Application of mesenchymal stromal cell sheets to prevent medication-related osteonecrosis of the jaw with titanium implants in rats.

Medication-related osteonecrosis of the jaw (MRONJ) is an intractable adverse event. Dental implants are one of the triggering factors of MRONJ, and implant therapy with low MRONJ risk is required. This study aimed to investigate a rat model of MRONJ induced by extraoral placement of titanium materials and the use of mesenchymal stromal cell (MSCs) sheets to prevent MRONJ. Eight-week-old male rats were administered zoledronate and dexamethasone thrice weekly until killing. A week after drug initiation, a titanium screw and a plate were placed on the left buccal side of the mandible. Allogeneic bone marrow-derived MSC sheets were co-grafted with the titanium plates in the MSC sheet ( +) group. Six weeks after titanium placement, the rats were killed, and their excised mandibular bones were subjected to micro-computed tomography (CT) analysis. Histological analysis was performed after the titanium implants were removed. Empty lacunae visualized on hematoxylin and eosin staining were used as evidence of bone necrosis. Bone necrosis was reduced in the MSC sheet ( +) group. Tartrate-resistant acid phosphatase (TRAP) staining revealed a decreased number of TRAP-positive cells in areas with a large number of empty lacunae in the MSC sheet (-) group. Micro-CT analyses demonstrated that the bone volume fraction (BV/TV) was not significantly different between the MSC sheet (-) and ( +) groups. We conclude that MRONJ can be triggered by a titanium placement in rats, and grafting of allogeneic MSC sheets has the potential to prevent MRONJ.

A collagen-coated PGA conduit for interpositional-jump graft with end-to-side neurorrhaphy for treating facial nerve paralysis in rat.

PURPOSE: This study investigated the potential of collagen-coated polyglycolic acid (PGA) tube with interpositional jump graft (IPJG) in rat. MATERIALS AND METHODS: A total of 16 Lewis rats were used in this study. Facial nerve paralysis was created by ligating facial nerve trunk with a ligature clip. The rats were divided into 3 groups. Nerve conduit group (n = 6) were treated by IPJG with collagen-coated PGA tubes between the facial nerve trunks and the hypoglossal nerves. Autograft group (n = 6) were treated by IPJG with the greater auricular nerves. As the control group (n = 4), non-treated-model rats with facial nerve paralysis were used. The number of myelinated fibers, fiber diameter, axon diameter, myelin thickness, and g-ratio, were analyzed histologically at 13 weeks after surgery. Compound muscle action potential (CMAP) and retrograde tracing were measured. RESULT: Although the number of myelinated fibers in autograft group (1957 ± 775) had significantly higher than that of nerve conduit group (90 ± 41, P < .05), the nerve conduit group showed the regeneration of myelinated nerve axons. CMAP amplitude values of the autograft (4706 ± 1154 µV) and the nerve conduit groups (4119 ± 1397 µV) were significantly higher than that of the control group (915 ± 789 µV, P < .05). Retrograde tracing confirmed the double innervation of mimetic muscles by the facial and hypoglossal nucleus in both groups. CONCLUSION: This study showed histologically and physiologically the superior effectiveness of performing IPJG with a collagen-coated PGA conduit in a rat model.

Poly( N-isopropylacrylamide)-Grafted Polydimethylsiloxane Substrate for Controlling Cell Adhesion and Detachment by Dual Stimulation of Temperature and Mechanical Stress.

Stretchable temperature-responsive cell culture surfaces composed of poly( N-isopropylacrylamide) (PIPAAm) gel-grafted polydimethylsiloxane (PIPAAm-PDMS) were prepared to demonstrate that dual stimulation of temperature and mechanical stress extensively altered graft polymer thickness, surface wettability, and cell detachment behavior. The PIPAAm-PDMS surface was hydrophilic and hydrophobic below and above the lower critical solution temperature, respectively, which was ascribed to the phase transition of PIPAAm chains. When uniaxial stretching was applied, the grafted PIPAAm gel surface was modulated to be more hydrophobic as shown by an increase in the contact angle. Atomic force microscopy observation revealed that uniaxial stretching made the grafted gel layer thinner and deformed the nanoscale aggregates of the grafted PIPAAm gel, implying extension of the PIPAAm chains. The stretched PIPAAm-PDMS became more cell adhesive than the unstretched PIPAAm-PDMS at 37 °C. Furthermore, dual stimulation, shrinking the already stretched PIPAAm-PDMS and decreasing the temperature, induced more rapid cell detachment than only a change in temperature did. Similarly, upon comparison with a single stimulation of a change in temperature or mechanical stress, dual stimulation accelerated cell sheet detachment and harvesting. This new stretchable and temperature-responsive culture surface can easily adjust the surface property to a different cell adhesiveness by appropriately combining each stimulus and enable the fabrication of cell sheets of various species.

Effect of Temperature Changes on Serum Protein Adsorption on Thermoresponsive Cell-Culture Surfaces Monitored by A Quartz Crystal Microbalance with Dissipation.

Thermoresponsive cell-culture polystyrene (PS) surfaces that are grafted with poly(N-isopropylacrylamide) (PIPAAm) facilitate the cultivation of cells at 37 °C and the detachment of cultured cells as a sheet with an underlying extracellular matrix (ECM) by reducing the temperature. However, the ECM and cell detachment mechanisms are still unclear because the detachment of cells from thermoresponsive surfaces is governed by complex interactions among the cells/ECM/surface. To explore the dynamic behavior of serum protein adsorption/desorption, thermoresponsive surfaces that correspond to thermoresponsive tissue-culture PS dishes were formed on sensor chips for quartz crystal microbalance with dissipation (QCM-D) measurements. X-ray photoelectron spectroscopy (XPS) measurements and temperature-dependent frequency and dissipation shifts, Δf and ΔD, using QCM-D revealed that the thermoresponsive polymers were successfully grafted onto oxidized, thin PS films on the surfaces of the sensor chips. Increased amounts of adsorbed bovine serum albumin (BSA) and fibronectin (FN) were observed on the thermoresponsive polymer-grafted surfaces at 37 °C when compared with those at 20 °C because of enhanced hydrophobic interactions with the hydrophobic, thermoresponsive surface. While the calculated masses of adsorbed BSA and FN using QCM-D were 3⁻5 times more than those that were obtained from radiolabeling, the values were utilized for relative comparisons among the same substrate. More importantly, the thermoresponsive, dynamic behavior of serum protein adsorption/desorption was monitored using the QCM-D technique. Observations of this dynamic behavior revealed that the BSA and FN that were adsorbed at 37 °C remained on both surfaces after decreasing the temperature to 20 °C.

Stripe-patterned thermo-responsive cell culture dish for cell separation without cell labeling.

A stripe-patterned thermo-responsive surface is prepared to enable cell separation without labeling. The thermo-responsive surface containing a 3 µm striped pattern exhibits various cell adhesion and detachment properties. A mixture of three cell types is separated on the patterned surface based on their distinct cell-adhesion properties, and the composition of the cells is analyzed by flow cytometry.

Thermoresponsive cationic copolymer brushes for mesenchymal stem cell separation.

Thermoresponsive, cationic, copolymer brushes poly(N-isopropylacrylamide(IPAAm)-co-N,N-dimethylaminopropylacrylamide-co-N-tert-butylacrylamide(tBAAm)) and poly(IPAAm-co-3-acrylamidopropyl trimethylammonium chloride-co-tBAAm) were prepared on glass substrates through surface-initiated atom transfer radical polymerization. Prepared copolymer brushes were investigated as thermally modulated cell separation materials. Densely packed cationic copolymer brushes were formed on the glass substrates, and the positive charge density was modulated by controlling the composition of cationic moieties and species. During observation of cell adhesion and detachment properties on copolymer brushes, human bone marrow mesenchymal stem cells (hbmMSC) exhibited thermally modulated cell adhesion and detachment, while other bone-marrow-derived cells did not adhere. Using these properties, hbmMSC could be purified from mixtures of human bone-marrow-derived cells simply by changing the external temperature. Therefore, the prepared cationic copolymer brush is useful for separation of hbmMSC.

Enhanced Wettability Changes by Synergistic Effect of Micro/Nanoimprinted Substrates and Grafted Thermoresponsive Polymer Brushes.

Thermoresponsive polymer brushes are grafted on micro/nanostructured polymer substrates as new intelligent interfaces that synergistically enhance wettability changes in response to external temperature stimuli. Thermoplastic poly(styrene-co-4-vinylbenzyl chloride) [P(St-co-VBC)] is synthesized using radical polymerization and spin-coated on a glass substrate. Micro/nanopillar and hole patterns are imprinted on the P(St-co-VBC) layer using thermal nanoimprint lithography. Poly(N-isopropylacrylamide) (PIPAAm) brushes are grafted on the micro/nanostructured P(St-co-VBC) layer through surface-initiated atom-transfer radical polymerization using 4-vinylbenzyl chloride as the initiator. The imprinted micro/nanostructures and grafted PIPAAm brush chain lengths affect the surface wettability. Combinations of nanopillars or nanoholes (diameter 500 nm) and longer PIPAAm brushes enhance hydrophobic/hydrophilic changes in response to temperature changes, compared with the flat substrate. The thermoresponsive hydrophobic/hydrophilic transition is synergistically enhanced by the nanostructured surface changing from Cassie-Baxter to Wenzel states. This PIPAAm-brush-modified micro/nanostructured P(St-co-VBC) is a new intelligent interface that effectively changes wettability in response to external temperature changes.

Thermoresponsive nanostructured surfaces generated by the Langmuir-Schaefer method are suitable for cell sheet fabrication.

Thermoresponsive poly(N-isopropylacrylamide) (PIPAAm)-immobilized surfaces for controlling cell adhesion and detachment were fabricated by the Langmuir-Schaefer method. Block copolymers composed of polystyrene and PIPAAm (St-IPAAms) having various chain lengths and compositions were synthesized by reversible addition-fragmentation chain transfer radical polymerization. The St-IPAAm Langmuir film at an air-water interface was horizontally transferred onto a hydrophobically modified glass substrate while regulating its density. Atomic force microscopy images clearly visualized nanoscaled sea-island structures on the surface. By adjusting both the composition of St-IPAAms and the density of immobilized PIPAAms, a series of thermoresponsive surfaces was prepared to control the strength, rate, and quality of cell adhesion and detachment through changes in temperature across the lower critical solution temperature range of PIPAAm molecules. In addition, a two-dimensional cell structure (cell sheet) was more rapidly recovered on the optimized surfaces than on conventional PIPAAm surfaces. These unique PIPAAm surfaces are suggested to be useful for controlling the strength of cell adhesion and detachment.

Promotion of mouse ameloblast proliferation by Lgr5 mediated integrin signaling.

Rodent incisors grow throughout the animal's lives, and the tooth-forming cells are provided from proximal ends of the incisors where the tooth epithelium forms a stem cell niche called cervical loop. The committing cells in a cervical loop actively begin to proliferate (pre-ameloblasts), and differentiating into ameloblasts. This study showed that the lower incisors of mice null for CD61 (CD61(-/-) ), also known as integrin ß3, were significantly shorter than those of the wild-type mice at 8-week-old. The protein and mRNA expressions levels of Fgfr2, Lgr5, and Notch1, which are known to be involved in pre-ameloblastic cell proliferation and stem cell maintenance, were reduced in the cervical loop of 2-week-old CD61(-/-) mice. The proliferation of pre-ameloblasts was reduced in CD61(-/-) ameloblasts. The siRNA-mediated suppression of CD61 (siCD61) reduced the proliferation of pre-ameloblastic cell line ALC, and the expression levels of Lgr5 and Notch1 were reduced by the transfection with siCD61. The suppression of Lgr5 by transfection with siLgr5 suppressed the proliferation of the ALC cells. These results suggested that CD61 signaling is required for the proper growth of the cervical loop and for the promotion of the proliferation of pre-ameloblastic cells through Lgr5.

Terminal-functionality effect of poly(N-isopropylacrylamide) brush surfaces on temperature-controlled cell adhesion/detachment.

Terminally functionalized poly(N-isopropylacrylamide) (PIPAAm) brush grafted glass surfaces were prepared by a surface-initiated reversible addition-fragmentation chain transfer radical (SI-RAFT) polymerization. SI-RAFT mediated PIPAAm chains possessed terminal dodecyl trithiocarbonate groups which can be substituted with various functional groups. In this study, dodecyl groups were substituted with hydrophilic maleimide groups for controlling the thermoresponsive character of PIPAAm brushes. PIPAAm brushes exhibited reversible temperature-dependent surface wettability changes around PIPAAm's lower critical solution temperature. Phase transition of dodecyl-terminated PIPAAm brushes clearly shifted to lower temperature than that of maleimide-terminated PIPAAm brushes, and this shift was attributed to promoted PIPAAm dehydration via terminal hydrophobes. By using this feature, the specific adhesion temperatures of bovine carotid artery endothelial cells (BAECs) on the PIPAAm brush surfaces were successfully controlled. BAECs were initiated to adhere on dodecyl-PIPAAm surfaces at 31 °C, while their adhesion was significantly suppressed on maleimide-PIPAAm surfaces under 33 °C. In contrast, terminal functionality scarcely affected the thermoresponsive behavior of PIPAAm brushes in the polymer rehydration process by reducing temperatures, and thus, the difference in spontaneous cell detachment from different PIPAAm-brush surface was negligible. Consequently, confluently cultured cells were able to be harvested as contiguous cell sheets from individual surfaces with comparable periods at 20 °C.

Hydrophobized thermoresponsive copolymer brushes for cell separation by multistep temperature change.

For preparing a thermally modulated biointerface that separates cells without the modification of cell surfaces for regenerative medicine and tissue engineering, poly(N-isopropylacrylamide-co-butyl methacrylate) (P(IPAAm-co-BMA), thermo-responsive hydrophobic copolymer brushes with various BMA composition were formed on glass substrate through a surface-initiated atom transfer radical polymerization (ATRP). Characterization of the prepared surface was performed by X-ray photoelectron spectroscopy (XPS), attenuated total reflection Fourier transform infrared spectroscopy (ATR/FT-IR), and gel-permeation chromatography (GPC) measurement. Prepared copolymer brush surfaces were characterized by observing the adhesion (37 °C) and detachment (20 or 10 °C) of four types of human cells: human umbilical vein endothelial cells (HUVECs), normal human dermal fibroblasts (NHDFs), human aortic smooth muscle cells (SMCs), and human skeletal muscle myoblast cells (HSMMs). HUVECs and NHDFs exhibited their effective detachment temperature at 20 and 10 °C, respectively. Using cells' intrinsic temperature sensitivity for detachment from the copolymer brush, a mixture of green fluorescent protein (GFP)-expressing HUVECs (GFP-HUVECs) and NHDFs was separated.

Simultaneous enhancement of cell proliferation and thermally induced harvest efficiency based on temperature-responsive cationic copolymer-grafted microcarriers.

The development of large-scale suspension cell cultures using microcarriers has long been a focus of attention in the fields of pharmacy and biotechnology. Previously, we developed cell-detachable microcarriers based on temperature-responsive poly(N-isopropylacrylamide) (PIPAAm)-grafted beads, on which adhering cells can be noninvasively harvested by only reducing the temperature without the need for proteolytic enzyme treatment. In this study, to improve the cell harvest efficiency from bead surfaces while maintaining cell adhesion and proliferation properties, we prepared temperature-responsive cationic copolymer-grafted beads bearing a copolymer brush consisting of IPAAm, positively charged quaternary amine monomer (3-acrylamidopropyl trimethylammonium chloride; APTAC), and hydrophobic monomer (N-tert-butylacrylamide; tBAAm). The incorporation of positively charged APTAC into the grafted copolymer brush facilitated bead dispersibility in a cell culture system containing Chinese hamster ovary (CHO-K1) cells and consequently allowed for enhanced cell proliferation in the system compared to that of unmodified CMPS and conventional PIPAAm homopolymer-grafted beads. Additionally, P(IPAAm-co-APTAC-co-tBAAm) terpolymer-grafted beads exhibited the most rapid and efficient cell detachment behavior after the temperature was reduced to 20 °C, presumably because the highly hydrated APTAC promoted the overall hydration of the P(IPAAm-co-APTAC-co-tBAAm) chains. Therefore, P(IPAAm-co-APTAC-co-tBAAm) terpolymer-grafted microcarriers are effective in facilitating both cell proliferation and thermally induced cell detachment in a suspension culture system.

Terminally functionalized thermoresponsive polymer brushes for simultaneously promoting cell adhesion and cell sheet harvest.

For preparing cell sheets effectively for cell sheet-based regenerative medicine, cell-adhesion strength to thermoresponsive cell culture surfaces need to be controlled precisely. To design new thermoresponsive surfaces via a terminal modification method, thermoresponsive polymer brush surfaces were fabricated through the surface-initiated reversible addition-fragmentation chain transfer (RAFT) radical polymerization of N-isopropylacrylamide (IPAAm) on glass substrates. The RAFT-mediated grafting method gave dithiobenzoate (DTB) groups to grafted PIPAAm termini, which can be converted to various functional groups. In this study, the terminal carboxylation of PIPAAm chains provided high cell adhesive property to thermoresponsive surfaces. Although cell adhesion is generally promoted by a decrease in the grafted PIPAAm amount, the decrease also decelerated thermally-induced cell detachment, whereas the influence of terminal modification was negligible on the cell detachment. Consequently, the terminally modified PIPAAm brush surfaces allowed smooth muscle cells (SMCs) to simultaneously adhere strongly and detach themselves rapidly. In this study, SMCs were unable to reach a confluent monolayer on as-prepared PIPAAm brush surfaces (grafted amount: 0.41 µg/cm(2)) without terminal carboxylation due to their insufficient cell-adhesion strength. On the other hand, though a decrease in the PIPAAm amount allowed SMCs to form a confluent cell monolayer on the PIPAAm brush surface, the SMCs were unable to be harvested as a monolithic cell sheet by low-temperature culture at 20 °C. Because of their unique property, only terminal-carboxylated PIPAAm brush surfaces achieved rapid harvesting of complete cell sheets by low-temperature culturing.

Micropatterned thermoresponsive polymer brush surfaces for fabricating cell sheets with well-controlled orientational structures.

Newly developed fabrication technique of thermoresponsive surface using RAFT-mediated block copolymerization and photolithography achieved stripe-like micropatterning of poly(N-isopropylacrylamide) (PIPAAm) brush domains and poly(N-isopropylacrylamide)-b-poly(N-acryloylmorpholine) domains. Normal human dermal fibroblasts were aligned on the physicochemically patterned surfaces simply by one-pot cell seeding. Fluorescence images showed the well-controlled orientation of actin fibers and fibronectin in the confluent cell layers with associated extracellular matrix (ECM) on the surfaces. Furthermore, the aligned cells were harvested as a tissue-like cellular monolayer, called "cell sheet" only by reducing temperature below PIPAAm's lower critical solution temperature (LCST) to 20 °C. The cell sheet harvested from the micropatterned surface possessed a different shrinking rate between vertical and parallel sides of the cell alignment (approximately 3:1 of aspect ratio). This indicates that the cell sheet maintains the alignment of cells and related ECM proteins, promising to show the mechanical and biological aspects of cell sheets harvested from the functionalized thermoresponsive surfaces.

Tissue-engineered nerve guides with mesenchymal stem cells in the facial nerve regeneration.

Nerve guides with mesenchymal stem cells have been investigated in the rat facial nerve defect model to promote peripheral nerve regeneration and shorten recovery time to improve patients' quality of life. A 7-mm facial nerve gap experimental rat model is frequently employed in facial nerve regeneration studies. Facial nerve regeneration with nerve guides is evaluated by (1) assessing myelinated fiber counts using toluidine blue staining, (2) immunohistological analysis, (3) determining the g-ratio (axon diameter/total outer diameter) of regenerated nerve on transmission electron microscopic images, (4) retrograde nerve tracing in the facial nucleus, (5) electrophysiological evaluations using compound muscle action potential, and (6) functional evaluations using rat facial palsy scores. Dental pulp and adipose-derived stem cells, easily harvested using a minimally invasive procedure, possess characteristics of mesenchymal tissue lineages and can differentiate into Schwann-like cells. Cultured dental pulp-derived cells can produce neurotrophic factors, including nerve growth factor, brain-derived neurotrophic factor, and glial cell line-derived neurotrophic factor. These neurotrophic factors promote peripheral nerve regeneration and afford protection against facial motor neuron death. Moreover, artificial nerve guides can maneuver axonal regrowth, and dental pulp-derived cells and adipose-derived Schwann cells may supply neurotrophic factors, promoting axonal regeneration. In the present review, the authors discuss facial nerve regeneration using nerve guides with mesenchymal stem cells.

Assessment of cell sheets derived from human periodontal ligament cells: a pre-clinical study.

Periodontal-ligament-derived cells (PDL cells) have stem-cell-like properties and, when implanted into periodontal defects in vivo, can induce periodontal regeneration including the formation of new bone, cementum, and periodontal ligament. We have previously demonstrated that PDL cell sheets, harvested from temperature-responsive cell culture dishes, have a great potential for periodontal regeneration. The purpose of this study has been to validate the safety and efficacy of human PDL (hPDL) cell sheets for use in clinical trials. hPDL tissues from three donors were enzymatically digested, and the obtained cells were cultured with media containing autologous serum in a cell-processing center (CPC). The safety and efficacy of hPDL cell sheets were evaluated both in vitro and in vivo. In vitro studies showed that the hPDL cell sheets had high alkaline phosphatase activity and periostin expression (known PDL markers) and no contamination with microorganisms. In vivo studies revealed that hPDL cell sheets, implanted with dentin blocks, induced the formation of cementum and PDL-like tissue in immunodeficient mice. The hPDL cells presented no evidence of malignant transformation. Thus, hPDL cell sheets created in CPCs are safe products and possess the potential to regenerate periodontal tissues.

Validation of human periodontal ligament-derived cells as a reliable source for cytotherapeutic use.

AIM: Periodontal ligament (PDL) is a reliable cell source for periodontal regeneration. In this study, an optimal protocol for the extraction, expansion, and characterization of human PDL (hPDL) cells was examined for clinical trials. MATERIALS AND METHODS: hPDL tissues were obtained from 41 surgically extracted teeth and digested with enzymes. Human adipose-derived stem cells (hADSCs), bone marrow-derived mesenchymal stem cells (hBMMSCs), and gingival fibroblasts (hGFs) were used for comparison. For each sample, the proliferative capacity, colony-forming ability, alkaline phosphatase activity, differentiation ability, the cell surface antigens, gene expression, and regenerative potential were examined. RESULTS: hPDL cells were more successfully extracted with collagenase/dispase [29/30 (96.7%)] than with trypsin/EDTA [8/11 (72.7%)], and exhibited osteogenic potential both in vitro and in vivo. The proliferation of hPDL cells was rapid at a low cell density. hPDL cells frequently differentiated into cementoblastic/osteoblastic lineage (∼60%). In contrast, their adipogenic and chondrogenic potentials were lower than those of hADSCs and hBMMSCs. Some genes (NCAM1, S100A4, and periostin) were preferentially expressed in hPDL cells compared with those of hBMMSCs and hGFs. Immunohistochemical studies revealed the expressions of S100A4 and periostin in hPDL tissue. CONCLUSION: A protocol for the successful cultivation and validation of hPDL cells is proposed for clinical settings.

Water stable nanocoatings of poly(N-isopropylacrylamide)-based block copolymers on culture insert membranes for temperature-controlled cell adhesion.

This study demonstrated the spin-coating of functional diblock copolymers to develop smart culture inserts for thermoresponsive cell adhesion/detachment control. One part of the block components, the poly(n-butyl methacrylate) block, strongly supported the water stable surface-immobilization of the thermoresponsive poly(N-isopropylacrylamide) (PNIPAAm) block, regardless of temperature. The chain length of the PNIPAAm blocks was varied to regulate thermal surface functions. Immobilized PNIPAAm concentrations became larger with increasing chain length (1.0-1.6 µg cm-2) and the thicknesses of individual layers were relatively comparable at 10-odd nanometers. A nanothin coating scarcely inhibited the permeability of the original porous membrane. When human fibroblasts were cultured on each surface at 37 °C, the efficiencies of cell adhesion and proliferation decreased with longer PNIPAAm chains. Meanwhile, by reducing the temperature to 20 °C, longer PNIPAAm chains promoted cell detachment owing to the significant thermoresponsive alteration of cell-surface affinity. Consequently, we successfully produced a favorable cell sheet by choosing an appropriate PNIPAAm length for block copolymers.

Allogeneic multipotent mesenchymal stromal cell sheet transplantation promotes healthy healing of wounds caused by zoledronate and dexamethasone in canine mandibular bones.

INTRODUCTION: Many cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is an intractable disease, have been reported. Although a general intravenous injection of multipotent mesenchymal stromal cells (MSCs) may be effective for treating BRONJ, it has some severe problems. Therefore, our aim was to develop a treatment of locally administered MSCs. In this study, we investigated the effect of MSC sheet transplantation in the mandibular bone healing in beagle dogs, which were administered zoledronate and dexamethasone. METHODS: MSCs isolated from subcutaneous fat were seeded onto temperature-responsive culture dishes to produce MSC sheets. Zoledronate and dexamethasone were administered to beagle dogs. Then, the parts of mandibular cortical bones were removed, and MSC sheets were transplanted to cover those bone defects (MSC sheet transplant side) or not (Control side). The specimens were evaluated in micro CT, histology, and immunohistochemistry. RESULTS: Four weeks after surgery, redness and swellings were observed in the mucosal wounds of the control sides of 2 of 3 dogs. In contrast, the mucosal wounds of the MSC sheet transplant sides of all dogs completely healed. Histological images showed some free sequestrums and many bacterial colonies, and Immunohistological analysis showed some cathepsin K-positive multinuclear cells detached from jaw bone surfaces in the control sides. CONCLUSIONS: MSC sheet transplantation promotes healthy healing of wounds caused by zoledronate and dexamethasone in canine mandibular bones. And the injured canine mandibular bones administered zoledronate and dexamethasone showed BRONJ-like findings.