Pavan Kumar B, Ram Mohan S, Mohan A P, Jeevan Kumar K A, Yashwanth Yadav B
Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, 508254 Andhra Pradesh India.
J Maxillofac Oral Surg. 2016 Mar;15(1):1-11. doi: 10.1007/s12663-015-0793-2. Epub 2015 May 13.
Bone marrow (BM) derived pleuripotent undifferentiated stem cells represent a promising population for supporting new concepts in cellular therapy.
The aim of this study is to evaluate the versatility of pleuripotent undifferentiated stem cells derived from BM aspiration and its applications in oral and maxillofacial surgical procedures.
A total of 30 patients out of which 15 were with hard tissue defects (cystic lesions n = 6, post surgical alveolar defects n = 4, peri implant defects n = 3, alveolar clefts n = 2) and 15 soft tissue lesions (leukoplakia and lichen planus n = 6, oral submucous fibrosis n = 7, post traumatic soft tissue loss n = 2) were included in the study on randomized clinical basis. The patients received autologous BM derived mononuclear cells which were being locally delivered into the lesion and followed up. The parameters used were (1) To compare and evaluate the bone regeneration by radiographic assessment at the end of 3rd and 6th month postoperatively. (2) Duration of the procedure. (3) Clinical improvement in the management of soft tissue lesions. (4) Assessment of wound healing by Vancouver burn scar assessment of wound. (5) Safety, postoperative infections and complications.
For hard tissue lesions CT scans and OPG revealed adequate regenerated bone, bridging the defect after 3 months. Hounsfield units of regenerated bone after 6 months were more or less similar to native bone which was statistically significant (unpaired t test = p < 0.05). For soft tissue lesions (1) 7 cases of OSMF showed adequate clinical mouth opening (one way anova test = p < 0.05), reduction in burning sensation and blanching of mucosa, (2) 6 cases of leukoplakia and lichen planus and 2 cases of post traumatic soft tissue defects showed good clinical improvement by Vancouver burn scar assessment of wound index.
The study shows that there is a definite beneficial effect in bone regeneration and soft tissue wound healing with the use of BM-derived mononuclear cells.
骨髓来源的多能未分化干细胞是细胞治疗新观念的一个有前景的细胞群。
本研究旨在评估骨髓穿刺获得的多能未分化干细胞的多功能性及其在口腔颌面外科手术中的应用。
随机选取30例患者纳入研究，其中15例为硬组织缺损（囊性病变6例、术后牙槽骨缺损4例、种植体周围缺损3例、牙槽嵴裂2例），15例为软组织病变（白斑和扁平苔藓6例、口腔黏膜下纤维化7例、创伤后软组织缺损2例）。患者接受自体骨髓来源的单核细胞，并将其局部注入病变部位，随后进行随访。所使用的参数包括：（1）术后第3个月和第6个月末通过影像学评估比较和评价骨再生情况。（2）手术持续时间。（3）软组织病变治疗中的临床改善情况。（4）通过温哥华烧伤瘢痕伤口评估法评估伤口愈合情况。（5）安全性、术后感染及并发症。
对于硬组织病变，CT扫描和口腔全景片显示术后3个月有足够的再生骨，填补了缺损。6个月后再生骨的亨氏单位与正常骨大致相似，具有统计学意义（非配对t检验，p<0.05）。对于软组织病变：（1）7例口腔黏膜下纤维化患者临床开口度足够（单因素方差分析，p<0.05），烧灼感减轻，黏膜变白；（2）6例白斑和扁平苔藓患者以及2例创伤后软组织缺损患者通过温哥华烧伤瘢痕伤口指数评估显示临床改善良好。
本研究表明，使用骨髓来源的单核细胞对骨再生和软组织伤口愈合有明确的有益作用。
