]. Each patient underwent flap surgery, at which time the autologous ADMPC was transplanted into the bone defect along with a fibrin carrier.…”

“…Each patient underwent flap surgery, at which time the autologous ADMPC was transplanted into the bone defect along with a fibrin carrier. The results suggest that ADMPC autografting may be a treatment option for severe periodontitis by inducing periodontal regeneration [ 139 ]. We predict that ADMPC autografts have great potential as a new treatment for alveolar bone regeneration and will continue to attract attention.…”

Odontologia: uma visão contemporânea - Volume 11

“…Após 4 semanas do transplante, foram detectadas células positivas para GFP no tecido regenerado e células PCNA no ligamento periodontal do osso regenerado no grupo teste, o que sugere que as células tronco adiposas desdiferenciadas promovem resultados semelhantes aos resultados das células-tronco mesenquimais. No que tange a experimentos em humanos com células do tecido adiposo, Takedachi et al (2022) avaliaram 12 pacientes com defeitos periodontais submetidos a transplante com células progenitoras de múltiplas linhagens derivadas de tecido adiposo autólogas, isoladas do tecido adiposo subcutâneo e transportadas para o defeito ósseo com material transportador de fibrina. Após 36 semanas, os pacientes foram avaliados e foi observada diminuição de profundidade de sondagem (PS) e redução do nível de inserção clínica (NIC).…”

“…Esse tipo de transplante requer um dente extraível que não seja funcional na cavidade oral e não seja afetado por uma cárie ou periodontite. No caso do transplante autólogo, essa exigência limita significativamente o número de pacientes indicados ( TAKEDACHI et al, 2022) . Dessa maneira, terceiros molares humanos são frequentemente extraídos e descartados, podendo ser uma fonte adequada de células-tronco da polpa dentária, do ligamento periodontal e papila apical se ainda estiverem em desenvolvimento radicular (NGUYEN et al, 2013).…”

Periodontal Tissue Regeneration by Recombinant Human Collagen Peptide Granules Applied With β-Tricalcium Phosphate Fine Particles

“…Periodontal regenerative therapy was developed to regenerate periodontal attachments, such as the periodontal ligament, cementum, and alveolar bone, lost due to severe periodontitis. Recently, the concept of tissue engineering has been incorporated into periodontal regenerative therapy [1,2], whereby cells [3][4][5], signaling molecules (growth factors) [6,7], and scaffold materials [8,9] are jointly used for tissue regeneration. Scaffolds play an important role in promoting cell adhesion, proliferation, differentiation, and subsequent extracellular matrix deposition and blood vessel network establishment in tissue defects [10,11].…”