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Evaluation of the Efficacy of Stem Cells Therapy in the Periodontal Regeneration: A Meta-Analysis and Mendelian Randomization Study

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Abstract

Stem cell therapy for periodontal defects has shown good promise in preclinical studies. The purpose of this study was to evaluate the impact of stem cell support on the regeneration of both soft and hard tissues in periodontal treatment. PubMed, Cochrane Library, Embase, and Web of Science were searched and patients with periodontal defects who received stem cell therapy were included in this study. The quality of the included articles was assessed using Cochrane’s tool for evaluating bias, and heterogeneity was analyzed using the I2 method. An Mendelian randomization investigation was conducted using abstract data from the IEU public databases obtained through GWAS. Nine articles were included for the meta-analysis. Stem cell therapy effectively rebuilds periodontal tissues in patients with periodontal defects, as evidenced by a reduction in probing depth, clinical attachment level  and bone defect depth . And delta-like homolog 1 is a protective factor against periodontal defects alternative indicator of tooth loosening. The findings of this research endorse the utilization of stem cell treatment for repairing periodontal defects in individuals suffering from periodontitis. It is recommended that additional extensive clinical investigations be carried out to validate the efficacy of stem cell therapy and encourage its widespread adoption.

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Data Availability

The datasets generated and/or analyzed during the current study are available in the IEU Open GWAS Project, [http://gwas.mrcieu.ac.uk].

Code Availability

Not applicable.

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Acknowledgements

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Funding

This work was supported by the National Natural Science Foundation of China [81800788 and 81773339], Science and Technology Department of Hunan Province, China [2017WK2041 and 2018SK52511], Scientific Research Project of Hunan Provincial Health Commission [202208043514], Natural Science Foundation of Hunan Province [2022JJ30062], Natural Science Foundation of Changsha City [kq2202403 and kq2202412], Education and Teaching Reform Research Project of Central South University [2020jy165-3].

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Authors and Affiliations

  1. Department of Stomatology, The Second **angya Hospital, Central South University, Changsha, Hunan, China

    **g Hu, Ze-Yue Ou-Yang, Ya-Qiong Zhao, Jie Zhao, Li Tan, Qiong Liu, Min-yuan Wang, Qin Ye, Yao Feng, Meng-Mei Zhong, Ning-**n Chen, **ao-Lin Su, Qian Zhang, Yun-Zhi Feng & Yue Guo

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Contributions

**g Hu: contributed to the conceptualization, formal analysis, data curation, writing-original draft preparation. Ze-Yue Ou-Yang was a major contributor in methodology, software, writing- reviewing and editing. Ya-Qiong Zhao, Jie Zhao performed the visualization. Li Tan, Qiong Liu, Min-yuan Wang, Qin Ye, Yao Feng, Meng-Mei Zhong, Ning-**n Chen, **ao-Lin Su, Qian Zhang, Yun-Zhi Feng and Yue Guo read and approved the final manuscript.

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Correspondence to Yun-Zhi Feng or Yue Guo.

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**g Hu and Ze-Yue Ou-Yang contributed equally to this work and share the first authorship.

Supplementary Information

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12015_2024_10690_MOESM1_ESM.png

Supplementary file1 (PNG 370 KB) (A, C, E, G) Funnel plot of meta-analyses of PD, CAL, BDD, GR, (B, D, F, H) and sensitivity analysis of the effects of meta-analyses of PD, CAL, BDD, GR.

12015_2024_10690_MOESM2_ESM.png

Supplementary file2 (PNG 338 KB) (A) Comparison between autologous stem cell therapy versus therapy without autologous stem cell in terms of PD; (B) Subgroup analysis according to 3-, 6- and 12-month follow-up results of PD. "a", "b" and "d" subscript letters next to the year of study denotes different follow-up time groups within the same study. "1" and "2" subscript number next to the year of study: denotes different treatment groups within the same study.

12015_2024_10690_MOESM3_ESM.png

Supplementary file3 (PNG 311 KB) (A) Comparison between autologous stem cell therapy versus therapy without autologous stem cell in terms of CAL; (B) Subgroup analysis according to 3-, 6- and 12-month follow-up results of CAL. "a", "b" and "d" subscript letters next to the year of study denotes different follow-up time groups within the same study.

12015_2024_10690_MOESM4_ESM.png

Supplementary file4 (PNG 265 KB) Comparison between autologous stem cell therapy versus therapy without autologous stem cell in terms of BDD; (B) Subgroup analysis according to 3-, 6- and 12-month follow-up results of BDD. "a", "b" and "d" subscript letters next to the year of study denotes different follow-up time groups within the same study.

12015_2024_10690_MOESM5_ESM.png

Supplementary file5 (PNG 308 KB) Comparison between autologous stem cell therapy versus therapy without autologous stem cell in terms of GR; (B) Subgroup analysis according to 3-, 6- and 12-month follow-up results of GR. "a", "b" and "d" subscript letters next to the year of study denotes different follow-up time groups within the same study. "1" and "2" subscript number next to the year of study: denotes different treatment groups within the same study.

Supplementary file6 (PNG 216 KB) Leave-one-out plot.

Supplementary file7 (PNG 158 KB) Funnel plot of SNPs associated with DLK1 and their risk of loose teeth.

Supplementary file8 (DOCX 19 KB) Table S1: Literature search format.

12015_2024_10690_MOESM9_ESM.docx

Supplementary file9 (DOCX 39 KB) Table S2 STROBE-MR checklist of recommended items to address in reports of Mendelian randomization studies

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Hu, J., Ou-Yang, ZY., Zhao, YQ. et al. Evaluation of the Efficacy of Stem Cells Therapy in the Periodontal Regeneration: A Meta-Analysis and Mendelian Randomization Study. Stem Cell Rev and Rep 20, 980–995 (2024). https://doi.org/10.1007/s12015-024-10690-x

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