Comparative evaluation of efficacy of stem cells in combination with PLA/PGA membrane versus sub-epithelial connective tissue for the treatment of multiple gingival recession defects: a clinical study.

Background: Umbilical Mesenchymal Stem Cells possess immunoregulatory capacities that have been permissive to allogenic transplantation. Recent animal studies have demonstrated histologically that bone marrow- derived mesenchymal stem cells (MSCs) may enhance the regeneration of periodontal defects in dogs by differentiating MSCs into cementoblasts, osteoblasts and periodontal fibroblasts.

Aim: To compare the clinical efficacy between stem cells in combination with PLA/PGA membrane and subepithelial connective tissue graft (SCTG) in the treatment of multiple gingival recession defects.

Methods: Twenty four patients aged between 20 to 33 years (mean age 27.41 ± 1.06 years) with multiple gingival recession defects on labial or buccal surface of the teeth in the aesthetic zone either in maxilla or mandible were treated. The test group was treated using stem cells cultured on bioresorbable PLA/PGA membrane, while control group was treated using SCTG. Following parameters were assessed, Plaque Index (PI),Gingival Bleeding Point Index (GBI), Relative gingival margin level (RGML), Relative attachment level (RAL) and Probing pocket depth (PPD) Results: In the test group, mean percent defect coverage was 72.43 ± 13.55 % and the predictability was 41.17% for root coverage i.e 14 of 34 defects, while in the control group, mean percent defect coverage was 82.06 ± 10.99 % and the predictability was 50 % for root coverage i.e 15 of 30 defects.

Conclusion: Stem cells in combination with bioresorbable PLA/PGA membrane was effective for root coverage resulted in a significant reduction in gingival recession, greater gain in CAL and WKG. Stem cells in combination with bioresorbable PLA/PGA membrane resulted in significantly higher CAL gain than SCTG.