Triad tissue engineering: Gingival mesenchymal stem cells, platelet rich fibrin and hydroxyapatite scaffold to ameliorate relapse post orthodontic treatment

Relapse post-orthodontic treatment rate approximately 61.5% and this phenomenon is a problem in the orthodontic field that cannot be solved yet. Efforts to prevent have been carried out such as retention devices, but require a fairly long duration. The need for the latest effective methods to inhibit relapse post-orthodontic treatment is tissue engineering approach. The aim of this review was to summarize tissue engineering approach to ameliorate relapse post orthodontic tooth movement. The tissue engineering approach in inhibiting relapse is by combining biomaterials between Gingival Mesenchymal Stem Cells (GMSCs), scaffold (Hydroxyapatite) and growth factors (Platelet Rich Fibrin). GMSCs have an ability to differentiate into osteogenic lineage, immunoregulator and immunomodulation property. Thus, it has autocrine and paracrine effect that can stimulate endogenous stem cell. PRF is an autologous blood line that contains concentrated platelets consisting of a strong fibrin matrix with mechanical properties to assist remodeling process. It also has abundant growth factor that can facilitate GMSCs to differentiate and proliferate optimally. Efforts are needed to accelerate remodeling alveolar bone post-orthodontic treatment. Hydroxyapatite scaffold is a good choice as a osteogenic template for GMSCs. It can act as an osteoinductive and osteo-conductive that can stimulate GMSCs' osteogenic differentiation. Furthermore, the combination of those biomaterial is expected to ameliorate relapse post orthodontic treatment.