Mesenchymal stem cells (MSCs) are being actively explored to regenerate periodontal tissues, soft tissues, and bone in oral and maxillofacial surgery. Periodontal tissues—including gingiva, periodontal ligament (PDL), cementum, and alveolar bone—require true functional regeneration, not just defect filling.
MSCs contribute via two main mechanisms: differentiation into osteoblasts, fibroblasts, and cementoblasts, and secretion of trophic factors and extracellular vesicles that modulate inflammation, stimulate angiogenesis, and recruit the patient’s own repair cells. Periodontal ligament, dental pulp, gingiva, and bone marrow–derived MSCs have demonstrated new bone, cementum, and PDL fiber formation in animal models, especially when combined with scaffolds such as collagen membranes or bone substitutes. Preclinical studies suggest that “site-specific” cells, such as PDL-derived MSCs, may achieve superior regeneration compared with bone marrow MSCs. Early clinical trials indicate improvements in clinical attachment level and probing depth, though sample sizes are still small and protocols vary.
Cell-free approaches using MSC-conditioned medium or exosomes are gaining interest, as they enhance bone fill and PDL regeneration while avoiding the challenges of cell harvesting and survival.
In soft tissue reconstruction, dental and gingival MSCs exhibit strong proliferative and angiogenic capabilities, supporting gingiva and oral mucosa healing and improving graft and implant integration.
Adipose-derived MSCs and buccal fat pad–derived cells are particularly useful for volume restoration and coverage. Their easy harvest and secretion of pro-angiogenic factors enhance vascularization and soft tissue quality around implants or in mucogingival surgery. Additionally, their immunomodulatory effects may stabilize chronic inflammatory conditions such as periodontitis or peri-implantitis, creating a favorable environment for long-term tissue stability.
For bone regeneration in the jaws, MSCs from bone marrow, dental pulp, PDL, periosteum, and buccal fat pad have been applied experimentally and clinically for:
When seeded onto scaffolds—calcium phosphate ceramics, xenografts, or collagen matrices—MSCs support predictable bone formation with low donor site morbidity and good implant integration. Systematic reviews indicate that bone marrow and adipose-derived MSCs improve bone volume and density, while dental tissue–derived MSCs show particular promise for smaller intra-alveolar and periodontal defects.
Across all applications, successful MSC therapy relies on:
While current data are promising, larger and long-term clinical trials are needed before MSC-based therapies can become routine care in oral and maxillofacial surgery.
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