The combination of epigallocatechin-3-gallate and platelet rich plasma in periodontal ligament stem cells for jaw osteomyelitis therapy: A review

Osteomyelitis is an inflammatory disease which can occur in the jaw and may be complicated to another chronic disease. The existing therapies are using antibiotics and surgical therapy. However, these therapies can cause the bacteria resistance and invasiveness on the tissue. The combination of Epigallocatechin-3-Gallate (EGCG) and Platelet Rich Plasma (PRP) on Periodontal Ligament Stem Cells (PDLSCs) using the local injection method can be used as an alternative treatment to decrease the resistance and prevent the invasiveness on the tissue. The aim of this review was to summarize the tissue engineering used for jaw osteomyelitis therapy. PRP contains various important growth factors (PDGF, HGF, IGF-1, EGF, VEGF, TGF-a and FGF), chemokines and cytokines is necessary to induce the osteoid, collagen and extracellular matrix formation. PDLSCs have the ability and multipotent capacity to differentiate into cementoblasts, osteoblasts, adipocytes and collagen-forming cells. EGCG can increase RUNX2, Osterix and BMP-2. Furthermore, it can decrease RANKL, HMGB1 and HSP-70 expression. Thus, it can be an osteoinduction in osteogenic processes. When EGCG and PRP are integrated with PDLSCs, PRP improves the cell sheet reconstruction, the elevated role of PDLSCs that can trigger osteogenic gene expression of MiR-17 and hsa-mir-218, and stimulate the expression of ALP, RUNX2, Col-1 and OCNLP. This combination also increases the osteogenic differentiation, the aggregation, and cohesiveness of particulate-based bone for alveolar bone remodeling. Moreover, the combination of EGCG and PRP in PDLSCs has the potential to treat jaw osteomyelitis.