Prins Henk-Jan, Schulten Engelbert A J M, Ten Bruggenkate Christiaan M, Klein-Nulend Jenneke, Helder Marco N
Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands Department of Oral and Maxillofacial Surgery, MOVE Research Institute Amsterdam, VU University Medical Center/ACTA, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, MOVE Research Institute Amsterdam, VU University Medical Center/ACTA, Amsterdam, The Netherlands.
Stem Cells Transl Med. 2016 Oct;5(10):1362-1374. doi: 10.5966/sctm.2015-0369. Epub 2016 Jul 7.
UNLABELLED: : In patients undergoing maxillary sinus floor elevation (MSFE) for dental implant placement, bone substitutes are currently evaluated as alternatives for autologous bone. However, bone substitutes have only osteoconductive properties and lack osteoinductive potential. Therefore, this phase I study evaluated the potential additive effect on bone regeneration by the addition of freshly isolated, autologous but heterologous stromal vascular fraction (SVF), which is highly enriched with adipose stromal/stem cells when compared with native adipose tissue. From 10 patients, SVF was procured using automatic processing, seeded on either β-tricalcium phosphate (n = 5) or biphasic calcium phosphate carriers (n = 5), and used for MSFE in a one-step surgical procedure. Primary objectives were feasibility and safety. The secondary objective was efficacy, evaluated by using biopsies of the augmented area taken 6 months postoperatively, concomitant with dental implant placement. Biopsies were assessed for bone, graft, and osteoid volumes. No adverse effects were reported during the procedure or follow-up (≥3 years). Bone and osteoid percentages were higher in study biopsies (SVF supplemented) than in control biopsies (ceramic only on contralateral side), in particular in β-tricalcium phosphate-treated patients. Paired analysis on the six bilaterally treated patients revealed markedly higher bone and osteoid volumes using microcomputed tomography or histomorphometric evaluations, demonstrating an additive effect of SVF supplementation, independent of the bone substitute. This study demonstrated for the first time the feasibility, safety, and potential efficacy of SVF seeded on bone substitutes for MSFE, providing the first step toward a novel treatment concept that might offer broad potential for SVF-based regenerative medicine applications. SIGNIFICANCE: This is the first-in-human study using freshly isolated, autologous adipose stem cell preparations (the stromal vascular fraction [SVF] of adipose tissue) applied in a one-step surgical procedure with calcium phosphate ceramics (CaP) to increase maxillary bone height for dental implantations. All 10 patients received CaP plus SVF on one side, whereas bilaterally treated patients (6 of 10) received CaP only on the opposite side. This allowed intrapatient evaluation of the potential added value of SVF supplementation, assessed in biopsies obtained after 6 months. Feasibility, safety, and potential efficacy of SVF for bone regeneration were demonstrated, showing high potential for this novel concept.
未标注:在接受上颌窦底提升术(MSFE)以植入牙种植体的患者中,目前正在评估骨替代物作为自体骨替代品的可行性。然而,骨替代物仅具有骨传导特性,缺乏骨诱导潜能。因此,这项I期研究评估了添加新鲜分离的自体但异源的基质血管成分(SVF)对骨再生的潜在附加作用,与天然脂肪组织相比,SVF富含脂肪基质/干细胞。从10名患者中,通过自动处理获取SVF,将其接种在β-磷酸三钙(n = 5)或双相磷酸钙载体(n = 5)上,并在一步手术中用于MSFE。主要目标是可行性和安全性。次要目标是疗效,通过术后6个月在植入牙种植体时对增大区域进行活检来评估。对活检样本的骨、移植物和类骨质体积进行评估。在手术过程或随访(≥3年)期间未报告不良反应。研究活检样本(补充SVF)中的骨和类骨质百分比高于对照活检样本(仅对侧使用陶瓷),特别是在β-磷酸三钙治疗的患者中。对6名双侧治疗患者的配对分析显示,使用微型计算机断层扫描或组织形态计量学评估,骨和类骨质体积明显更高,证明补充SVF具有附加作用,与骨替代物无关。这项研究首次证明了接种在骨替代物上的SVF用于MSFE的可行性、安全性和潜在疗效,为一种新的治疗概念迈出了第一步,该概念可能为基于SVF的再生医学应用提供广阔前景。 意义:这是第一项在人体中使用新鲜分离的自体脂肪干细胞制剂(脂肪组织的基质血管成分[SVF])的研究,该制剂在一步手术中与磷酸钙陶瓷(CaP)一起应用,以增加上颌骨高度用于牙种植。所有10名患者一侧接受CaP加SVF,而双侧治疗患者(10名中的6名)另一侧仅接受CaP。这允许在患者体内评估补充SVF的潜在附加值,在6个月后获得的活检样本中进行评估。证明了SVF用于骨再生的可行性、安全性和潜在疗效,显示了这一新概念的巨大潜力。
Tissue Eng Part B Rev. 2012-9-28
Clin Oral Implants Res. 2018-4-11
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008-8
Biomimetics (Basel). 2025-6-20
Front Pharmacol. 2025-3-13
Int J Mol Sci. 2024-6-20
Biomimetics (Basel). 2024-4-12
Int J Implant Dent. 2024-2-5
Nat Rev Endocrinol. 2015-3
Stem Cells Transl Med. 2014-2-20