Abstract:The Class II furcation defects present a significant challenge in periodontal treatment and pose a considerable risk to tooth survival. While scaffold‐free Periodontal ligament stem cells (PDLSCs)‐derived cell pellets (CP) and sheets (CS) aid regeneration, the molecular mechanisms and efficacy of PDLSC‐CP remain unclear, especially in large animals. This study investigates PDLSC‐CP's regenerative potential for Class II defects through in vitro and in vivo analyses. PDLSC‐CP demonstrated superior cell viability, improved the extracellular matrix (ECM) quality, enhanced biomechanical properties, and a greater potential for periodontal tissue regeneration compared to PDLSC‐CS in both in vitro and in vivo scenarios. Importantly, autocrine transforming growth factor‐β1 (TGF‐β1) in PDLSC‐CP upregulated odonto/osteogenesis‐related factors by activating the TGF‐β1/Smad pathway. However, LY2109761, an inhibitor of TGF‐β receptor I and II, suppressed periodontal tissue regeneration in immunodeficient mice. In the beagle dog with Class II furcation defects, PDLSC‐CP regenerated and repaired periodontal bone defects, which is more effective than the control group, the bone substitutes group, and the mixed group (PDLSC‐CP and bone substitutes). These findings highlight PDLSC‐CP as a promising strategy for periodontal bone defect treatment, where autocrine TGF‐β1 stimulates the TGF‐β1/Smad pathway to drive periodontal tissue regeneration.