Stem Cells, Scaffolds and Gene Therapy for Periodontal Engineering

The periodontium is continually exposed to a variety of challenges. Over the past decade, preclinical and clinical research has highlighted the complex modulatory role of the periodontal ligament (PDL) as a mediator of tissue repair and homeostasis. Experiments carried out in both human and animal models have highlighted the importance of the PDL as a protective structure. The unique properties of PDL cells endow this tissue with functional attributes that are not replicated by other biological systems. Furthermore, distinct PDL matricellular properties favor a synchronized molecular response to environmental challenges that supports normal dental and alveolar adaptation. Today, the mechanism by which periodontal integrity is restored and maintained is the focus of novel and innovative research. The ability to decipher the molecular mechanisms that support periodontal homeostasis, together with emerging science in biomaterials and stem cell biology, represents a unique opportunity to enhance the predictability of current regenerative surgical approaches and to develop novel treatment strategies for periodontal tissue engineering. This review will focus on the most recent available information concerning cells, gene delivery, and new scaffold technologies that are relevant in periodontal regeneration.