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使用接种自体牙周膜来源间充质干细胞的异种骨替代物进行牙周再生:一项为期12个月的半随机对照试验性临床试验。

Periodontal regeneration using a xenogeneic bone substitute seeded with autologous periodontal ligament-derived mesenchymal stem cells: A 12-month quasi-randomized controlled pilot clinical trial.

作者信息

Sánchez Nerea, Fierravanti Ludovica, Núñez Javier, Vignoletti Fabio, González-Zamora María, Santamaría Silvia, Suárez-Sancho Susana, Fernández-Santos María Eugenia, Figuero Elena, Herrera David, García-Sanz Jose A, Sanz Mariano

机构信息

ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain.

Margarita Salas Center for Biological Research (CIB-CSIC), Madrid, Spain.

出版信息

J Clin Periodontol. 2020 Nov;47(11):1391-1402. doi: 10.1111/jcpe.13368.

Abstract

AIM

To evaluate the safety and efficacy of autologous periodontal ligament-derived mesenchymal stem cells (PDL-MSCs) embedded in a xenogeneic bone substitute (XBS) for the regenerative treatment of intra-bony periodontal defects.

MATERIAL AND METHODS

This quasi-randomized controlled pilot phase II clinical trial included patients requiring a tooth extraction and presence of one intra-bony lesion (1-2 walls). Patients were allocated to either the experimental (XBS + 10 × 10 PDL-MSCs/100 mg) or the control group (XBS). Clinical and radiographical parameters were recorded at baseline, 6, 9 and 12 months. The presence of adverse events was also evaluated. Chi-square, Student's t test, Mann-Whitney U, repeated-measures ANOVA and regression models were used.

RESULTS

Twenty patients were included. No serious adverse events were reported. Patients in the experimental group (n = 9) showed greater clinical attachment level (CAL) gain (1.44, standard deviation [SD] = 1.87) and probing pocket depth (PPD) reduction (2.33, SD = 1.32) than the control group (n = 10; CAL gain = 0.88, SD = 1.68, and PPD reduction = 2.10, SD = 2.46), without statistically significant differences.

CONCLUSION

The application of PDL-MSCs to XBS for the treatment of one- to two-wall intra-bony lesions was safe and resulted in low postoperative morbidity and appropriate healing, although its additional benefit, when compared with the XBS alone, was not demonstrated.

摘要

目的

评估嵌入异种骨替代物(XBS)中的自体牙周膜来源间充质干细胞(PDL-MSCs)用于骨内牙周缺损再生治疗的安全性和有效性。

材料与方法

这项半随机对照II期临床试验纳入了需要拔牙且存在一处骨内病变(1 - 2壁)的患者。患者被分配至试验组(XBS + 10×10 PDL-MSCs/100mg)或对照组(XBS)。在基线、6个月、9个月和12个月时记录临床和影像学参数。还评估了不良事件的发生情况。使用卡方检验、学生t检验、曼-惠特尼U检验、重复测量方差分析和回归模型。

结果

纳入20例患者。未报告严重不良事件。试验组(n = 9)患者的临床附着水平(CAL)增加量(1.44,标准差[SD]=1.87)和探诊深度(PPD)减少量(2.33,SD = 1.32)高于对照组(n = 10;CAL增加量 = 0.88,SD = 1.68,PPD减少量 = 2.10,SD = 2.46),但无统计学显著差异。

结论

将PDL-MSCs应用于XBS治疗一至两壁骨内病变是安全的,术后发病率低且愈合良好,尽管与单独使用XBS相比,其额外益处未得到证实。

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