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Two types of dentition are generated in a human's lifetime: the primary dentition, followed by the permanent dentition. Undoubtedly, teeth are essential for speech and mastication in both dentitions, but it is becoming apparent that dental pulp also plays a role in harboring mesenchymal stem cells (MSCs). To date, three kinds of MSCs derived from dental pulp have been established: permanent tooth, primary tooth, and immature apical papilla. The dental pulp from primary teeth is considered a particularly good source of MSCs; it can be obtained from extracted primary teeth, of which humans have 20. The past decade has seen many reports of dental pulp-derived MSCs, and the field is becoming increasingly popular. The present article describes the characterization of dental pulp-derived MSCs from primary teeth. It also discusses future banking activity of primary teeth, because it is known that dental pulp-derived MSCs have similar potential to those derived from bone marrow. Methods with which to optimize the cryopreservation process should therefore be investigated, because banked dental pulp may provide a great resource in future regenerative medicine.

Keywords: banking, CD271, dental pulp, dental pulp-derived mesenchymal stem cells, mesenchymal stem cells, permanent teeth, primary dentition

The idea that somatic stem cells are localized in periodontal ligament (PDL) tissues as PDL stem cells (PDLSCs) responsible for construction and reconstruction of the periodontium has been widely accepted. Many dental scientists have attempted to clarify the identity of these PDLSCs, but the number of PDLSCs localized in PDL tissues is too small to be routinely and conveniently analyzed. Therefore, researchers have been attempting to develop undifferentiated PDL cell lines by transducing them with genes that are suitable for immortalization. The present authors were the first to succeed in establishing two clonal human PDL stem/progenitor cell lines that possessed multipotency derived from PDL tissues and that expressed PDL-related molecules as well as neural crest- and embryonic stem-related markers. The differentiation stages of these cell lines appeared to vary based on their potential to differentiate into other lineage cells, their response to tissue regeneration-related cytokines, and their behavior when transplanted into immunodeficient rats. This review describes the phenotypes of these cell lines compared with reported PDLSCs or other MSCs and discusses contemporary circumstances related to PDL regenerative medicine. Differential analyses between these two clones will reveal the mechanism of differentiation of PDLSCs as well as their phenotypes. The results will also allow for the acquisition of a mass population of PDLSCs or other stem cells directed toward PDL-lineage cells and to develop an unmet treatment needed for construction and reconstruction of PDL tissues based on tissue engineering techniques.

Keywords: periodontal ligament stem cells, periodontal ligament stem/progenitor cell lines

Periodontitis is a chronic inflammatory disease associated with loss of periodontal attachment, collagen, and alveolar bone. Regeneration of periodontal tissues can be supported by the local application of enamel matrix derivative (EMD). However, periodontal regeneration remains a major and often unpredictable challenge as the result of a number of unknown factors. The authors' in vitro studies revealed that EMD stimulated the wound fill rate, proliferation, and adhesion of periodontal ligament (PDL) cells. However, in the presence of an inflammatory environment or biomechanical loading, the beneficial effects of EMD decreased significantly. EMD also stimulated the synthesis of growth factors and collagen, as well as calcium deposition, in PDL cell cultures. These beneficial effects of EMD on PDL cells were also significantly diminished by inflammation and biomechanical forces, respectively. The findings suggest that critical PDL cell functions pertinent to periodontal regeneration are reduced in an inflammatory environment and under biomechanical loading. Therefore, effective anti-infectious and anti-inflammatory periodontal treatment before the application of EMD may be critical to ensure the full regenerative capacity of the PDL tissue. Furthermore, occlusal loading of EMD-treated teeth, at least immediately following surgery, should be minimized to obtain optimal regenerative healing results. A better understanding of the interactions of growth factors and biomechanical signals will result in more powerful regenerative therapeutic strategies.

Keywords: biomechanics, inflammation, periodontal healing, regeneration

Dental stem cells are excellent for oral and craniofacial tissue engineering. A profound knowledge about molecular processes in dental stem cells is necessary to create treatment approaches in oral medicine. Transcription factors regulate gene expression and provide decisive information for cellular functions. In recent years, the authors have investigated transcriptomes in dental stem cells before and after osteogenic differentiation. The present paper reports on the potential role of selected transcription factors, including ZBTB16, TP53, and SP1, in dental stem cell differentiation. This review discusses putative molecular processes in dental stem cells and summarizes the current knowledge.

Keywords: dental stem cells, differentiation, molecular biology, transcription factors

Innovative developments in the multidisciplinary field of tissue engineering have yielded various implementation strategies and the possibility of functional tissue regeneration. Technologic advances in the combination of stem cells, biomaterials, and growth factors have created unique opportunities to fabricate tissues in vivo and in vitro. The therapeutic potential of human multipotent mesenchymal stem cells (MSCs), which are harvested from bone marrow and adipose tissue, has generated increasing interest in a wide variety of biomedical disciplines. These cells can differentiate into a variety of tissue types, including bone, cartilage, fat, and nerve tissue. Adipose-derived stem cells have some advantages compared with other sources of stem cells, most notably that a large number of cells can be easily and quickly isolated from adipose tissue. In current clinical therapy for periodontal tissue regeneration, several methods have been developed and applied either alone or in combination, such as enamel matrix proteins, guided tissue regeneration, autologous/allogeneic/xenogeneic bone grafts, and growth factors. However, there are various limitations and shortcomings for periodontal tissue regeneration using current methods. Recently, periodontal tissue regeneration using MSCs has been examined in some animal models. This method has potential in the regeneration of functional periodontal tissues because the various secreted growth factors from MSCs might not only promote the regeneration of periodontal tissue but also encourage neovascularization of the damaged tissues. Adipose-derived stem cells are especially effective for neovascularization compared with other MSC sources. In this review, the possibility and potential of adipose-derived stem cells for regenerative medicine are introduced. Of particular interest, periodontal tissue regeneration with adipose-derived stem cells is discussed.

Keywords: adipose-derived stem cells, mesenchymal stem cells, periodontal disease, periodontal tissue regeneration, tissue engineering

Somatic stem cells have been acknowledged for their ability to differentiate into multiple cell types and their capacity for self-renewal. Some mesenchymal stem cells play a dominant role in the repair and reconstruction of periodontal tissues. Both dental-derived and some non-dental-derived mesenchymal stem cells possess the capacity for periodontal regeneration under certain conditions with induced differentiation, proliferation, cellular secretion, and their interactions. Stem cell-based tissue engineering technology promises to bring improvements to periodontal regeneration, biologic tooth repair, and bioengineered implants. The present review discusses the roles and values of various somatic stem cells in periodontal regeneration.

Keywords: mesenchymal stem cell, periodontal regeneration, somatic stem cell, tissue engineering

Purpose: Recent studies have shown that periodontal ligament stem cells (PDLSCs) play a key role in periodontal regeneration. However, the origin of these cells remains unclear. Meanwhile, bone marrow is thought to be the most common source of adult stem cells in many tissues and organs. Thus, the present investigation sought to determine whether systemically delivered bone marrow-derived mesenchymal stem cells (BM-MSCs) could participate in periodontal regeneration and differentiate into periodontal-specific cells and to explore the origin of PDLSCs.
Methods: Enhanced green fluorescent protein (EGFP)-labeled BM-MSCs were delivered into lethally irradiated rats by intra-bone marrow (IBM) transplantation. Four weeks after transplantation, periodontal defects with and without infection of anaerobic cultured Porphyromonas gingivalis were established. The animals were killed 1, 2, 4, or 6 weeks after periodontal defect surgery. Histomorphologic analysis, direct observation with the fluorescence microscope, and immunohistochemical staining were performed to evaluate the localization and differentiation of BM-MSCs.
Results: EGFP-positive BM-MSCs could be observed as early as 1 week after surgery, and the number of EGFP-positive cells reached a maximum at 2 weeks. Meanwhile, EGFP-positive cells were observed in the newly formed bone, PDL, and cementum 4 weeks after surgery. Immunohistochemical staining verified that EGFP-positive BM-MSCs could differentiate into osteoblasts.
Conclusions: These findings provide direct evidence that BM-MSCs can participate in and modulate periodontal regeneration.

Keywords: bone marrow, mesenchymal stem cells, periodontal ligament, regeneration

Sinus floor grafting with bone morphogenetic protein-2 for transsinus implant placement or as a salvage technique for sinus-involved peri-implantitis has been found to be successful. Transsinus implants for All-on-Four treatment, zygomatic implants including quad zygomatics, and infected transsinus implants underwent peri-implant grafting, which was found to seal off the sinus cavity from the oral cavity in an effort to prevent or treat sinusitis/peri-implantitis.

Keywords: bone morphogenetic protein-2, M point, oroantral fistula, peri-implantitis, sinus elevation, sinusitis, transsinus implants, zygomatic implants

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