Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere, Tampere, Finland; Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland; Department of Otolaryngology, Head and Neck Surgery and Oral Diseases and Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland; Department of Oral and Maxillofacial Surgery, Central Hospital of Central Finland Health Care District, Jyväskylä, Finland; Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland.
Stem Cells Transl Med. 2014 Apr;3(4):530-40. doi: 10.5966/sctm.2013-0173. Epub 2014 Feb 20.
Although isolated reports of hard-tissue reconstruction in the cranio-maxillofacial skeleton exist, multipatient case series are lacking. This study aimed to review the experience with 13 consecutive cases of cranio-maxillofacial hard-tissue defects at four anatomically different sites, namely frontal sinus (3 cases), cranial bone (5 cases), mandible (3 cases), and nasal septum (2 cases). Autologous adipose tissue was harvested from the anterior abdominal wall, and adipose-derived stem cells were cultured, expanded, and then seeded onto resorbable scaffold materials for subsequent reimplantation into hard-tissue defects. The defects were reconstructed with either bioactive glass or β-tricalcium phosphate scaffolds seeded with adipose-derived stem cells (ASCs), and in some cases with the addition of recombinant human bone morphogenetic protein-2. Production and use of ASCs were done according to good manufacturing practice guidelines. Follow-up time ranged from 12 to 52 months. Successful integration of the construct to the surrounding skeleton was noted in 10 of the 13 cases. Two cranial defect cases in which nonrigid resorbable containment meshes were used sustained bone resorption to the point that they required the procedure to be redone. One septal perforation case failed outright at 1 year because of the postsurgical resumption of the patient's uncontrolled nasal picking habit.
虽然有孤立的颅颌面硬组织重建报告，但缺乏多例患者的病例系列研究。本研究旨在回顾在四个解剖位置不同的部位（额窦 3 例、颅骨 5 例、下颌骨 3 例和鼻中隔 2 例）进行的 13 例连续颅颌面硬组织缺损患者的经验。从前腹壁采集自体脂肪组织，并培养、扩增脂肪源性干细胞，然后将其接种到可吸收支架材料上，随后再将其植入硬组织缺损部位。使用生物活性玻璃或 β-磷酸三钙支架来重建缺损，这些支架上接种了脂肪源性干细胞（ASCs），在某些情况下还添加了重组人骨形态发生蛋白-2。ASCs 的生产和使用符合良好生产规范指南。随访时间为 12 至 52 个月。在 13 例中有 10 例成功地将构建体与周围骨骼整合。在使用非刚性可吸收封闭网的 2 例颅骨缺损病例中，由于骨吸收导致需要再次进行手术。1 例鼻中隔穿孔病例在 1 年内直接失败，原因是患者在手术后恢复了不受控制的挖鼻习惯。
