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自体基质血管成分与磷酸钙陶瓷骨再生的 10 年前瞻性队列研究:长期安全性评估。

Long-Term Safety of Bone Regeneration Using Autologous Stromal Vascular Fraction and Calcium Phosphate Ceramics: A 10-Year Prospective Cohort Study.

机构信息

Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

出版信息

Stem Cells Transl Med. 2023 Sep 15;12(9):617-630. doi: 10.1093/stcltm/szad045.

Abstract

This prospective cohort study aimed to assess long-term safety, dental implant survival, and clinical and radiological outcomes after maxillary sinus floor elevation (MSFE; lateral window technique) using freshly isolated autologous stromal vascular fraction (SVF) combined with calcium phosphate ceramics. All 10 patients previously participating in a phase I trial were included in a 10-year follow-up. They received either β-tricalcium phosphate (β-TCP; n = 5) or biphasic calcium phosphate (BCP; n = 5) with SVF-supplementation on one side (study). Bilaterally treated patients (6 of 10; 3 β-TCP, 3 BCP) received only calcium phosphate on the opposite side (control). Clinical and radiological assessments were performed on 44 dental implants at 1-month pre-MSFE, and 0.5- to 10-year post-MSFE. Implants were placed 6 months post-MSFE. No adverse events or pathology was reported during a 10-year follow-up. Forty-three dental implants (98%) remained functional. Control and study sides showed similar peri-implant soft-tissue quality, sulcus bleeding index, probing depth, plaque index, keratinized mucosa width, as well as marginal bone loss (0-6 mm), graft height loss (0-6 mm), and graft volume reduction. Peri-implantitis was observed around 6 implants (control: 4; study: 2) in 3 patients. This study is the first to demonstrate the 10-year safety of SVF-supplementation in MSFE for jawbone reconstruction. SVF-supplementation showed enhanced bone regeneration in the short term (previous study) and led to no abnormalities clinically and radiologically in the long term.

摘要

本前瞻性队列研究旨在评估使用新鲜分离的自体基质血管成分 (SVF) 联合磷酸钙陶瓷进行上颌窦底提升 (MSFE; 侧窗技术) 的长期安全性、牙种植体存活率以及临床和影像学结果。所有 10 名先前参与 I 期试验的患者均纳入 10 年随访。他们在一侧接受β-磷酸三钙 (β-TCP; n = 5) 或双相磷酸钙 (BCP; n = 5) 与 SVF 联合治疗(研究组)。10 名患者中的 6 名双侧治疗患者(3 名β-TCP,3 名 BCP)在对侧仅接受磷酸钙治疗(对照组)。在 MSFE 前 1 个月、MSFE 后 0.5-10 年对 44 颗牙种植体进行临床和影像学评估。MSFE 后 6 个月植入种植体。在 10 年随访期间未报告任何不良事件或病理学。43 颗牙种植体 (98%) 仍保持功能。对照组和研究组的种植体周围软组织质量、龈沟出血指数、探诊深度、菌斑指数、角化黏膜宽度以及边缘骨吸收 (0-6mm)、移植物高度损失 (0-6mm) 和移植物体积减少均相似。3 名患者的 6 颗种植体 (对照组:4 颗;研究组:2 颗)周围观察到种植体周围炎。本研究首次证明了 SVF 在上颌窦底提升骨重建中应用的 10 年安全性。SVF 补充在短期内显示出增强的骨再生作用(先前的研究),并且在长期内临床和影像学上没有异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/772b/10502529/228e29ac2340/szad045_fig4.jpg

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