Osterix combined with gene-activated matrix: A potential integrated strategy for achieving cementum regeneration

Introduction: Human periodontitis is the most common infectious disease that results in the destruction of periodontal supporting tissues including the root cementum. Currently cementum regeneration, as a vital event, is considered as a gold standard of successful periodontal tissue reconstruction. Nevertheless, one of the important requirements of cementum reestablishment is the recruitment and differentiation of pre-cementoblasts into functional cementoblasts, which requires effective regulator factors. Recently, Osterix (Osx) is known to be a key transcriptional factor essential for osteogenesis and especially for cementogenesis. Although there are various interesting approaches involving tissue engineering, gene-activated matrix (GAM) is one of the most promising approaches to achieve reliable restoration of the periodontium. The Hypothesis: Based on the recent advances in understanding the mechanisms of Osx in cementum development and formation, we hypothesize that Osx plays a critical role in periodontal regeneration and Osx combined with GAM may be an effective strategy for the regeneration of cementum. Evaluation of the Hypothesis: Osx combined with GAM could pave the way for the development of new tissue engineering procedures and have the potential to play a pivotal role in cementum regeneration, eventually increasing the predictability of periodontal tissue regeneration.