Transplant of Adipose-derived Stem Cells Combined with Decellularized Human Gingiva: A New Available Approach to Gingival Recession Repair
Gingival recession is exposure of root surfaces due to the apical migration of gingival tissue borders which may bring on dentin hypersensitivity, root cavities, scratchs, aesthetic ailment, etc. Stem cell-based tissue technology is a promising attack for the intervention of gingival recession. However, the development of root cell-based therapy is dependent on the usage of an equal root cell beginning and suited biomaterials. In this paper, we proposed that grafting of adipose-derived root cells combined with decellularized human gum to the gingival recession sites could assist to renew gingival recession. We believe it is particularly utile to future clinical surveies and application in this field.
Gingival recession is a common clinical circumstance and its sweep and prevalence addition with age. Gingival recession is defined as apical migration of the gingival tissue borders with exposure of root surfaces ( 1-6 ) . To day of the month, many surgical techniques have been proposed to handle gingival recession including free gingival autoplasties, subepithelial connective tissue transplants, laterally positioned i¬‚ap, a dual papilla i¬‚ap, a semilunar i¬‚ap, and a coronally repositioned i¬‚ap ( 5, 7, 8 ) . However, these techniques face many challenges. Therefore, the development of new engineerings to renew gingival recession has importance in bettering patient ‘s quality of life.
Stem cell-based therapy provides an chance for periodontic regeneration and fix ( 9-12 ) . Adipose-derived root cells are multipotent root cells that have many advantages over other root cell beginnings, such as more handiness, copiousness, higher malleability, higher proliferation rate, easiness of isolation, etc ( 13-17 ) .
Recently, the usage of ADSCs has appeared as a possible attack for intervention of periodontic devolution ( 10, 11, 18, 19 ) . Therefore, the ADSCs have of import eligibilities for usage in regenerative medical specialty and would be a possible scheme for periodontic tissue regeneration in future.
Transplant of ADSCs into damaged periodontic tissue was investigated in a old survey ( 20 ) . However, utilizing of these root cells for tissue regeneration aims is dependent on many bioenvironmental factors such as cell microenvironment and signaling molecules. One of the attempts in tissue technology is to fix a biomimetic scaffold to supply a man-made extracellular matrix for cells and advance their growing, proliferation, and specific distinction. However, the usage of some man-made scaffolds of all time faces many challenges such as biocompatibility, biodegradation rate, cytotoxicity, immunogenicity, suitableness for specific cells, etc. , that limit their broad application in tissue technology field ( 21 ) . In recent surveies, to get the better of the mentioned drawbacks of the man-made scaffolds, natural decellularized extracellular matrices were used as back uping constructions for seeded cells ( 22-24 ) . The used DECM of a tissue for seeding of root cells can modulate cellular behaviour, proliferation, and specific distinction proportionated to the native tissue which is because of its particular 3-dimensional construction and the presence of specific signaling molecules in it ( 25, 26 ) .
Harmonizing to the old surveies, we hypothesized that the organ transplant of ADSCs combined with decellularized human gum into the gingival recession sites would be a fresh curative attack for gingival recession fix, particularly be utile to clinical surveies and applications.
Evaluation of the hypothesis
The rating of this hypothesis can be carried out from the undermentioned facets:
( 1 ) In recent old ages, human ADSCs attracted many attendings for regeneration of assorted tissues including bone, gristle, and periodontic tissues ( 27-30 ) . Recent surveies showed that transplanted ADSCs into damaged periodontic tissue sites can renew and mend the periodontic lesions, and may be applicable to presymptomatic and clinical periodontic tissue fix ( 11, 18, 20 ) .
( 2 ) Presently, the extracellular matrix-based scaffolds are considered as an attractive option for soft tissue autoplasties for the intervention of gingival recession and periodontic regeneration ( 31 ) . Use of DECM of gum as scaffold for cell seeding may supply an accessible tissue beginning and besides represents a suited 3-dimensional scaffold for cell fond regard, adhesion, proliferation, migration, distinction, and would decide the mentioned challenges of using the man-made scaffoldsin vivoand overcome restrictions of the autoplasties ( 32 ) . Decellularization of the ECM can continue the belongingss of the native tissue, but take antigenic agents and cellular constituents which would originate host immune response. The ECM of tissues can supply biomechanical belongingss similar to the native tissue and certain region-specific biochemical factors to modulate behaviour and distinction of root cells and regeneration procedure of gingival recession. Therefore, the ECM may play an of import function in interceding specific distinction of ADSCs ( 26, 33 ) .
( 3 ) Repair of gingival recession utilizing surgical techniques faces many challenges. It is a hard job for the alveolar consonant and unwritten sawboness to work out. Gingival recession is a extremely prevailing job that may be hold many results such as dentin hypersensitivity, root cavities, scratchs, aesthetic ailment, and dental cervical wear of substance ( 34, 35 ) . The purpose of gingival recession fix is to derive complete root coverage to the cementoenamel junction and reconstruct the lost tissues on the root surface. Treatment of gingival by guided tissue regeneration has attracted many attendings in recent old ages. To day of the month, different biomaterial-based scaffolds have been used for handling gingival recession by guided tissue regeneration technique ( 36-38 ) . Therefore, such an attack may supply penetrations into the fix and regeneration of gingival recession in patients.
Stem cell-based tissue regeneration is a possible curative technique for the intervention of periodontic tissue defects in instance of gingival recession ( 39, 40 ) . However, deficiency of suited microenvironment at the graft site for root cells growing and distinction is an of import challenge. Decellularized human gum provides a fresh promising 3-dimensional microenvironment for root cell growing, proliferation, and specific distinction for tissue technology applications, which can act upon root cell proliferation and distinction ( 26, 41 ) .
Use of suited biomaterials and an available root cell beginning can significantly better root cell-based therapy ( 42-45 ) . Reconstruction of the biomimeticin vitromicroenvironment for root cells and obtaining a suited root cell beginning are of import issues for gingival recession fix. In this paper, we hypothesized that the organ transplant of ADSCs combined with decellularized human gum into the gingival recession sites would be a fresh curative attack for gingival recession fix.
Although we propose that ADSCs combined with decellularized human gum might implement of import functions in gingival recession fix, farther surveies need to be performed before this technique can be applied clinically.
Conflict of Interest Statement
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