Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis

Background and Aim. Soft and hard periodontal tissues contain limited numbers of stem cells. This makes regeneration of the periodontium in patients with periodontitis challenging and unpredictable. Granulation tissue is traditionally removed during periodontal corrective therapy, but it is believed...

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Main Authors: Naiwen Tan, Maja Sabalic, Linh Nguyen, Francesco D’Aiuto
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Stem Cells International
Online Access:http://dx.doi.org/10.1155/2023/8789852
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author Naiwen Tan
Maja Sabalic
Linh Nguyen
Francesco D’Aiuto
author_facet Naiwen Tan
Maja Sabalic
Linh Nguyen
Francesco D’Aiuto
author_sort Naiwen Tan
collection DOAJ
description Background and Aim. Soft and hard periodontal tissues contain limited numbers of stem cells. This makes regeneration of the periodontium in patients with periodontitis challenging and unpredictable. Granulation tissue is traditionally removed during periodontal corrective therapy, but it is believed to contain multipotent stem cells which could be used for regenerative therapy. The aim of this research was to critically appraise the evidence on cellular components within granulation tissue in patients with periodontitis and its regenerative potential when compared to control healthy periodontal tissue. Methods. Electronic searches were conducted in five databases including CENTRAL, MEDLINE, EMBASE, Web of Science, and Dentistry & Oral Sciences Source using a combination of MeSH terms and keywords up to 21 June 2022. Human studies including patients aged over 18 years with all forms of periodontitis were included. Following the risk of bias assessment, both qualitative and quantitative analyses were performed. Results. A total of twelve studies were included in qualitative analysis and six of them in quantitative analyses. The evidence suggested that cells derived from periodontitis granulation tissue have osteogenic, adipogenic, chondrogenic, neurogenic, and angiogenic differentiation abilities as well as immunoregulatory properties. In particular, CD44+, CD73+, CD90+, CD105+, and CD146+ cells were found widely in granulation tissue whilst the only meta-analysis confirmed that CD90+ cells were present in lower numbers within the granulation tissue when compared with healthy periodontal tissue (WMD=−23.43%, 95% CI -30.43 to -16.44, p<0.00001). Conclusions. This review provided further evidence that granulation tissue from patients with periodontitis can be a potential stem cell source for regenerative therapy.
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spelling doaj-art-7e315c413c0248c9b27ea81b70e2d7d62025-02-03T06:42:37ZengWileyStem Cells International1687-96782023-01-01202310.1155/2023/8789852Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysisNaiwen Tan0Maja Sabalic1Linh Nguyen2Francesco D’Aiuto3UCL Eastman Dental InstituteUCL Eastman Dental InstituteUCL Eastman Dental InstituteUCL Eastman Dental InstituteBackground and Aim. Soft and hard periodontal tissues contain limited numbers of stem cells. This makes regeneration of the periodontium in patients with periodontitis challenging and unpredictable. Granulation tissue is traditionally removed during periodontal corrective therapy, but it is believed to contain multipotent stem cells which could be used for regenerative therapy. The aim of this research was to critically appraise the evidence on cellular components within granulation tissue in patients with periodontitis and its regenerative potential when compared to control healthy periodontal tissue. Methods. Electronic searches were conducted in five databases including CENTRAL, MEDLINE, EMBASE, Web of Science, and Dentistry & Oral Sciences Source using a combination of MeSH terms and keywords up to 21 June 2022. Human studies including patients aged over 18 years with all forms of periodontitis were included. Following the risk of bias assessment, both qualitative and quantitative analyses were performed. Results. A total of twelve studies were included in qualitative analysis and six of them in quantitative analyses. The evidence suggested that cells derived from periodontitis granulation tissue have osteogenic, adipogenic, chondrogenic, neurogenic, and angiogenic differentiation abilities as well as immunoregulatory properties. In particular, CD44+, CD73+, CD90+, CD105+, and CD146+ cells were found widely in granulation tissue whilst the only meta-analysis confirmed that CD90+ cells were present in lower numbers within the granulation tissue when compared with healthy periodontal tissue (WMD=−23.43%, 95% CI -30.43 to -16.44, p<0.00001). Conclusions. This review provided further evidence that granulation tissue from patients with periodontitis can be a potential stem cell source for regenerative therapy.http://dx.doi.org/10.1155/2023/8789852
spellingShingle Naiwen Tan
Maja Sabalic
Linh Nguyen
Francesco D’Aiuto
Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
Stem Cells International
title Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
title_full Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
title_fullStr Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
title_full_unstemmed Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
title_short Regenerative Potential of Granulation Tissue in Periodontitis: A Systematic Review and Meta-analysis
title_sort regenerative potential of granulation tissue in periodontitis a systematic review and meta analysis
url http://dx.doi.org/10.1155/2023/8789852
work_keys_str_mv AT naiwentan regenerativepotentialofgranulationtissueinperiodontitisasystematicreviewandmetaanalysis
AT majasabalic regenerativepotentialofgranulationtissueinperiodontitisasystematicreviewandmetaanalysis
AT linhnguyen regenerativepotentialofgranulationtissueinperiodontitisasystematicreviewandmetaanalysis
AT francescodaiuto regenerativepotentialofgranulationtissueinperiodontitisasystematicreviewandmetaanalysis