The Effect of Periodontal Ligament Stem Cell Sheets for Periodontal Regeneration in Animal Studies: A Meta- Analysis
Keywords:
Periodontal treatment, Periodontal ligament stem cell sheets, Osseous defect, Meta-analysisAbstract
Background : The use of cell sheet engineering technique on periodontal ligament stem cells was developed for periodontal treatment which transplantation of cell sheets onto periodontal defects. Currently, the novel cell sheets have gained interest because that can be more easily fabricated and manipulated than conventional tissue engineering methods.Objective : The meta-analysis was to quantitatively find out the effect of periodontal ligament stem cell sheets for periodontal regeneration in animal model.Methods : PubMed database was systematically searched for related articles, together with searching in Google scholar. They were all filtered for articles in English or Thai from 1990 to 2019.Results : Nine articles, which are randomized controlled trials and preclinical animal trials were accepted and extracted for meta-analysis. Data was calculated for standard mean difference (SMD) at 95% CI and random effect model was used. the results showed groups of the periodontal ligament stem cell sheet therapy had a positive influence on the regeneration of cementum (SMD=3.041; 95% CI= 1.504 – 4.578, p=0.000) and alveolar bone (SMD = 2.114; 95% CI 0.709 – 3.520, p = 0.003) when compared to the control groups. However, the data was high heterogeneity (I2=82.2%, I2=82.6%). Moreover, subgroup analysis showed that the periodontal ligament stem cell sheet groups could regenerate the alveolar bone more than the control groups that used guided tissue regeneration therapy without stem cell sheets (SMD = 0.843; 95% CI= (-0.017) – 1.703, p=0.055), and the data was homogeneity (I2=28.9%).Conclusion : The analysis of evidences promoted to the novel cell sheet technique for periodontal ligament stem cell sheets benefit on periodontal regeneration, especially alveolar bone regeneration. However, as less preclinical animal trials and possible the risk of bias problems, the further higher quality researches and randomized controlled trials in animal models are still required to prove the effectiveness of periodontal ligament stem cell sheets for periodontal tissue regeneration in the future.
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