Signalling Pathway manipulation and periodontal regeneration

Objective: Periodontitis is an inflammatory disease of the periodontium caused by microorganisms and calculus accumulation on the oral biofilm, which leads to destruction of tissues supporting the tooth. The destruction of periodontal tissues involves the detachment of periodontal ligament (PDL) fibres, concomitant with resorption of bone and cementum, and ultimately resulting in premature tooth loss. Regeneration of the periodontal region is challenged by the complex immune-inflammatory response of the host, resulting in unsatisfactory clinical outcomes when using the currently available therapeutic approaches. 

Method: Using cell signalling manipulation methods and developing cell signalling activation biomaterials, periodontal cells can be differentiated in vitro and in vivo (periodontal defect model) to cementoblasts and osteoblasts to regenerate periodontal tissues

Result: In a recent study we have shown that cementum is incapable of repair without proper intervention and we were able to demonstrate robust cementum repair and regeneration mediated via the activation of Wnt/β-catenin signalling pathway on the root surface.  We further showed that a novel bioscaffold, with properties that enhance Wnt/β-catenin signalling, was able to induce osteogenic/cementogenic differentiation of human periodontal ligament cells (hPDLCs). These findings are particular relevant in terms of periodontal tissue regeneration, in which the ultimate aim is to repair and regenerate the damaged periodontal structures, including the cementum, periodontal ligament and alveolar bone. Considering the complex three dimensional environment of the tooth, we found that the Wnt/β-catenin signalling pathway provide important cues to hPDLCs, which then adapt to the nature of the bone-periodontal ligament-cementum complex and differentiate into location specific cell lineages. 

Conclusion: This study demonstrated the role of the Wnt/β-catenin signalling pathway in periodontal tissue regeneration and its application in the treatment and management of periodontitis.