Cell‐Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review

Federico Moreno Sancho,  Yago Leira,  Marco Orlandi,  Jacopo Buti,  William V. Giannobile, Francesco D'Aiuto

Stem Cells Translational Medicine

Current treatments to regrow alveolar bone and periodontal tissues are mostly effective and well adopted. These strategies are mainly based on the use of a combination of lab-made or natural scaffolds and/or bioactive agents, obviating the incorporation of stem cells. However, there are some inherent limitations associated with traditional techniques and it was hypothesised that the use of stem cell therapy as part of comprehensive treatment protocols may help overcome these hurdles to improve the regeneration of bone and the periodontal tissues.

Researchers conducted a systematic review of all published, controlled studies in humans looking into the clinical effect of the use of cell-based therapies for alveolar bone and periodontal regeneration.  They also explored the potential of these therapies to eventually be used in day-to-day clinical practice.  

The studies included in the review showed that stem cell therapy has the potential to improve outcomes of regenerative treatment for the reconstruction of alveolar bone and periodontal tissues. It was found that the bone defects left after a tooth is taken out, as well as long-standing large bone defects which would usually require block bone grafts, seem to be strong candidates for the application of stem cell therapy. 

However, given the complexity, invasiveness and costs associated with techniques - which try to increase the number of cells through complex processing of donor tissues -  the additional clinical benefit when compared to ‘minimal manipulation’ must be clarified in future clinical trials.

The review showed that there is insufficient evidence to identify a best‐performing, first choice cell‐based technique. It also highlighted a high risk of bias in most of the studies and the need for well‐designed, randomized, clinical controlled trials including the gold standard of treatment as a positive control. 

Further research evaluating the clinical effect and cost‐effectiveness of simple, fast, and economical methods for cell harvesting and processing is warranted. 

The study authors plan to conduct a randomised controlled trial investigating the effect of one simple stem cell therapy on bone regeneration following the loss of a tooth. 

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