Ogawa Shin, Hoshina Hideyuki, Nakata Koh, Yamada Kazuho, Uematsu Kohya, Kawase Tomoyuki, Takagi Ritsuo, Nagata Masaki
Oral Implant Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan.
Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan.
Clin Implant Dent Relat Res. 2016 Aug;18(4):707-16. doi: 10.1111/cid.12356. Epub 2015 May 27.
Sinus lift (SL) using cultured autogenous periosteal cells (CAPCs) combined with autogenous bone and platelet-rich plasma (PRP) was performed to evaluate the effect of cell administration on bone regeneration, by using high-resolution three-dimensional computed tomography (CT).
SL with autogenous bone and PRP plus CAPC [CAPC(+)SL] was performed in 23 patients. A piece of periosteum taken from the mandible was cultured in M199 medium with 10% fetal bovine serum (FBS) for 6 weeks. As control, 16 patients received SL with autogenous bone and PRP [CAPC(-)SL]. Three-dimensional CT imaging was performed before and 4 months and 1 year after SL, and stratification was performed based on CT numbers (HUs) corresponding to soft tissue and cancellous or cortical bone.
The augmented bone in CAPC(+)SL revealed an increase in HUs corresponding to cancellous bone as well as a decrease in HUs corresponding to grafted cortical bone. In addition, HUs corresponding to cancellous bone in the graft bed were increased in CAPC(+)SL but were decreased in CAPC(-)SL. Insertion torque during implant placement was significantly higher in CAPC(+)SL.
By promoting bone anabolic activity both in augmented bone and graft bed, CAPCs are expected to aid primary fixation and osseointegration of implants in clinical applications.
采用高分辨率三维计算机断层扫描(CT),对使用培养的自体骨膜细胞(CAPCs)联合自体骨和富血小板血浆(PRP)进行的上颌窦提升术(SL)进行评估,以评价细胞给药对骨再生的影响。
对23例患者实施了自体骨、PRP加CAPC的上颌窦提升术[CAPC(+)SL]。从下颌骨获取的一块骨膜在含10%胎牛血清(FBS)的M199培养基中培养6周。作为对照,16例患者接受了自体骨和PRP的上颌窦提升术[CAPC(-)SL]。在SL术前、术后4个月和1年进行三维CT成像,并根据对应于软组织和松质骨或皮质骨的CT值(HUs)进行分层。
CAPC(+)SL中增加的骨显示对应于松质骨的HUs增加,对应于移植皮质骨的HUs减少。此外,CAPC(+)SL中移植床对应于松质骨的HUs增加,而CAPC(-)SL中则减少。CAPC(+)SL中种植体植入时的插入扭矩明显更高。
通过促进增骨和移植床中的骨合成代谢活性,CAPCs有望在临床应用中辅助种植体的初期固定和骨整合。