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      Efficacy of Human Umbilical Stem Cells Cultured on Polylactic/ Polyglycolic Acid Membrane in the Treatment of Multiple Gingival Recession Defects: a Randomized Controlled Clinical Study

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          Abstract

          Statement of the Problem:

          Recently allogenic mesenchymal stem cells are proposed to have multipotential progenitor cell capabilities to differentiate into cementoblasts, osteoblasts, and periodontal ligament fibroblasts.

          Purpose:

          The aim of the present study was to compare the efficacy of human umbilical stem cells cultured on polylactic acid (PLA), polyglycolic acid (PGA) membrane with PLA/PGA membrane alone in the treatment of multiple gingival recession defects.

          Materials and Method:

          A total number of 14 cases of multiple gingival recession (Miller’s Class I or II) located in the anterior region were randomly selected and divided into test (stem cells in combination with PLA/PGA membrane) and control group (PLA/PGA membrane alone). Clinical parameters including gingival recession, probing pocket depth, clinical attachment level, and width of keratinized gingiva were recorded at baseline, and at 6 months postoperative.

          Results:

          At baseline, there was 2.28 mm and 2.14mm mean gingival recession at 16 sites and 14 sites in test and control groups respectively. At 6 months post-surgery, test group showed 1.57 mm mean reduction of gingival recession indicating 66% root coverage, while the control group showed 1.24mm mean reduction of gingival recession indicating 57% root coverage.

          Conclusion:

          In the present study, the stem cell with PLA/PGA membrane showed significantly higher mean root coverage compared to only PLA/PGA membrane group.

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          Most cited references27

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          Reduced plaque formation by the chloromethyl analogue of victamine C.

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            Subepithelial connective tissue graft technique for root coverage.

            This article describes the use of the subepithelial connective tissue graft as a donor source for root coverage. The success of these grafts has been attributed to the double-blood supply at the recipient site from the underlying connective tissue base and the overlying recipient flap. Four cases have been illustrated to demonstrate the versatility of this procedure for areas of single or multiple root coverage especially in the maxillary arch, coverage of existing crown margins and areas requiring a combination of ridge augmentation and root coverage. An increase of 2 to 6 mm of root coverage has been achieved in 56 cases over 4 years with minimal sulcus depth and no recurrence of recession. The donor site is a closed wound which produces less postoperative discomfort.
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              Mesenchymal stem cells: biology and potential clinical uses.

              There has been an increasing interest in recent years in the stromal cell system functioning in the support of hematopoiesis. The stromal cell system has been proposed to consist of marrow mesenchymal stem cells that are capable of self-renewal and differentiation into various connective tissue lineages. Recent efforts demonstrated that the multiple mesenchymal lineages can be clonally derived from a single mesenchymal stem cell, supporting the proposed paradigm. Dexter demonstrated in 1982 that an adherent stromal-like culture was able to support maintenance of hematopoietic stem as well as early B lymphopoeisis. Recent data from in vitro models demonstrating the essential role of stromal support in hematopoiesis shaped the view that cell-cell interactions in the marrow microenvironment are critical for normal hematopoietic function and differentiation. Maintenance of the hematopoietic stem cell population has been used to increase the efficiency of hematopoietic stem cell gene transfer. High-dose chemotherapy and frequently cause stromal damage with resulting hematopoietic defects. Data from preclinical transplantation studies suggested that stromal cell infusions not only prevent the occurrence of graft failure, but they have an immunomodulatory effect. Preclinical and early clinical safety studies are paving the way for further applications of mesenchymal stem cells in the field of transplantation with respect to hematopoietic support, immunoregulation, and graft facilitation.
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                Author and article information

                Journal
                J Dent (Shiraz)
                J Dent (Shiraz)
                Journal of Dentistry
                Journal of Dentistry Shiraz University of Medical Sciences (Iran )
                2345-6485
                2345-6418
                June 2017
                : 18
                : 2
                : 95-103
                Affiliations
                [1 ]Dept. of Periodontics, Sharad Pawar Dental College, Wardha, India Affifilated to Datta Meghe Institute of Medical Sciences, Nagpur, India.
                [2 ]Dept. of Periodontics, College of Dentistry, Sakaka Affifilated to Aljouf University, Aljouf Province, KSA.
                Author notes
                Correspondence: Kiran Kumar Ganji, Dept. of Periodontics, College of Dentistry, Sakaka Affifilated to Aljouf University, Aljouf Province, KSA. Tel:+966540640338
                Article
                JDS-18-2
                5463777
                28620633
                24b4d1eb-514a-446b-be2d-28683bf07d9e
                Copyright: © Journal of Dentistry Shiraz University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : July 2016
                : September 2016
                : October 2015
                Categories
                Original Article

                pla/pga membrane , stem cells , gingival recession

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