Aimetti Mario, Ferrarotti Francesco, Mariani Giulia Maria, Cricenti Luca, Romano Federica
Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
Clin Adv Periodontics. 2015 May;5(2):104-109. doi: 10.1902/cap.2013.130047.
Because of their accessibility and biologic features, dental pulp stem cells (DPSCs) hold great promise for regeneration in clinical applications. To the best of the authors' knowledge, no data are available concerning their regenerative potential in human periodontal intrabony defects. The present case series explores the clinical and radiographic effectiveness of autologous DPSCs/collagen sponge biocomplex in the treatment of non-contained intrabony defects in patients with chronic periodontitis.
Four healthy patients displaying at least one prevalently 1- or 2-wall intrabony defect and one vital third molar requiring extraction were consecutively included in the study. Before surgery, patients were enrolled in a strict periodontal program including oral hygiene instructions and scaling and root planing. The third molar was extracted and used as the autologous DPSC source. The dental pulp was mechanically dissociated and filtered through 50-μm pores to obtain a cellular suspension enriched in stem cells. The selected intrabony defects, one per patient, were filled with the cellular suspension endorsed onto a collagen sponge. The mean probing depth decreased from 8.0 ± 0.8 mm at baseline to 3.3 ± 1.0 mm at the 12-month evaluation. The mean clinical attachment level amounted to 11.0 ± 0.8 mm before the surgery and to 6.0 ± 1.4 mm at 12 months. At the end of the observational period, the mean radiographic defect fill was 4.2 ± 1.9 mm.
Within the limitations of this case series, it can be concluded that autologous DPSCs may represent a very promising tool for the treatment of angular bone defects with unfavorable architecture.
由于牙髓干细胞(DPSCs)易于获取且具有生物学特性,在临床应用中具有巨大的再生潜力。据作者所知,尚无关于其在人类牙周骨内缺损中再生潜力的数据。本病例系列探讨了自体牙髓干细胞/胶原海绵生物复合物治疗慢性牙周炎患者非包容性骨内缺损的临床和影像学效果。
四名健康患者被连续纳入本研究,这些患者至少有一个主要为一壁或两壁的骨内缺损,且有一颗需要拔除的活髓第三磨牙。手术前,患者参加了严格的牙周治疗计划,包括口腔卫生指导以及龈上洁治和根面平整。拔除第三磨牙并将其用作自体牙髓干细胞的来源。牙髓经机械分离并通过50μm孔径的滤网过滤,以获得富含干细胞的细胞悬液。为每位患者选择的一个骨内缺损用负载于胶原海绵上的细胞悬液填充。平均探诊深度从基线时的8.0±0.8mm降至12个月评估时的3.3±1.0mm。手术前平均临床附着水平为11.0±0.8mm,12个月时为6.0±1.4mm。在观察期结束时,平均影像学缺损填充为4.2±1.9mm。
在本病例系列的局限性范围内,可以得出结论,自体牙髓干细胞可能是治疗结构不佳的角形骨缺损的一种非常有前景的工具。