Periodontal-Derived Mesenchymal Cell Sheets Promote Periodontal Regeneration in Inflammatory Microenvironment

In this study, we investigated the periodontal regenerative potential of dental follicle cell (DFC) sheets and periodontal ligament cell (PDLC) sheets in the simulating inflammatory microenvironment of periodontitis, to confirm their regenerative potential for clinical application and explain the possible mechanism. The biological characteristics of DFC sheets and PDLC sheets were explored in lipopolysaccharide from Porphyromonas gingivalis (P. gingivalis LPS)-induced inflammation microenvironment in vitro, then cell sheets were transplanted into canine periodontal defects with experimental periodontitis in situ for 3 months. The results showed that P. gingivalis LPS greatly impaired the differentiation of PDLC sheets, whereas promoted gene expression of bone sialoprotein (BSP), osteopontin (OPN), and periostin (POSTN) in DFC sheets. LPS activated toll-like receptor 4 and NF-κB p65 phosphorylation in PDLC sheets. In experimental periodontitis, new periodontal attachment could be obtained in both PDLC sheets and DFC sheets. However, the complete periodontal regeneration, including periodontal ligament-cementum complex structure was observed only in DFC sheet groups, which also showed more alveolar bone formation than PDLC sheets. These results suggest that DFC sheets were more effective for periodontal regeneration in chronic inflammatory microenvironment of periodontitis. It is probably because of their ability to adapt the inflammatory environment and strong capacity to promote periodontal regeneration. This approach provides a tangible pathway toward clinical translation.