自体骨膜细胞培养的牙槽骨组织工程的临床研究:成骨与吸收的协调激活。
A clinical study of alveolar bone tissue engineering with cultured autogenous periosteal cells: coordinated activation of bone formation and resorption.
机构信息
Department of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
出版信息
Bone. 2012 May;50(5):1123-9. doi: 10.1016/j.bone.2012.02.631. Epub 2012 Mar 2.
In ongoing clinical research into the use of cultured autogenous periosteal cells (CAPCs) in alveolar bone regeneration, CAPCs were grafted into 33 sites (15 for alveolar ridge augmentation and 18 for maxillary sinus lift) in 25 cases. CAPCs were cultured for 6weeks, mixed with particulate autogenous bone and platelet-rich plasma, and then grafted into the sites. Clinical outcomes were determined from high-resolution three-dimensional computed tomography (3D-CT) images and histological findings. No serious adverse events were attributable to the use of grafted CAPCs. Bone regeneration was satisfactory even in cases of advanced atrophy of the alveolar process. Bone biopsy after bone grafting with CAPCs revealed prominent recruitment of osteoblasts and osteoclasts accompanied by angiogenesis around the regenerated bone. 3D-CT imaging suggested that remodeling of the grafted autogenous cortical bone particles was faster in bone grafting with CAPCs than in conventional bone grafting. The use of CAPCs offers cell-based bone regeneration therapy, affording complex bone regeneration across a wide area, and thus expanding the indications for dental implants. Also, it enables the content of particulate autogenous bone in the graft material to be reduced to as low as 40%, making the procedure less invasive, or enabling larger amounts of graft materials to be prepared. It may also be possible to dispense with the use of autogenous bone altogether in the future. The results suggest that CAPC grafting induces bone remodeling, thereby enhancing osseointegration and consequently reducing postoperative waiting time after dental implant placement.
在正在进行的使用培养自体骨膜细胞 (CAPCs) 进行牙槽骨再生的临床研究中,将 CAPCs 移植到 25 例患者的 33 个部位(15 个用于牙槽嵴增高,18 个用于上颌窦提升)。CAPCs 培养 6 周后,与颗粒状自体骨和富含血小板的血浆混合,然后移植到这些部位。临床结果通过高分辨率三维计算机断层扫描(3D-CT)图像和组织学发现来确定。没有与移植 CAPCs 相关的严重不良事件。即使是牙槽突严重萎缩的病例,骨再生也令人满意。CAPC 骨移植后的骨活检显示,再生骨周围有明显的成骨细胞和破骨细胞募集,并伴有血管生成。3D-CT 成像表明,与传统骨移植相比,CAPC 骨移植中移植自体皮质骨颗粒的重塑更快。CAPC 的使用提供了基于细胞的骨再生治疗,可实现复杂的大面积骨再生,从而扩大了种植牙的适应证。此外,它可以将移植材料中颗粒状自体骨的含量降低到低至 40%,使手术的侵入性更小,或者可以制备更多的移植材料。将来也可能完全不需要使用自体骨。结果表明,CAPC 移植可诱导骨重塑,从而增强骨整合,进而减少种植牙植入后的术后等待时间。