Recent biological approaches have attempted to mimic/enhance the cellular Selumetinib events leading to the normal development/wound healing process of periodontal tissues [17]. Enamel Matrix

Derivative (EMD), the active component of Emdogain®, was the first signaling molecule that could regenerate periodontal tissue. Emdogain® is prepared from a piglet’s unerupted teeth and has been clinically used throughout the world after approval for the market in Europe (1995), the United States (1996), and Japan (1998) [18]. Amelogenin proteins that dominate 90% of EMD are capable of periodontal regeneration, but the contaminated ameloblastin functioned synergistically [19]. Better understanding of the wound healing/regeneration process has driven periodontal research to evaluate the role of growth factor, which is endogenously secreted during the wound healing/regeneration process. It is also meritorious that advances in molecular cloning have made unlimited quantities of recombinant human proteins available for tissue engineering. Various recombinant growth factors were studied for their periodontal regeneration ability in vitro and in vivo. Among them, platelet derived growth factor (PDGF; GEM21S®) and bone

morphogenic protein-2 (BMP-2; Infuse®) have already become commercially available for clinical use in the United States [20]. Furthermore, fibroblast growth factor (FGF)-2 is being investigated in a large clinical trial (Phase III) in Japan, and its clinical efficacy for periodontal regeneration has already reported

[21], [22] and [23]. buy Fulvestrant In either approach, there is a therapeutic limitation due to the morphology of alveolar resorption to obtain a predictable outcome. Both strategies are only applicable to angular bony defects, and not horizontal resorption. The classification of infrabony defects that referred to the number of surrounding bony walls also exerted a significant influence on the success and failure of regeneration [24] and [25]. To overcome nearly these limitations and achieve complete regeneration, the introduction of modern tissue engineering technologies is anticipated in this field. Periodontal regeneration is one of the earliest clinical disciplines that has achieved the therapeutic application of tissue engineering-based technologies. As well as the clinical application of growth factors (signaling molecules), preclinical studies of cell therapy targeted for periodontal regeneration have been carried out using various sources of somatic stem cells (Table 2) [9]. Somatic stem cells were obtained from both dental and non-dental tissues: periodontal ligament-derived stem cells (PDLSC), dental follicular cells (FDC), bone marrow stem cells (BMSC), and adipose stem cells (ASC). These stem cells have the capability of periodontal tissue formation as well as bone formation [26] and [27].