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颊脂垫来源的干细胞与牛无机骨矿物支架联合用于下颌后缩萎缩区的骨增量:一项探索性前瞻性临床研究。

Buccal fat pad-derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: An exploratory prospective clinical study.

机构信息

Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Clin Implant Dent Relat Res. 2019 Apr;21(2):292-300. doi: 10.1111/cid.12729. Epub 2019 Mar 1.

Abstract

BACKGROUND

Application of adipose-derived stem cells originated from buccal fat pad (BFP) can simplify surgical procedures and diminish clinical risks compared to large autograft harvesting.

PURPOSE

This study sought to evaluate and compare the efficacy of buccal fat pad-derived stem cells (BFPSCs) in combination with anorganic bovine bone mineral (ABBM) for vertical and horizontal augmentation of atrophic posterior mandibles.

MATERIALS AND METHODS

Fourteen patients with atrophic posterior mandible were elected for this prospective exploratory study. BFP (3-5 mL) was harvested and BFPSCs were isolated and combined with ABBM at 50% ratio. The vertical and horizontal alveolar deficiencies were augmented by 50% mixture of ABBM with either BFPSCs (group 1) or particulated autologous bone (group 2). Titanium mesh was contoured to the desired 3D shape of the alveolar ridge and fixated to the host sites over the graft material of the two groups. At first, the amount of new bone areas was calculated by quantitative analysis of cone beam computed tomography (CBCT) images that were taken 6 months postoperatively according to regenerative techniques (group 1 vs group 2 without considering the type of bone defects). Second, these amounts were calculated in each group based on the type of defects.

RESULTS

Quantitative analysis of CBCT images revealed the areas of new bone formation were 169.5 ± 5.90 mm and 166.75 ± 10.05 mm in groups 1 and 2, respectively. The area of new bone formation for vertical defects were 164.91 ± 3.74 mm and 169.36 ± 12.09 mm in groups 1 and 2, respectively. The area of new bone formation for horizontal deficiencies were 170.51 ± 4.54 mm and 166.98 ± 9.36 mm in groups 1 and 2, respectively. There were no statistically significant differences between the two groups in any of the pair-wise comparisons (P > 0.05).

CONCLUSIONS

The findings of the present study demonstrated lack of difference in bone volume formation between BFPSCs and autologous particulate bone in combination with ABBM. If confirmed by future large-scale clinical trial, BFPSCs may provide an alternative to autogenous bone for reconstruction of alveolar ridge defects.

摘要

背景

与大量自体移植物采集相比,颊脂垫来源的脂肪干细胞(BFP)的应用可简化手术程序并降低临床风险。

目的

本研究旨在评估和比较颊脂垫衍生的干细胞(BFPSCs)与无机牛骨矿物质(ABBM)联合用于垂直和水平增强萎缩性下颌后区的效果。

材料和方法

选择 14 名患有萎缩性下颌后区的患者进行这项前瞻性探索性研究。采集 3-5 毫升的颊脂垫,分离并与 ABBM 以 50%的比例混合。通过将 ABBM 与 BFPSCs(第 1 组)或颗粒自体骨(第 2 组)以 50%的混合物垂直和水平增强牙槽骨的缺陷。将钛网塑形为所需的牙槽嵴 3D 形状,并将其固定在两组移植物的宿主部位上。首先,根据再生技术,通过术后 6 个月的锥形束计算机断层扫描(CBCT)图像的定量分析计算新骨区域的数量(第 1 组与不考虑骨缺损类型的第 2 组相比)。其次,根据缺陷类型在每组中计算这些数量。

结果

CBCT 图像的定量分析显示,第 1 组和第 2 组的新骨形成区域分别为 169.5±5.90mm 和 166.75±10.05mm。第 1 组和第 2 组的垂直骨缺损的新骨形成区域分别为 164.91±3.74mm 和 169.36±12.09mm。第 1 组和第 2 组的水平骨缺损的新骨形成区域分别为 170.51±4.54mm 和 166.98±9.36mm。两组之间的任何两两比较均无统计学差异(P>0.05)。

结论

本研究结果表明,BFPSCs 与 ABBM 联合应用在骨量形成方面与自体颗粒骨无差异。如果未来的大规模临床试验得到证实,BFPSCs 可能为牙槽嵴缺损的重建提供自体骨的替代物。

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