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.


Best services for writing your paper according to Trustpilot

Premium Partner
From $18.00 per page
4,8 / 5
Writers Experience
Recommended Service
From $13.90 per page
4,6 / 5
Writers Experience
From $20.00 per page
4,5 / 5
Writers Experience
* All Partners were chosen among 50+ writing services by our Customer Satisfaction Team

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

None declared.


[ 1 ] M.G. Marini, S.L.A. Greghi, E. Passanezi and A.C.P. Sant’Ana, Gingival recession: prevalence, extension and badness in grownups, Journal of Applied Oral Science 12 ( 2004 ) , pp. 250-255.

[ 2 ] A. Kumar and S.S. Masamatti, A new categorization system for gingival and palatine recession, Journal of Indian Society of Periodontology 17 ( 2013 ) , p. 175.

[ 3 ] V. Anand, M. Gulati, P. Rastogi and J. Dixit, Free gingival autoplasty for augmentation of keratinized tissue in apical to gingival recession–A instance study, Journal of Oral Biology and Craniofacial Research 2 ( 2012 ) , pp. 135-137.

[ 4 ] L.R. Gilbert, P. Lohra, V. Mandlik, S. Rath and A. Jha, Comparative rating of surgical modes for coverage of gingival recession: An Armed Forces Medical College position, Medical Journal Armed Forces India ( 2012 ) .

[ 5 ] M.M. KASSAB and R.E. COHEN, Treatment of gingival recession, The Journal of the American Dental Association 133 ( 2002 ) , pp. 1499-1506.

[ 6 ] A. Tugnait and V. Clerehugh, Gingival recession—its significance and direction, Journal of dental medicine 29 ( 2001 ) , pp. 381-394.

[ 7 ] H. Singh and H. Singh, Bioactive amniotic sac as a guided tissue regeneration ( GTR ) membrane for intervention of stray gingival recession. A instance study, Indian Journal of Dentistry 4 ( 2013 ) , pp. 110-113.

[ 8 ] H. Alghamdi, N. Babay and A. Sukumaran, Surgical direction of gingival recession: A clinical update, The Saudi Dental Journal 21 ( 2009 ) , pp. 83-94.

[ 9 ] P.M. Bartold, S. Shi and S. Gronthos, Stem cells and periodontic regeneration, Periodontology 2000 40 ( 2006 ) , pp. 164-172.

[ 10 ] D. Sadeghi, H. Nazarian and H. Nojehdehian, Adipose-derived root cells combined with beta-tricalcium phosphate: A novel possible scheme for periodontic defects regeneration, Medical hypotheses 82 ( 2014 ) , pp. 54-56.

[ 11 ] M. Tobita, A.C. Uysal, R. Ogawa, H. Hyakusoku and H. Mizuno, Periodontal tissue regeneration with adipose-derived root cells, Tissue Engineering Part A 14 ( 2008 ) , pp. 945-953.

[ 12 ] Y. Yamada, M. Ueda, H. Hibi and S. Baba, A novel attack to periodontic tissue regeneration with mesenchymal root cells and platelet-rich plasma utilizing tissue technology engineering: A clinical instance study, International Journal of Periodontics & A ; Restorative Dentistry 26 ( 2006 ) .

[ 13 ] R. Madonna, Y.-J. Geng and R. De Caterina, Adipose tissue-derived root cells word picture and potency for cardiovascular fix, Arteriosclerosis, thrombosis, and vascular biological science 29 ( 2009 ) , pp. 1723-1729.

[ 14 ] P. Gir, G. Oni, S.A. Brown, A. Mojallal and R.J. Rohrich, Human adipose root cells: current clinical applications, Plastic and rehabilitative surgery 129 ( 2012 ) , pp. 1277-1290.

[ 15 ] B.M. Buehrer and B. Cheatham, Isolation and word picture of human adipose-derived root cells for usage in tissue technology, Organ Regeneration, Springer ( 2013 ) , pp. 1-11.

[ 16 ] T. Rada, R.L. Reis and M.E. Gomes, Adipose tissue-derived root cells and their application in bone and gristle tissue technology, Tissue Engineering Part B: Reviews 15 ( 2009 ) , pp. 113-125.

[ 17 ] L. Guasti, W. Prasongchean, G. Kleftouris, et al. , High malleability of paediatric adipose tissue-derived root cells: excessively much for selective skeletogenic distinction? , Stem cells translational medical specialty 1 ( 2012 ) , pp. 384-395.

[ 18 ] M. Tobita and H. Mizuno, Adipose-derived root cells for periodontic tissue regeneration, Adipose-Derived Stem Cells, Springer ( 2011 ) , pp. 461-470.

[ 19 ] N.H. Lin, S. Gronthos and P. Mark Bartold, Stem cells and future periodontic regeneration, Periodontology 2000 51 ( 2009 ) , pp. 239-251.

[ 20 ] M. Takedachi, K. Sawada, S. Yamamoto, et al. , Periodontal tissue regeneration by organ transplant of adipose tissue-derived root cells, Journal of Oral Biosciences 55 ( 2013 ) , pp. 137-142.

[ 21 ] K.H. Wu, X.M. Mo and Y.L. Liu, Cell sheet technology for the injured bosom, Medical hypotheses 71 ( 2008 ) , pp. 700-702.

[ 22 ] S.F. Badylak, The extracellular matrix as a scaffold for tissue Reconstruction, Seminars in cell & A ; developmental biological science vol. 13, Elsevier ( 2002 ) , pp. 377-383.

[ 23 ] S.F. Badylak, D.O. Freytes and T.W. Gilbert, Extracellular matrix as a biological scaffold stuff: construction and map, Acta biomaterialia 5 ( 2009 ) , pp. 1-13.

[ 24 ] H. Lu, T. Hoshiba, N. Kawazoe, I. Koda, M. Song and G. Chen, Cultured cell-derived extracellular matrix scaffolds for tissue technology, Biomaterials 32 ( 2011 ) , pp. 9658-9666.

[ 25 ] N.F. Huang and S. Li, Regulation of the matrix microenvironment for root cell technology and regenerative medical specialty, Annals of biomedical technology 39 ( 2011 ) , pp. 1201-1214.

[ 26 ] M. Pei, J. Li, M. Shoukry and Y. Zhang, A reappraisal of decellularized root cell matrix: a novel cell enlargement system for gristle tissue technology, Eur Cell Mater 22 ( 2011 ) , p. 43.

[ 27 ] A.M. Parker and A.J. Katz, Adipose-derived root cells for the regeneration of damaged tissues, ( 2006 ) .

[ 28 ] J.M. Gimble, A.J. Katz and B.A. Bunnell, Adipose-derived root cells for regenerative medical specialty, Circulation research 100 ( 2007 ) , pp. 1249-1260.

[ 29 ] H. Mizuno, Adipose-derived root cells for tissue fix and regeneration: ten old ages of research and a literature reappraisal, Journal of Nippon Medical School 76 ( 2009 ) .

[ 30 ] P. Zuk, Adipose-derived root cells in tissue regeneration: a reappraisal, ISRN Stem Cells 2013 ( 2013 ) .

[ 31 ] S. Goktas, A.M. Matuska, N. Pierre, T.M. Gibson, J.J. Dmytryk and P.S. McFetridge, Decellularization method influences early reconstructing of an allogenic tissue scaffold, Journal of Biomedical Materials Research Part A 102 ( 2014 ) , pp. 8-16.

[ 32 ] S. Naderi, J.K. Zadeh, N.M. Shahri, et al. , Three-dimensional Scaffold from Decellularized Human Gingiva for Cell Cultures: Glycoconjugates and Cell Behavior, Cell Journal ( Yakhteh ) 15 ( 2013 ) , p. 166.

[ 33 ] J. Li and M. Pei, Decellularized Stem Cell Matrix: A Novel Approach for Autologous Chondrocyte Implantation-Based Cartilage Repair, Stem Cells and Cancer Stem Cells, Volume 12, Springer ( 2014 ) , pp. 109-115.

[ 34 ] I. Bignozzi, C. Littarru, A. Crea, G. Vittorini Orgeas and L. Landi, Surgical Treatment Options for Grafting Areas of Gingival Recession Association with Cervical Lesions: A Review, Journal of Esthetic and Restorative Dentistry 25 ( 2013 ) , pp. 371-382.

[ 35 ] G. Rasperini, R. Acunzo and E. Limiroli, Decision doing in gingival recession intervention: scientific grounds and clinical experience, Clinical Progresss in Periodonticss 1 ( 2011 ) , pp. 41-52.

[ 36 ] G.P. Prato, C. Tinti, G. Vincenzi, C. Magnani, P. Cortellini and C. Clauser, Guided tissue regeneration versus mucogingival surgery in the intervention of human buccal gingival recession, Journal of periodontology 63 ( 1992 ) , pp. 919-928.

[ 37 ] A. Banihashemrad, E. Aghassizadeh and M. Radvar, Treatment of gingival recessions by guided tissue regeneration and coronally advanced flap, The New York province dental diary 75 ( 2009 ) , pp. 54-58.

[ 38 ] M.J. Daneshaˆ?Meyer and U.M. Wikesjo , Gingival recession defects and guided tissue regeneration: a reappraisal, Journal of periodontic research 36 ( 2001 ) , pp. 341-354.

[ 39 ] M. Maumus, D. Guerit, K. Toupet, C. Jorgensen and D. Noel, Mesenchymal root cell-based therapies in regenerative medical specialty: applications in rheumatology, Stem Cell Res Ther 2 ( 2011 ) , p. 14.

[ 40 ] H. Hirai, Stem cells and regenerative medical specialty, Human cell 15 ( 2002 ) , pp. 190-198.

[ 41 ] H. Lin, G. Yang, J. Tan and R.S. Tuan, Influence of decellularized matrix derived from human mesenchymal root cells on their proliferation, migration and multi-lineage distinction potency, Biomaterials 33 ( 2012 ) , pp. 4480-4489.

[ 42 ] M. Cooke, K. Vulic and M. Shoichet, Design of biomaterials to heighten root cell endurance when transplanted into the damaged cardinal nervous system, Soft Matter 6 ( 2010 ) , pp. 4988-4998.

[ 43 ] S.M. Willerth and S.E. Sakiyama-Elbert, Combining root cells and biomaterial scaffolds for building tissues and cell bringing, ( 2008 ) .

[ 44 ] V.F. Segers and R.T. Lee, Biomaterials to heighten root cell map in the bosom, Circulation research 109 ( 2011 ) , pp. 910-922.

[ 45 ] J.C. Tung, S.L. Paige, B.D. Ratner, C.E. Murry and C.M. Giachelli, Engineered Biomaterials Control Differentiation and Proliferation of Human-Embryonic-Stem-Cell-Derived Cardiomyocytes via Timed Notch Activation, Stem cell studies 2 ( 2014 ) , pp. 271-281.



I'm Niki!

Would you like to get a custom essay? How about receiving a customized one?

Check it out