Research progress on cell sheet technology and its application in periodontal tissue regeneration

At present, conventional periodontal treatment cannot achieve complete and effective periodontal tissue regeneration. Cell sheet technology (CST) is a kind of cell transplantation method without scaffold material that can maintain complete extracellular matrix, important ion channels of cells, growth factor receptors, etc., and ensure the interaction between cells and the extracellular matrix. In this paper, the application and research progress of the cell sheet in the field of periodontal tissue regeneration are reviewed. Different types of seed cells can be prepared into monolayer cell sheet, multilayer cell sheet, cell sheet fragments and cell sheet polymers. Among them, the monalayer cell sheet is easily damaged and requires high deoperator; the multilayer cell sheet shows improved mechanical properties, but its thickness needs to be controlled to avoid cell necrosis. The cell sheet fragment can be used in the narrow space between the alveolar bone and root cementum to reduce the difficulty of operation and improve the mechanical properties of the cell sheet. Cell sheet polymers are three-dimensional structures that can provide strong mechanical support and improve the stability of the cell sheet, but the stability of their biological activity needs to be further improved. In methods for construction of the cell sheet, the antifibrosis and antiangiogenesis properties of the amniotic sheet have shown that this structure is suitable as the matrix of cell culture; the method of using a temperature-sensitive culture dish is simple and easy; continuous induction with vitamin C can retain some important proteins on the cell surface; and the magnetic tissue engineering method can increase cell adhesion and easily form a stable cell sheet. The above methods have their own characteristics. In clinical applications, monolayer cell sheet is mainly used for direct transplantation to the receiving site to construct periodontal tissue; multilayer cell sheet of the same or different species overlap and are then transplanted to the receiving site; and multilayer cell sheet of the same kind are wrapped with scaffold material and then transplanted to the receiving site to construct a three-dimensional structure. Overall, cell sheet technology has shown good potential in periodontal tissue regeneration.