Use of autologous stem cells for the regeneration of periodontal defects in animal studies: a systematic review and meta analysis

Introduction. The periodontium is a complex organ comprising cementum, bone, gingiva and periodontal ligament. These tissues provide the teeth with masticatory load dampening and attachment to the alveolar bone. Periodontal disease is one of the main causes of tooth loss. The goals of periodontal therapy are the arrest of periodontal disease and the regeneration of damaged tissues. Regenerative therapies such as guided tissue regeneration and enamel matrix derivative have been utilized in clinical practice. Outcomes for these therapies have been poorly predictable and the scope of these therapies are limited to a few cases such as narrow intrabony periodontal tissue defect. Advances in cytotherapeutics led to cell-based periodontal tissue treatment. Periodontal tissue contains many types of cells, including mature multipotent mesenchymal stem cells. They are self-renewable, proliferative cells with a potential to differentiate into adult cell types. In this study we compare various types of mesenchymal stem cells and their application for the regeneration of periodontal defects. Aim. To overview preclinical animal trials and quantify the effect size that stem cell therapy has on the regeneration of periodontal tissue complex. Methods. Medline database search was conducted according to the PRISMA guidelines. Online search strategy was: periodont* AND regenerat* AND (Stem OR Adipose OR Periodontal OR pulp) AND Cell. Preclinical studies published between 2007.09.01 and 2017.09.01 in English language were included. Studies must have been conducted in vivo, on animals, MSCs had to be autologous and of following types: periodontal ligament, dental pulp, cementum, alveolar periosteal, gingival margin or adipose. The main goal of selected articles had to be periodontal defect regeneration using MSCs. Defects had to be caused by mechanical intervention with no signs of inflammation. Statistical analysis was conducted u [...]