A tissue-engineered biocomplex for periodontal reconstruction. A proof-of-principle randomized clinical study

Aim To assess the safety/efficacy of a tissue-engineered biocomplex in periodontal reconstruction. Methods Twenty-seven intrabony defects were block-randomized across three treatment groups: Group-A (N-A = 9) received autologous clinical-grade alveolar bone marrow mesenchymal stem cells (a-BMMSCs), seeded into collagen scaffolds, enriched with autologous fibrin/platelet lysate (aFPL). In Group-B (N-B = 10), the collagen scaffold/aFPL devoid of a-BMMSCs filled the osseous defect. Group-C (N-C = 8) received Minimal Access Flap surgery retaining the soft tissue wall of defects identically with Groups-A/-B. Subjects were clinically/radiographically assessed before anaesthesia (baseline) and repeatedly over 12 months. Results Quality controls were satisfied before biocomplex transplantation. There were no adverse healing events. All approaches led to significant clinical improvements (p < .001) with no inter-group differences. At 12 months, the estimated marginal means for all groups were as follows: 3.0 (95% CI: 1.9-4.1) mm for attachment gain; 3.7 (2.7-4.8) mm for probing pocket depth reduction; 0.7 (0.2-1.3) mm increase in recession. An overall greater mean reduction in the radiographic Cemento-Enamel Junction to Bottom Defect (CEJ-BD) distance was found for Groups-A/-C over Group-B (p < .023). Conclusion Radiographic evidence of bone fill was less pronounced in Group-B, although clinical improvements were similar across groups. All approaches aimed to trigger the innate healing potential of tissues. Cell-based therapy is justified for periodontal reconstruction and remains promising in selected cases.

Automated summary

The study aimed to evaluate the safety and efficacy of a tissue-engineered biocomplex in periodontal reconstruction. The results showed that all treatment approaches led to significant clinical improvements without adverse healing events. Over the 12-month period, there were significant clinical improvements in all groups.