Baba Shunsuke, Yamada Yoichi, Komuro Akira, Yotsui Yoritaka, Umeda Makoto, Shimuzutani Kimishige, Nakamura Sayaka
Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka 540-0008, Japan.
Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka 540-0008, Japan; Department of Oral and Maxillofacial Surgery, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Stem Cells Int. 2016;2016:6205910. doi: 10.1155/2016/6205910. Epub 2016 Nov 20.
Regenerative medicine is emerging as a promising option, but the potential of autologous stem cells has not been investigated well in clinical settings of periodontal treatment. In this clinical study, we evaluated the safety and efficacy of a new regenerative therapy based on the surgical implantation of autologous mesenchymal stem cells (MSCs) with a biodegradable three-dimensional (3D) woven-fabric composite scaffold and platelet-rich plasma (PRP). Ten patients with periodontitis, who required a surgical procedure for intrabony defects, were enrolled in phase I/II trial. Once MSCs were implanted in each periodontal intrabony defect, the patients were monitored during 36 months for a medical exam including laboratory tests of blood and urine samples, changes in clinical attachment level, pocket depth, and linear bone growth (LBG). All three parameters improved significantly during the entire follow-up period ( < 0.0001), leading to an average LBG of 4.7 mm after 36 months. Clinical mobility measured by Periotest showed a decreasing trend after the surgery. No clinical safety problems attributable to the investigational MSCs were identified. This clinical trial suggests that the stem cell therapy using MSCs-PRP/3D woven-fabric composite scaffold may constitute a novel safe and effective regenerative treatment option for periodontitis.
再生医学正成为一种有前景的选择,但自体干细胞在牙周治疗临床环境中的潜力尚未得到充分研究。在这项临床研究中,我们评估了一种基于自体间充质干细胞(MSC)与可生物降解的三维(3D)编织织物复合支架及富血小板血浆(PRP)手术植入的新型再生疗法的安全性和有效性。十名患有牙周炎且需要对骨内缺损进行手术治疗的患者参加了I/II期试验。一旦将MSC植入每个牙周骨内缺损处,对患者进行36个月的监测,包括血液和尿液样本的实验室检查、临床附着水平、牙周袋深度和线性骨生长(LBG)的变化。在整个随访期间,所有三个参数均有显著改善(<0.0001),36个月后平均LBG为4.7毫米。通过Periotest测量的临床动度在手术后呈下降趋势。未发现可归因于研究用MSC的临床安全问题。这项临床试验表明,使用MSC-PRP/3D编织织物复合支架的干细胞疗法可能构成一种治疗牙周炎的新型安全有效的再生治疗选择。