Meshram Mitsu, Anchlia Sonal, Shah Harsh, Vyas Siddharth, Dhuvad Jigar, Sagarka Lalit
117, Department of Oral and Maxillofacial Surgery, Government of Dental College and Hospital, Civil Hospital, Ahmedabad-16, India.
J Maxillofac Oral Surg. 2019 Mar;18(1):112-123. doi: 10.1007/s12663-018-1106-3. Epub 2018 Mar 29.
The purpose of this study was to evaluate the use of buccal fat pad-derived stem cells (BFPSCs) as a source for full thickness bone defect repair secondary to pathology in maxilla or mandible.
Fat-derived stem cells were isolated from buccal fat pad, differentiated into osteocytes in osteogenic medium, and seeded onto human bone defects. Autologous buccal fat pad was harvested and BFPSCs cultured within 4-6 weeks. Bone defects secondary to enucleation of pathologic cyst or tumors were reconstructed with osteogenically differentiated fat-derived stem cells. Hematoxylin and eosin staining, immunohistochemical staining for osteocalcin, alkaline phosphatase and genotypic and phenotypic marker analysis, and histomorphometric measurements of new bone were performed.
Maxillofacial bone defects were successfully reconstructed by BFPSCs, which after implantation at an in vivo site yielded faster osseous regeneration. BFPSCs were associated with superior bone density formation, better blending of margins with enhanced bone trabecular formation, well-organized and well-vascularized lamellar bone with Haversian channels and osteocytes resulting in superior functional and cosmetic results with better quality of life and with significant decrease in secondary complications.
Buccal fat pad is an ideal tool in the hands of an oral and maxillofacial surgeon for tissue engineering and clinical use requiring bone tissue growth and repair, secondary to large osseous defects. This study demonstrates the feasibility of reconstructing bony defects with fat-derived stem cells.
本研究旨在评估使用颊脂垫来源的干细胞(BFPSCs)作为上颌骨或下颌骨病理性全层骨缺损修复的细胞来源。
从颊脂垫中分离脂肪来源的干细胞,在成骨培养基中分化为骨细胞,然后接种到人类骨缺损处。采集自体颊脂垫,并在4 - 6周内培养BFPSCs。用成骨分化的脂肪来源干细胞重建因病理性囊肿或肿瘤摘除导致的骨缺损。进行苏木精和伊红染色、骨钙素免疫组化染色、碱性磷酸酶以及基因型和表型标志物分析,并对新骨进行组织形态计量学测量。
BFPSCs成功重建了颌面部骨缺损,植入体内后能实现更快的骨再生。BFPSCs与更高的骨密度形成相关,边缘融合更好,骨小梁形成增强,具有哈弗斯管和骨细胞的组织良好且血管化良好的板层骨,从而带来更好的功能和美容效果,提高生活质量,并显著减少继发性并发症。
对于需要骨组织生长和修复以应对大的骨缺损的组织工程和临床应用而言,颊脂垫是口腔颌面外科医生手中一种理想的工具。本研究证明了用脂肪来源的干细胞重建骨缺损的可行性。