Published online Sep 26, 2018. doi: 10.4252/wjsc.v10.i9.116
Peer-review started: May 14, 2018
First decision: June 6, 2018
Revised: June 8, 2018
Accepted: June 30, 2018
Article in press: June 30, 2018
Published online: September 26, 2018
Processing time: 135 Days and 14.7 Hours
The gingiva, the masticatory portion of the oral mucosa, is excised and discarded frequently during routine dental treatments and following tooth extraction, dental crown lengthening, gingivectomy and periodontal surgeries. Subsequent to excision, healing eventually happens in a short time period after gingival surgery. Clinically, the gingival tissue can be collected very easily and, in the laboratory, it is also very easy to isolate gingival-derived mesenchymal stem cells (GMSCs) from this discarded gingival tissue. GMSCs, a stem cell population within the lamina propria of the gingival tissue, can be isolated from attached and free gingiva, inflamed gingival tissues, and from hyperplastic gingiva. Comparatively, they constitute more attractive alternatives to other dental-derived mesenchymal stem cells due to the availability and accessibility of gingival tissues. They have unique immunomodulatory functions and well-documented self-renewal and multipotent differentiation properties. They display positive signals for Stro-1, Oct-4 and SSEA-4 pluripotency-associated markers, with some co-expressing Oct4/Stro-1 or Oct-4/SSEA-4. They should be considered as the best stem cell source for cell-based therapies and regenerative dentistry. The clinical use of GMSCs for regenerative dentistry represents an attractive therapeutic modality. However, numerous biological and technical challenges need to be addressed prior to considering transplantation approaches of GMSCs as clinically realistic therapies for humans.
Core tip: Current therapeutic interventions in dentistry depend on biomaterials such as metals, polymers, ceramics, and composites. These restorative synthetic dental materials cannot restore the physiological architecture and function of the tissue. Thus, dentistry should move from restorative to regenerative dentistry, with the ability to regrow damaged or missing teeth with their own dental stem cells. Regenerating an entire tooth or individual parts of the tooth require a suitable number of specific stem cell populations for use and implantation. Considering their neural crest origin and ease of availability, gingival-derived mesenchymal stem cells should be considered as an attractive source for stem cells that can be used in regenerative dentistry.