Periodontal regeneration using a xenogeneic bone substitute seeded with autologous periodontal ligament-derived mesenchymal stem cells: A 12-month quasi-randomized controlled pilot clinical trial

J Clin Periodontol. 2020 Nov;47(11):1391-1402. doi: 10.1111/jcpe.13368.

Abstract

Aim: To evaluate the safety and efficacy of autologous periodontal ligament-derived mesenchymal stem cells (PDL-MSCs) embedded in a xenogeneic bone substitute (XBS) for the regenerative treatment of intra-bony periodontal defects.

Material and methods: This quasi-randomized controlled pilot phase II clinical trial included patients requiring a tooth extraction and presence of one intra-bony lesion (1-2 walls). Patients were allocated to either the experimental (XBS + 10 × 106 PDL-MSCs/100 mg) or the control group (XBS). Clinical and radiographical parameters were recorded at baseline, 6, 9 and 12 months. The presence of adverse events was also evaluated. Chi-square, Student's t test, Mann-Whitney U, repeated-measures ANOVA and regression models were used.

Results: Twenty patients were included. No serious adverse events were reported. Patients in the experimental group (n = 9) showed greater clinical attachment level (CAL) gain (1.44, standard deviation [SD] = 1.87) and probing pocket depth (PPD) reduction (2.33, SD = 1.32) than the control group (n = 10; CAL gain = 0.88, SD = 1.68, and PPD reduction = 2.10, SD = 2.46), without statistically significant differences.

Conclusion: The application of PDL-MSCs to XBS for the treatment of one- to two-wall intra-bony lesions was safe and resulted in low postoperative morbidity and appropriate healing, although its additional benefit, when compared with the XBS alone, was not demonstrated.

Keywords: cell therapy; mesenchymal stem cells; periodontal ligament; periodontal regeneration; tissue engineering.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Bone Loss* / diagnostic imaging
  • Alveolar Bone Loss* / surgery
  • Bone Regeneration
  • Bone Substitutes* / therapeutic use
  • Guided Tissue Regeneration, Periodontal
  • Humans
  • Mesenchymal Stem Cells*
  • Periodontal Attachment Loss / surgery
  • Periodontal Ligament

Substances

  • Bone Substitutes

Associated data

  • ISRCTN/ISRCTN 13093912