A Novel Innovation of Periodontal Ligament-Derived Stem Cells and Erythropoietin Combination in the Aspirin-Based Tetra-PEG Hydrogel as Bone Defect Therapy in the Chronic Periodontitis: A Review

An inflammation of the tooth-supporting tissues, or well-known as periodontitis has a worldwide prevalence of 20-50% and 60% in Indonesia. This disease results in alveolar bone destruction if not treated immediately. Allograft implant procedure is the gold standard treatment, but possibly induce allergic reaction. Periodontal ligament-derived stem cells (PDLSCs) are self-renewal mesenchymal stem cells with multipotent abilities. Erythropoietin or EPO is a glycoprotein cytokine acts as an antioxidant, angiogenic, and anti-apoptotic agent. Aspirin-based tetra-poly-ethylene glycol (PEG) hydrogel is a material used as a scaffold that has anti-fouling and anti-inflammatory properties. The combination of these material potentially against periodontopathogenic bacterial load, thus downregulating the NF-kB pathway as the major pro-inflammatory pathway that may induces periodontal tissue breakdown. A well synergism between each material may exert such excellent angiogenesis and PDLSCs’ osteogenic differentiation, manifests in remarkable performances in regenerating periodontal tissue.