Preview

Endodontics Today

Advanced search

Clinical application of collagen in combination with growth factors and cells in regenerative dentistry

https://doi.org/10.36377/ET-0146

Abstract

Type I collagen, being the main structural protein of the extracellular matrix, provides optimal conditions for cell adhesion and proliferation and can also serve as a system for localized delivery of bioactive molecules. However, for a number of clinical conditions, the regenerative capacity of collagen alone remains insufficient, which has stimulated the development of combined systems designed to enhance its regenerative potential. The combination of collagen implants with growth factors and stem cells represents a promising approach in regenerative dentistry. This review summarizes clinical studies focused on the use of collagen matrices combined with mesenchymal stem cells, dental pulp cells, fibroblasts, as well as with growth factors such as PDGF-BB, BMP-2, and FGF-2.

Despite the limited clinical evidence, the integration of collagen with bioactive components already demonstrates consistent advantages over conventional treatment methods. Studies show that these combined constructs accelerate the regeneration of hard and soft tissues, thereby reducing the need for autografts and minimizing surgical trauma.

About the Authors

S. Yu. Voloshin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Sergei Yu. Voloshin – Laboratory Assistant, Center for Innovative Collagen Developments, Institute of Regenerative Medicine, Biomedical Science and Technology Park

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



K. A. Gadzhieva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Khadizhat A. Gadzhieva – Postgraduate Student, Department of Oral and Maxillofacial Surgery E.V. Borovsky Institute of Dentistry

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



K. R. Zhalilova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Kamila R. Zhalilova – Student, N.V. Sklifosovsky Institute of Clinical Medicine

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



I. P. Ashurko
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Igor P. Ashurko – Dr. Sci. (Med.), Professor, Department of Oral and Maxillofacial Surgery E.V. Borovsky Institute of Dentistry

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



P. S. Timashev
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Petr S. Timashev – Dr. Sci. (Chem.), Professor, Scientific Director of the Biomedical Science and Technology Park

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



A. A. Antoshin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Artem A. Antoshin – Cand. Sci. (Biol.), Head of the Center for Innovative Collagen Developments, Institute of Regenerative Medicine, Biomedical Science and Technology Park

8c2 Trubetskaya Str., Moscow 119048, Russian Federation


Competing Interests:

The authors report no conflict of interest.



References

1. Takayama T., Imamura K., Yamano S. Growth factor delivery using a collagen membrane for bone tissue regeneration. Biomolecules. 2023;13(5):809. https://doi.org/10.3390/biom13050809

2. Kumada Y., Zhang S. Significant type I and type III collagen production from human periodontal ligament fibroblasts in 3D peptide scaffolds without extra growth factors. PLoS ONE. 2010;5(4):e10305. https://doi.org/10.1371/journal.pone.0010305

3. Feng Y., Li H.P. Optimizing collagen-based biomaterials for periodontal regeneration: clinical opportunities and challenges. Front Bioeng Biotechnol. 2024;12:1469733. https://doi.org/10.3389/fbioe.2024.1469733

4. Baek S.-H., Yang B.-E., Park S.-Y., On S.-W., Ahn K.-M., Byun S.-H. Efficacy of cross-linked collagen membranes for bone regeneration: In vitro and clinical studies. Bioengineering. 2025;12(8):876. https://doi.org/10.3390/bioengineering12080876

5. Woo H.N., Cho Y.J., Tarafder S., Lee C.H. The recent advances in scaffolds for integrated periodontal regeneration. Bioact Mater. 2021;6(10):3328–3342. https://doi.org/10.1016/j.bioactmat.2021.03.012

6. McKay W.F., Peckham S.M., Badura J.M. A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE Bone Graft). Int Orthop. 2007;31(6):729–734. https://doi.org/10.1007/s00264-007-0418-6

7. Yamano S., Haku K., Yamanaka T., Dai J., Takayama T., Shohara R. et al. The effect of a bioactive collagen membrane releasing PDGF or GDF-5 on bone regeneration. Biomaterials. 2014;35(8):2446–2453. https://doi.org/10.1016/j.biomaterials.2013.12.006

8. Theodosaki A.M., Tzemi M., Galanis N., Bakopoulou A., Kotsiomiti E., Aggelidou E., Kritis A. Bone regeneration with mesenchymal stem cells in scaffolds: systematic review of human clinical trials. Stem Cell Rev Rep. 2024;20(4):938–966. https://doi.org/10.1007/s12015-024-10696-5

9. Chang Y.T., Lai C.C., Lin D.J. Collagen scaffolds laden with human periodontal ligament fibroblasts promote periodontal regeneration in SD rat model. Polymers. 2023;15(12):2649. https://doi.org/10.3390/polym15122649

10. Bai Y., Yin G., Huang Z., Liao X., Chen X., Yao Y., Pu X. Localized delivery of growth factors for angiogenesis and bone formation in tissue engineering. Int Immunopharmacol. 2013;16(2):214–223. https://doi.org/10.1016/j.intimp.2013.04.001

11. Wang X., Zeng J., Gan D., Ling K., He M., Li J., Lu Y. Recent strategies and advances in hydrogel-based delivery platforms for bone regeneration. Nanomicro Lett. 2024;17(1):73. https://doi.org/10.1007/s40820-024-01557-4

12. Tkachev S., Chepelova N., Galechyan G., Ershov B., Golub D., Popova E. et al. Three-dimensional cell culture micro-CT visualization within collagen scaffolds in an aqueous environment. Cells. 2024;13(15):1234. https://doi.org/10.3390/cells13151234

13. Edelmayer M., Wehner C., Ulm C., Zechner W., Shafer D., Agis H. Which substances loaded onto collagen scaffolds influence oral tissue regeneration? – An overview of the last 15 years. Clin Oral Investig. 2020;24(10):3363–3394. https://doi.org/10.1007/s00784-020-03520-0

14. Apatzidou D.A., Iliopoulos J.M., Konstantinidis A., Verma M., Hardy P., Lappin D.F., Nile C.J. Inflammatory and bone remodelling related biomarkers following periodontal transplantation of the tissue engineered biocomplex. Clin Oral Investig. 2024;28(7):361. https://doi.org/10.1007/s00784-024-05754-8

15. Abdal-Wahab M., Abdel Ghaffar K.A., Ezzatt O.M., Hassan A.A.A., El Ansary M.M.S., Gamal A.Y. Regenerative potential of cultured gingival fibroblasts in treatment of periodontal intrabony defects (randomized clinical and biochemical trial). J Periodontal Res. 2020;55(3):441–452. https://doi.org/10.1111/jre.12728

16. Chen F.M., Gao L.N., Tian B.M., Zhang X.Y., Zhang Y.J., Dong G.Y., Lu H. et al. Treatment of periodontal intrabony defects using autologous periodontal ligament stem cells: a randomized clinical trial. Stem Cell Res Ther. 2016;7(1):33. https://doi.org/10.1186/s13287-016-0288-1 (Erratum in: Stem Cell Res Ther. 2018;9(1):260. https://doi.org/10.1186/s13287-018-1000-4)

17. Kadry W., Eldeftar M., Nassar Y., Abou-El-Fetouh A., Hakam M.M. Clinical, volumetric and densitometric evaluation of tissue engineered constructs for secondary alveolar cleft reconstruction: A randomized clinical trial. J Craniomaxillofac Surg. 2021;49(12):1141–1150. https://doi.org/10.1016/j.jcms.2021.09.003

18. Gomez-Sosa J.F., Cardier J.E., Wittig O., Díaz-Solano D., Lara E., Duque K., Ramos-González G. Allogeneic bone marrow mesenchymal stromal cell transplantation induces dentin pulp complex-like formation in immature teeth with pulp necrosis and apical periodontitis. J Endod. 2024;50(4):483–492. https://doi.org/10.1016/j.joen.2024.01.002

19. Morelli T., Neiva R., Nevins M.L., McGuire M.K., Scheyer E.T., Oh T.J. et al. Angiogenic biomarkers and healing of living cellular constructs. J Dent Res. 2011;90(4):456–462. https://doi.org/10.1177/0022034510389334

20. McGuire M.K., Scheyer E.T., Nevins M.L., Neiva R., Cochran D.L., Mellonig J.T. et al. Living cellular construct for increasing the width of keratinized gingiva: results from a randomized, within-patient, controlled trial. J Periodontol. 2011;82(10):1414–1423. https://doi.org/10.1902/jop.2011.100671

21. Ferrarotti F., Romano F., Gamba M.N., Quirico A., Giraudi M., Audagna M., Aimetti M. Human intrabony defect regeneration with micrografts containing dental pulp stem cells: A randomized controlled clinical trial. J Clin Periodontol. 2018;45(7):841–850. https://doi.org/10.1111/jcpe.12931

22. Tanikawa D.Y.S., Pinheiro C.C.G., Almeida M.C.A., Oliveira C.R.G.C.M., Coudry R.A., Rocha D.L., Bueno D.F. Deciduous dental pulp stem cells for maxillary alveolar reconstruction in cleft lip and palate patients. Stem Cells Int. 2020;2020:6234167. https://doi.org/10.1155/2020/6234167

23. Nakashima M., Iohara K., Murakami M., Nakamura H., Sato Y., Ariji Y., Matsushita K. Pulp regeneration by transplantation of dental pulp stem cells in pulpitis: a pilot clinical study. Stem Cell Res Ther. 2017;8(1):61. https://doi.org/10.1186/s13287-017-0506-5

24. Sheikh Z., Qureshi J., Alshahrani A.M., Nassar H., Ikeda Y., Glogauer M., Ganss B. Collagen based barrier membranes for periodontal guided bone regeneration applications. Odontology. 2017;105(1):1–12. https://doi.org/10.1007/s10266-016-0267-0

25. Sammarco V.J., Chang L. Modern issues in bone graft substitutes and advances in bone tissue technology. Foot Ankle Clin. 2002;7(1):19–41. https://doi.org/10.1016/s1083-7515(01)00003-1

26. Bunyaratavej P., Wang H.L. Collagen membranes: a review. J Periodontol. 2001;72(2):215–229. https://doi.org/10.1902/jop.2001.72.2.215

27. Tavelli L., Barootchi S., Rodriguez M.V., Mancini L., Majzoub J., Travan S. et al. Recombinant human platelet-derived growth factor improves root coverage of a collagen matrix for multiple adjacent gingival recessions: A triple-blinded, randomized, placebo-controlled trial. J Clin Periodontol. 2022;49(11):1169–1184. https://doi.org/10.1111/jcpe.13706

28. Li F., Yu F., Liao X., Wu C., Wang Y., Li C. et al. Efficacy of recombinant human BMP2 and PDGF-BB in orofacial bone regeneration: A systematic review and meta-analysis. Sci Rep. 2019;9(1):8073. https://doi.org/10.1038/s41598-019-44368-z

29. Jayakumar A., Rajababu P., Rohini S., Butchibabu K., Naveen A., Reddy P.K. et al. Multi-centre, randomized clinical trial on the efficacy and safety of recombinant human platelet-derived growth factor with β-tricalcium phosphate in human intra-osseous periodontal defects. J Clin Periodontol. 2011;38(2):163–172. https://doi.org/10.1111/j.1600-051X.2010.01639.x

30. Singh P., Suresh D.K. Clinical evaluation of GEM 21S(®) and a collagen membrane with a coronally advanced flap as a root coverage procedure in the treatment of gingival recession defects: A comparative study. J Indian Soc Periodontol. 2012;16(4):577–583. https://doi.org/10.4103/0972-124X.106919

31. Kitamura M., Akamatsu M., Machigashira M., Hara Y., Sakagami R., Hirofuji T. et al. FGF-2 stimulates periodontal regeneration: results of a multi-center randomized clinical trial. J Dent Res. 2011;90(1):35–40. https://doi.org/10.1177/0022034510384616

32. Cochran D.L., Oh T.J., Mills M.P., Clem D.S., McClain P.K., Schallhorn R.A. et al. A randomized clinical trial evaluating rh-FGF-2/β-TCP in periodontal defects. J Dent Res. 2016;95(5):523–530. https://doi.org/10.1177/0022034516632497

33. Alonso N., Tanikawa D.Y., Freitas R.S., Canan L. Jr, Ozawa T.O., Rocha D.L. Evaluation of maxillary alveolar reconstruction using a resorbable collagen sponge with recombinant human bone morphogenetic protein-2 in cleft lip and palate patients. Tissue Eng Part C Methods. 2010;16(5):1183–1189. https://doi.org/10.1089/ten.TEC.2009.0824

34. Canan L.W. Jr, da Silva Freitas R., Alonso N., Tanikawa D.Y., Rocha D.L., Coelho J.C. Human bone morphogenetic protein-2 use for maxillary reconstruction in cleft lip and palate patients. J Craniofac Surg. 2012;23(6):1627–1633. https://doi.org/10.1097/SCS.0b013e31825c75ba

35. Thammanichanon P., Ouyyamwongs W., Mai-Ngam K., Rittipakorn P. Clinical outcomes of rhBMP-2-loaded collagen sponge for alveolar ridge preservation: A pilot study. Eur J Dent. 2025. https://doi.org/10.1055/s-0045-1810610

36. Abbas A.A., Salman S.A., Wahid M.H.A. Recombinant human bone morphogenetic protein-2 as bone additive and its relation with the dental implant dimensions and stability: Split-mouth randomized clinical trial. Al-Rafidain Journal of Medical Sciences. 2023;5:263–268. https://doi.org/10.54133/ajms.v5i.294

37. Thoma D.S., Bienz S.P., Payer M., Hüsler J., Schmidlin P.R., Hämmerle C.H.F. et al. Randomized clinical study using xenograft blocks loaded with bone morphogenetic protein-2 or autogenous bone blocks for ridge augmentation – A three-dimensional analysis. Clin Oral Implants Res. 2019;30(9):872–881. https://doi.org/10.1111/clr.13492


Review

For citations:


Voloshin S.Yu., Gadzhieva K.A., Zhalilova K.R., Ashurko I.P., Timashev P.S., Antoshin A.A. Clinical application of collagen in combination with growth factors and cells in regenerative dentistry. Endodontics Today. 2025;23(4):710-716. https://doi.org/10.36377/ET-0146



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1683-2981 (Print)
ISSN 1726-7242 (Online)