ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Stem Cell Therapy May Reverse The Detrimental Effects Of Periodontal Disease Compared To Current NSPT Standard Of Care Practices
Clinical Question How will stem cell therapy induce regeneration of the periodontium in adults with periodontal disease related to plaque in comparison to current standard of care practices?
Clinical Bottom Line The use of stem cells in GTR has a promising future in treating and curing periodontal disease, but currently research is still being done via animal studies. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20979138Ding/2010mini pigAnimal Study
Key resultsUse of “allogenic periodontal ligament stem cells (PDLSCs) sheet cures periodontitis in a mini-pig model, possessing low immunogenicity and T cell suppression” through the presence of PGE2. PGE2 immunomodulation plays a pivotal role in PDLSC’s ability to reverse tissue damage, thereby curing periodontal disease in said mini pigs.
Evidence Search ("Stem Cells"[Mesh] AND "Periodontal Diseases/therapy"[Mesh] OR (Stem cells AND periodontal disease)
Comments on
The Evidence
This is an experimental study on the development of standard procedures in the use of allogenic PDLSC’s (Periodontal Ligament Stem Cells) to cure periodontal disease in mini pigs. Periodontal lesions were generated in 15 pigs for a total of 30 defects. The defects were randomly assigned into the following groups: 1) control group with initial periodontal therapy only, 2)"HA/TCP group" (flap surgery, transplantation of HA/TCP scaffolds, and membrane cover), 3)"HA/TCP scaffolds + autologous pPDLSC’s group" (flap surgery, "transplantation of autologous sheets combined with HA/TCP scaffolds", and membrane coverage; (d) "HA/TCP scaffolds allogeneic Guizhou minipig pPDLSCs group" (flap surgery, "transplantation of an allogeneic male Guizhou minipig pPDLSC sheet combined with HA/ TCP scaffolds", and membrane coverage); (e) "HA/TCP scaffolds autologous heterogenic mini-pig periodontal ligament cells (pPDLCs) group" (flap surgery, "transplantation of autologous pPDLCs sheets combined with HA/ TCP scaffolds", and membrane coverage). Data was collected via "clinical assessment" (week 4 post defect generation, prior to treatment @ week 0, and 12 weeks post-transplantation). "Routine blood and biochemical tests, immunoglobulin and T cell-related markers" were taken at week -4, 1-7 days, and weeks 2, 4, 8, and 12 (post-transplantation). CT scans (week 0 and 12 post-transplantation) and histological ("histomorphometric quantification of bone formation") exams were done at week 12 post-transplantation. The evidence appears to be sound relative to this study.
Applicability The evidence shows promising advances in GTR through the use of PDLSC’s given their low immunogenicity in the treatment of periodontal disease. It is also obvious however, that further research and clinical trials are needed before this information can transfer over in the treatment patients.
Specialty/Discipline (Periodontics)
Keywords Stem cell therapy, Periodontics
ID# 872
Date of submission: 04/28/2011spacer
E-mail jurek@uthscsa.edu
Author Janette Jurek
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie Jones, DDS
Faculty mentor/Co-author e-mail JonesA@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Rebecca Neitzke, Trey Patterson (San Antonio, TX) on 10/03/2014
A PubMed search on this topic was performed September 2014. A more recent publication was found: Monsarrat 2014, PMID: 24744392. This systematic review confirmed the findings in this CAT. The use of stem cells for the purpose of periodontal regeneration continues to be very promising, however, human research is still lacking.
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