Stem Cells in Periodontal Regeneration: A Scoping Review
Ola M Ezzatt*
Professor of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, Ain Shams University and Manager of Central Lab of Stem Cells and Biomaterial Applied Research (CLSBAR), Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
*Corresponding Author: Ola M Ezzatt, Professor of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, Ain Shams University and Manager of Central Lab of Stem Cells and Biomaterial Applied Research (CLSBAR), Faculty of Dentistry, Ain-Shams University, Cairo, Egypt.
Received:
April 17, 2025; Published: April 24, 2025
Abstract
Background: Periodontitis can lead to progressive and irreversible damage of the periodontium, including gingival recessions, loss of soft tissue attachment, intra-bony defects, and eventually tooth loss. In recent years, stem cell-based therapy has been introduced for periodontal tissue regeneration, but the potential effect of this therapy is still unclear. This scoping review aims to systematically explore and outline the available literature that investigated the potential of stem cells in periodontal regeneration.
Methods: A comprehensive electronic review of the available literature in PubMed, Clinical Trial Registration Site, Web of Science, and Scopus databases was conducted in January 2024 within a time frame starting from January 2014. This scoping review follows the extension of PRISMA-sR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) as a guideline and includes all studies that investigated the use of any type of stem cells in periodontal tissue regeneration.
Results: The initial search in databases yielded (1213) articles. The (28) included articles that met the eligibility criteria were (4) registered clinical trials, (19) pre-clinical studies, and (5) published eligible randomized clinical trials (RCTs).
Conclusions: Stem cell-based therapy showed promising results in the field of periodontal regeneration, particularly periodontal ligament stem cells (PDLSCs), but the path from basic research to practical therapeutic use is still ongoing.
Keywords: Periodontal; Oral Diagnosis
References
- Pitaru S., et al. “Cellular origins and differentiation control mechanisms during periodontal development and wound healing”. Journal of Periodontal Research 2 (1994): 81-94.
- Hämmerle CHF and Giannobile WV. “Biology of soft tissue wound healing and regeneration – Consensus Report of Group 1 of the 10th European Workshop on Periodontology”. Journal of Clinical Periodontologys15 (2014): S1-S5.
- Sculean A., et al. “Soft tissue wound healing around teeth and dental implants”. Journal of Clinical Periodontology15 (2014): S6-S22.
- Bartold PM., et al. “Tissue engineering: a new paradigm for periodontal regeneration based on molecular and cell biology”. Periodontology 20001 (2020): 253-269.
- Noguchi S., et al. “The histopathological comparison on the destruction of the periodontal tissue between normal junctional epithelium and long junctional epithelium”. Journal of Periodontal Research 1 (2017): 74-82.
- Chen FM., et al. “A review on endogenous regenerative technology in periodontal regenerative medicine”. Biomaterials31 (2010): 7892-7927.
- Bosshardt DD., et al. “Cell-to-cell communication - periodontal regeneration”. Clinical Oral Implants Research3 (2015): 229-239.
- Fraser D., et al. “Periodontal Wound Healing and Regeneration: Insights for Engineering New Therapeutic Approaches”. Frontiers in Dental Medicine (2022): 3.
- Melcher AH. “On the repair potential of periodontal tissues”. Journal of Periodontology5 (1976): 256-260.
- Taba M., et al. “Current concepts in periodontal bioengineering”. Orthodontics and Craniofacial Research4 (2005): 292-302.
- Thamaraiselvan M., et al. “Minimally Invasive Surgery Periodontal Therapy for the Treatment of Intrabony Periodontal Defects: A Systematic Review”. Contemporary Clinical Dentistry2 (2022): 101-107.
- Abedi N., et al. “Layered scaffolds in periodontal regeneration”. Journal of Oral Biology and Craniofacial Research 6 (2022): 782-797.
- Deng Y., et al. “Biomaterials for Periodontal Regeneration”. Dental Clinics of North America 4 (2022): 659-672.
- Wang HL., et al. “Periodontal regeneration”. Journal of Periodontology9 (2005): 1601-1622.
- Bottino MC., et al. “Recent advances in the development of GTR/GBR membranes for periodontal regeneration--a materials perspective”. Dental Material7 (2012): 703-721.
- Meng L., et al. “Stem cell homing in periodontal tissue regeneration”. Frontiers in Bioengineering and Biotechnology (2022): 10.
- Caton JG and Greenstein G. “Factors related to periodontal regeneration”. Periodontology 20001 (1993): 9-15.
- Hynes K., et al. “Clinical utility of stem cells for periodontal regeneration”. Periodontology 20001 (2012): 203-227.
- Zakrzewski W., et al. “Stem cells: past, present, and future”. Stem Cell Research and Therapy1 (2019): 68.
- Estrela C., et al. “Mesenchymal stem cells in the dental tissues: perspectives for tissue regeneration”. Brazilian Dental Journal2 (2011): 91-98.
- Arbildo-Vega H., et al. “Dental stem cells and their application in dentistry”. Journal of Oral Research3 (2020): 220-233.
- Magalhães FD., et al. “Dental tissue-derived stem cell sheet biotechnology for periodontal tissue regeneration: A systematic review”. Archives of Oral Biology (2021): 129.
- Liang JF., et al. “Identification of Dental Stem Cells Similar to Skeletal Stem Cells”. Journal of Dental Research9 (2022): 1092-1100.
- Kargozar S., et al. “Bone Tissue Engineering Using Human Cells: A Comprehensive Review on Recent Trends, Current Prospects, and Recommendations”. Applied Sciences1 (2019): 174.
- Gaur S and Agnihotri R. “Application of adipose tissue stem cells in regenerative dentistry: A systematic review”. Journal of International Society of Preventive and Community Dentistry 3 (2021): 266-271.
- Hu L., et al. “Regeneration characteristics of different dental derived stem cell sheets”. Journal of Oral Rehabilitation S1 (2020): 66-72.
- Novello S., et al. “Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta-analysis”. Journal of Periodontal Research 1 (2020): 1-12.
- Li S., et al. “Effect of human periodontal ligament stem cell-derived exosomes on cementoblast activity”. Oral Disease. Published online (2023).
- Wang M., et al. “SHED-derived exosomes improve the repair capacity and osteogenesis potential of hPDLCs”. Oral Disease4 (2023): 1692-1705.
- Lan Q., et al. “Effects of periodontal ligament stem cell-derived exosomes on osteoblastic proliferation, migration, differentiation, apoptosis, and signaling pathways”. Oral Disease Published online (2022).
- Sunartvanichkul T., et al. “Stem cell-derived exosomes from human exfoliated deciduous teeth promote angiogenesis in hyperglycemic-induced human umbilical vein endothelial cells”. Journal of Applied Oral Science (2023): 31.
- Hu Y., et al. “Human gingival mesenchymal stem cell-derived exosomes cross-regulate the Wnt/β-catenin and NF-κB signalling pathways in the periodontal inflammation microenvironment”. Journal of Clinical Periodontology6 (2023): 796-806.
- Wu N., et al. “Effect of an low-energy Nd: YAG laser on periodontal ligament stem cell homing through the SDF-1/CXCR4 signaling pathway”. BMC Oral Health1 (2023).
- Wang X., et al. “Strategies of cell and cell-free therapies for periodontal regeneration: the state of the art”. Stem Cell Research and Therapy1 (2022): 536.
- Tricco AC., et al. “PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation”. Annals of Internal Medicine 7 (2018): 467-473.
- Yan XZ., et al. “Cell-Based Approaches in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Periodontal Defect Models in Animal Experimental Work”. Tissue Engineering Part B: Reviews 5 (2015): 411-426.
- Li Q., et al. “Stem cell therapies for periodontal tissue regeneration: a network meta-analysis of preclinical studies”. Stem Cell Research and Therapy1 (2020): 427.
- Nguyen-Thi TD., et al. “Stem cell therapies for periodontal tissue regeneration: A meta-analysis of clinical trials”. Journal of Oral Biology and Craniofacial Research 5 (2023): 589-597.
- Lin LM., et al. “Clinical cell-based versus cell-free regenerative endodontics: clarification of concept and term”. International Endodontic Journal 6 (2021): 887-901.
- Nagata M., et al. “Conditioned Medium from Periodontal Ligament Stem Cells Enhances Periodontal Regeneration”. Tissue Engineering Part A 9-10 (2017): 367-377.
- Zhang Y., et al. “Exosome: A Review of Its Classification, Isolation Techniques, Storage, Diagnostic and Targeted Therapy Applications”. International Journal of Nanomedicine 15 (2022): 6917-6934.
- Apatzidou DA., et al. “A tissue-engineered biocomplex for periodontal reconstruction. A proof-of-principle randomized clinical study”. Journal of Clinical Periodontology8 (2022): 1111-1125.
- Tauqir S., et al. “The Use of Bio-Inks and the Era of Bioengineering and Tooth Regeneration”. Pesquisa Brasileira em Odontopediatria e Clínica Integrada (2022): 22.
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