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牙髓干细胞/祖细胞与胶原海绵生物复合物移植修复人下颌骨骨缺损。

Human mandible bone defect repair by the grafting of dental pulp stem/progenitor cells and collagen sponge biocomplexes.

机构信息

Department of Experimental Medicine, Section of Histology and Embryology, TERM Division, 2nd University of Naples, Naples, Italy.

出版信息

Eur Cell Mater. 2009 Nov 12;18:75-83. doi: 10.22203/ecm.v018a07.

Abstract

In this study we used a biocomplex constructed from dental pulp stem/progenitor cells (DPCs) and a collagen sponge scaffold for oro-maxillo-facial (OMF) bone tissue repair in patients requiring extraction of their third molars. The experiments were carried out according to our Internal Ethical Committee Guidelines and written informed consent was obtained from the patients. The patients presented with bilateral bone reabsorption of the alveolar ridge distal to the second molar secondary to impaction of the third molar on the cortical alveolar lamina, producing a defect without walls, of at least 1.5 cm in height. This clinical condition does not permit spontaneous bone repair after extraction of the third molar, and eventually leads to loss also of the adjacent second molar. Maxillary third molars were extracted first for DPC isolation and expansion. The cells were then seeded onto a collagen sponge scaffold and the obtained biocomplex was used to fill in the injury site left by extraction of the mandibular third molars. Three months after autologous DPC grafting, alveolar bone of patients had optimal vertical repair and complete restoration of periodontal tissue back to the second molars, as assessed by clinical probing and X-rays. Histological observations clearly demonstrated the complete regeneration of bone at the injury site. Optimal bone regeneration was evident one year after grafting. This clinical study demonstrates that a DPC/collagen sponge biocomplex can completely restore human mandible bone defects and indicates that this cell population could be used for the repair and/or regeneration of tissues and organs.

摘要

在这项研究中,我们使用了一种由牙髓干细胞/祖细胞(DPCs)和胶原海绵支架构建的生物复合物,用于修复需要拔除第三磨牙的患者的口腔颌面(OMF)骨组织。实验根据我们的内部伦理委员会指南进行,并获得了患者的书面知情同意。这些患者因第三磨牙的阻生导致第二磨牙远中牙槽嵴的双侧骨吸收,产生了一个没有壁的缺损,高度至少为 1.5 厘米。这种临床情况不允许第三磨牙拔除后自发骨修复,最终也会导致相邻第二磨牙的丧失。首先,我们为 DPC 分离和扩增拔除了上颌第三磨牙。然后将细胞接种到胶原海绵支架上,获得的生物复合物用于填充下颌第三磨牙拔除后留下的损伤部位。在自体 DPC 移植后 3 个月,通过临床探查和 X 射线评估,患者的牙槽骨得到了最佳的垂直修复,牙周组织完全恢复到第二磨牙。组织学观察清楚地表明,损伤部位的骨完全再生。移植后 1 年可见到最佳的骨再生。这项临床研究表明,DPC/胶原海绵生物复合物可以完全恢复人类下颌骨缺损,并表明这种细胞群体可用于组织和器官的修复和/或再生。

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