Gingival mesenchymal stem cells, concentrated growth factors and silk-fibroin scaffold to alleviate peripheral nerve regeneration: A review

Peripheral nerve injury in the orofacial region often occurs due to dental procedure, trauma, or pathological obstruction. It can lead to loss of sensation and muscle innervation problems which decrease a patient's quality of life. Some medical approaches to achieve peripheral nerve regeneration such as surgical still have side effects. Tissue engineering approach with combination of Gingival Mesenchymal Stem Cells (GMSC), Concentrated Growth Factor (CGF) and Silk-Fibroin (SF) scaffold have potential to accelerate peripheral nerve regeneration. Peripheral nerve injury leads to activation of Wallerian degeneration as a complex mechanism that can maintain repair Schwann cell differentiation by induced signaling response. In peripheral nerve regeneration, neuropathic factors are needed to assist nerve cell proliferation and differentiation. However, functional recovery failure often occurs because of insufficient axonal regeneration. Thus, tissue engineering has potential properties to alleviate peripheral nerve generation because GMSC has the ability to differentiate into neuron cells expressed neurogenic-associated markers which are β III-tubulin and glial fibrillary acidic protein (GFAP); CGF is one of growth factors that is able to hasten nerve regeneration by increasing Schwann cells proliferation and neurotrophic factors (NGF and GDNF) to achieve nerve recovery; and SF is a scaffold and nerve conduit that is biocompatible, biodegradable, and not immunogenic. All those components fulfil the principle of triad tissue engineering to alleviate peripheral nerve regeneration. GMSC, CGF and SF scaffold may have promising properties to alleviate peripheral nerve regeneration.