Mesenchymal Stem Cells in Socket Healing and MRONJ

This review aims to summarise the current understanding of the biological processes involved in socket healing after tooth extraction and the contribution of mesenchymal stem/progenitor cells (MSCs) during these processes. Additionally, it seeks to explore the mechanisms underlying medication-related osteonecrosis of the jaw (MRONJ), often linked to tooth extraction, to provide insights for future research directions. Socket healing is a complex biological process consisting of three phases: inflammatory, proliferative and modelling/remodelling. MSCs, particularly those derived from periodontal ligament (PDL) cells and bone lining cells, are known to play a significant role in the initial and subsequent stages of healing. However, the exact contributions of MSCs from surrounding tissues, such as PDL, alveolar bone marrow and periosteum, remain unclear. Recent advancements in cell lineage tracing techniques have provided new perspectives on the origin and role of MSCs in socket healing. Furthermore, the MRONJ conditions suppress MSC activities and lead to apoptosis, resulting in impaired socket healing. It may contribute to the development of MRONJ. Proper understanding of the cellular and molecular mechanisms underlying socket healing is crucial for improving clinical outcomes in dental procedures and managing complications like MRONJ. Continued research on the roles of MSCs and the application of advanced techniques will enhance therapeutic strategies for socket healing and related conditions.