Periodontitis is an inflammatory disease which manifests clinically as loss of supporting periodontal tissues including periodontal ligament, cementum, and alveolar bone, and periodontal therapy is aimed at achieving complete regeneration of these structures. To date, this goal has been tried to accomplish using various bone grafts, growth factors, and barrier membranes. Stem cells are the most fascinating area of biology today and have been used clinically in the field of medicine to treat many incurable diseases. Various human and animal studies have confirmed the presence of stem cells in dental tissues including periodontal ligament. This has opened new avenues aiming toward complete periodontal regeneration using cell-based therapies.
Though dental tissues are hard and rigid, they are vulnerable to damage caused by mechanical trauma, chemicals, congenital defects, cancer, and bacterial infections. Adult teeth demonstrate only limited reparative/regenerative ability as the formation of reparative or tertiary dentin. Similarly, periodontium also has limited capacity for regeneration in early phases of the disease. Despite our extensive knowledge concerning the pathology of diseases of teeth, restoration of damaged or diseased dental tissues has relied primarily on the use of synthetic implants and structural substitutions comprising inert compounds. Attempts to regenerate periodontal tissues have focused exclusively on regenerating lost alveolar bone with the help of autografts and alloplastic materials. More recently, several novel tissue-engineering approaches have emerged as perspective alternatives to conventional treatments including gene therapy and local administration of biocompatible scaffolds, with or without the presence of various growth factors. Most recent in the quest is the identification of putative dental stem cell populations and their potential use in stem cell based therapies to treat the damage caused by trauma, cancer, caries, and periodontal disease.
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