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J Clin Exp Dent. 2019 Apr 1;11(4):e373-e381. doi: 10.4317/jced.55574. eCollection 2019 Apr.

Regeneration of periodontal bone defects with dental pulp stem cells grafting: Systematic Review.

Author information

Dentistry Student, Faculty of Medicine and Health Sciences, University of Barcelona, Spain.
MD, DDS, MS, PhD, EBOS, OMFS, Chairman and Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Barcelona. Director of Master's Degree Program in Oral Surgery and Implantology (EHFRE International University/FUCSO). Coordinator/Researcher of the IDIBELL Institute. Head of Oral and Maxillofacial Surgery Department of the Teknon Medical Center, Barcelona, Spain.
MD, DDS, PhD, Aggregate Professor of Oral Surgery. Master's Degree Program in Oral Surgery and Implantology, School of Dentistry, University of Barcelona, Barcelona. Researcher of the IDIBELL Institute, Barcelona, Spain.



The main objective is to evaluate the way to graft the dental pulp stem cells (DPSC) in periodontal defects that best regenerate periodontal tissues. Numerous procedures have been done to promote periodontal regeneration. Bone grafts show good gains clinically and radiographically but histologically seem to have minimal osteoinductive capacity. Another option that exceeds conventional surgery in reducing probing depth and increasing insertion is guided tissue regeneration and tissue engineering that could be an alternative approach to help in the regeneration of living functional bone and peri-dental structures.

Material and Methods:

A search was carried out in Cochrane, PubMed-MEDLINE and Scopus databases with keywords: "dental pulp stem cells", "periodontal regeneration", "guided tissue regeneration, periodontal", "tissue regeneration", "periodontal bone defects", "periodontal tissue engineering" and "periodontal defect". Inclusion criteria were articles in English, maximum 10 years old, in which DPSC were used to regenerate a periodontal defect. Exclusion criteria were studies not published in English, case reports, case series, literature reviews, and studies in which periodontal defect was caused by dental extraction.


Out of the 185 articles identified, 101 after excluding duplicates, of which 94 were discarded when reading the title and abstract. 7 articles were obtained for the full text reading: a case report and a case series were eliminated. The systematic review is performed with 5 animal testing studies in vivo. The DPSC sheets regenerate a greater amount of bone than the injection. If HGF (hepatocyte growth factor) is added, the maximum bone volume regenerated (69.3 ± 3.9 mm3; p<0.01) is achieved. Similar results were obtained in all carriers tested except in the controls. The periodontal ligament stem cells (PDLSC) formed more new bone, compared to DPSC (p<0.001). The presence of new cementum and periodontal ligament induced by CMLPs, was detected histologically but DPSC cannot achieve it alone.


Cementum or PDL regeneration does not depend only on DPSC but on other unknown factors. PDLSC has better periodontal regeneration than DPSC. DPSC significantly favours the regeneration of periodontal bone tissue but has few advantages over other grafts. It is necessary to study which growth factors or matrices can enhance their capacity for periodontal regeneration. Key words:Dental pulp, stem cells, periodontal guided tissue regeneration, periodontal bone loss.

Conflict of interest statement

Conflict of interest statement:The authors have declared that no conflict of interest exist.

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