Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam, Research Institute MOVE, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
Tissue Eng Part B Rev. 2013 Feb;19(1):69-82. doi: 10.1089/ten.TEB.2012.0404. Epub 2012 Sep 28.
Bone loss in the oral and maxillofacial region caused by trauma, tumors, congenital disorders, or degenerative diseases is a health care problem worldwide. To restore (reconstruct) these bone defects, human or animal bone grafts or alloplastic (synthetic) materials have been used. However, several disadvantages are associated with bone graft transplantation, such as limited bone volume, donor-site morbidity, surgical and immune rejection risks, and lack of osseo-integration. Bone tissue engineering is emerging as a valid alternative to treat bone defects allowing the regeneration of lost bony tissue, thereby recovering its functionality. During the last decades, the increasing aged population worldwide has also raised the prevalence of maxillary atrophy. Maxillary sinus floor elevation (MSFE) has become a standard surgical procedure to overcome the reduced amount of bone, thus enabling the placement of dental implants. MSFE aims to increase the bone height in the posterior maxilla, by elevating the Schneiderian membrane and placing the graft material into the surgically created space in the maxillary sinus floor. Importantly, oral bone regeneration during MSFE offers a unique human clinical model in which new cell-based bone tissue engineering applications might be investigated, since biopsies can be taken after MSFE before a dental implant placement and analyzed at the cellular level. New approaches in oral bone regeneration are focusing on cells, growth factors, and biomaterials. Recently, adipose tissue has become interesting as an abundant source of mesenchymal stem cells, which might be applied immediately after isolation to the patient allowing a one-step surgical procedure, thereby avoiding expensive cell culture procedures and another surgical operation. In this new cell-based tissue engineering approach, stem cells are combined with an osteoconductive scaffold and growth factors, and applied immediately to the patient. In this review, MSFE is discussed as a valid model to test bone tissue engineering approaches, such as the one-step surgical procedure. This procedure might be applied in other regenerative medicine applications as well.
口腔颌面部因创伤、肿瘤、先天畸形或退行性疾病导致的骨丢失是一个全球性的医疗保健问题。为了修复（重建）这些骨缺损，人们曾使用过人类或动物骨移植物或异质（合成）材料。然而，骨移植存在一些缺点，如骨量有限、供区发病率、手术和免疫排斥风险以及缺乏骨整合。骨组织工程作为一种治疗骨缺损的有效替代方法正在兴起，它允许再生丢失的骨组织，从而恢复其功能。在过去的几十年中，全球人口老龄化的增加也导致了上颌萎缩的患病率上升。上颌窦底提升（MSFE）已成为一种标准的手术程序，以克服骨量减少，从而能够放置牙种植体。MSFE 的目的是通过提升筛状膜并将移植物材料放入上颌窦底的手术创建的空间中，来增加后上颌的骨高度。重要的是，MSFE 期间的口腔骨再生为新的基于细胞的骨组织工程应用提供了一个独特的人体临床模型，因为可以在 MSFE 后、牙种植体放置前进行活检，并在细胞水平上进行分析。口腔骨再生的新方法集中在细胞、生长因子和生物材料上。最近，脂肪组织已成为一种丰富的间充质干细胞来源而受到关注，这些细胞可以在分离后立即应用于患者，从而允许一步手术程序，避免昂贵的细胞培养程序和另一次手术。在这种新的基于细胞的组织工程方法中，干细胞与骨传导支架和生长因子结合，并立即应用于患者。在这篇综述中，MSFE 被讨论为测试骨组织工程方法的有效模型，如一步手术程序。该程序也可能应用于其他再生医学应用。
