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用于牙周组织再生的干细胞疗法:一项临床试验的荟萃分析。

Stem cell therapies for periodontal tissue regeneration: A meta-analysis of clinical trials.

作者信息

Nguyen-Thi Thuy-Duong, Nguyen-Huynh Bao-Hung, Vo-Hoang Thuy-Tien, Nguyen-Thanh Tung

机构信息

Odonto-stomatology Faculty, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, 49000, Viet Nam.

Faculty of Basic Science, University of Medicine and Pharmacy, Hue University, 6 Ngo Quyen Street, Hue, 49000, Viet Nam.

出版信息

J Oral Biol Craniofac Res. 2023 Sep-Oct;13(5):589-597. doi: 10.1016/j.jobcr.2023.07.001. Epub 2023 Jul 31.

Abstract

OBJECTIVE

Stem cell therapy in periodontal tissue regeneration has reported optimistic regenerative results; evidence supporting its superiority over conventional methods is still ambiguous. Therefore, this meta-analysis aims to evaluate the therapeutic effects of stem cells in human periodontal regeneration.

DESIGN

A literature search was conducted to retrieve relevant articles on periodontal regeneration in stem cell therapy. A meta-analysis of the studies was conducted using the Stata software.

RESULTS

Fifteen studies that examined the effect of stem cell therapies on periodontal tissue regeneration in 369 patients were selected from databases. Regardless of the various types of cells, both odontogenic (periodontal ligament, dental pulp, gingiva stem cell) and non-odontogenic (bone marrow, periosteum-derived, and umbilical cord stem cells), the cell therapies witnessed significant improvements in terms of clinical attachment level (SMD, -0.67; 95CI, -0.90 to -0.43), probing depth (SMD, -0.76; 95% CI, -1.21 to - 0.31), radiographic intrabony defect depth (SMD, -0.87; 95% CI, -1.52 to -0.23), and histomorphometric analysis of mineralized bone (SMD, 0.80; 95% CI, 0.42 to 1.19) when compared to traditional without-cell treatment in patients. However, evidence on gingival recession, alveolar thickness gain, bone mineral density of bone core, and bone volume fraction of bone core outcomes did not reach statistical significance.

CONCLUSIONS

Evidence suggests that the implementation of stem cell therapies in reconstructing compromised gingiva and alveolar bone tissue produces positive outcomes compared with conventional approaches. However, further well-designed investigations are needed to comprehensively identify the most effective source of cells and biomaterials for each case.

摘要

目的

干细胞疗法在牙周组织再生方面已报道了乐观的再生结果;但支持其优于传统方法的证据仍不明确。因此,本荟萃分析旨在评估干细胞在人类牙周再生中的治疗效果。

设计

进行文献检索以获取有关干细胞疗法中牙周再生的相关文章。使用Stata软件对这些研究进行荟萃分析。

结果

从数据库中选择了15项研究,这些研究调查了干细胞疗法对369例患者牙周组织再生的影响。无论细胞类型如何,无论是牙源性(牙周膜、牙髓、牙龈干细胞)还是非牙源性(骨髓、骨膜来源和脐带干细胞),与传统的无细胞治疗相比,细胞疗法在临床附着水平(标准化均数差,-0.67;95%置信区间,-0.90至-0.43)、探诊深度(标准化均数差,-0.76;95%置信区间,-1.21至-0.31)、影像学骨内缺损深度(标准化均数差,-0.87;95%置信区间,-1.52至-0.23)以及矿化骨的组织形态计量学分析(标准化均数差,0.80;95%置信区间,0.42至1.19)方面均有显著改善。然而,关于牙龈退缩、牙槽嵴厚度增加、骨核心骨密度和骨核心骨体积分数结果的证据未达到统计学意义。

结论

有证据表明,与传统方法相比,在重建受损牙龈和牙槽骨组织中实施干细胞疗法会产生积极结果。然而,需要进一步精心设计的研究来全面确定每种情况下最有效的细胞来源和生物材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff90/10415796/ee66e9d0c4a9/ga1.jpg

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