Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules

Background: Although bone tissue engineering for dentistry has been studied for many years, the clinical outcome for severe cases has not been established. Furthermore, there are limited numbers of studies that include long-term follow-up. In this study, the safety and efficacy of bone tissue engine...

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Autores principales:	Izumi Asahina, Hideaki Kagami, Hideki Agata, Masaki J. Honda, Yoshinori Sumita, Minoru Inoue, Tokiko Nagamura-Inoue, Arinobu Tojo
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bone regeneration tissue engineering mesenchymal stromal cells bone marrow stromal cells mesenchymal stem cells clinical study Medicine R
Acceso en línea:	https://doaj.org/article/78dd12ad4f714fd2a6d7ca0c6cba0e41
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spelling	oai:doaj.org-article:78dd12ad4f714fd2a6d7ca0c6cba0e412021-11-25T18:00:43ZClinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules10.3390/jcm102252312077-0383https://doaj.org/article/78dd12ad4f714fd2a6d7ca0c6cba0e412021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5231https://doaj.org/toc/2077-0383Background: Although bone tissue engineering for dentistry has been studied for many years, the clinical outcome for severe cases has not been established. Furthermore, there are limited numbers of studies that include long-term follow-up. In this study, the safety and efficacy of bone tissue engineering for patients with a severely atrophic alveolar bone were examined using autogenous bone marrow stromal cells (BMSCs), and the long-term stability was also evaluated. Methods: BMSCs from iliac bone marrow aspirate were cultured and expanded. Then, induced osteogenic cells were transplanted with autogenous platelet-rich plasma (PRP) and β-tricalcium phosphate granules (β-TCP) for maxillary sinus floor and alveolar ridge augmentation. Eight patients (two males and six females) with an average age of 54.2 years underwent cell transplantation. Safety was assessed by monitoring adverse events. Radiographic evaluation and bone biopsies were performed to evaluate the regenerated bone. Results: The major population of transplanted BMSCs belonged to the fraction of CD34<sup>−</sup>, CD45<sup>dim</sup>, and CD73<sup>+</sup> cells, which was only 0.065% of the total bone marrow cells. Significant deviations were observed in cell growth and alkaline phosphatase activities among individuals. However, bone regeneration was observed in all patients and the average bone area in the biopsy samples was 41.9% 6 months following transplantation, although there were also significant deviations among each case. No adverse events related to the transplants were observed. In the regenerated bone, 27 out of 29 dental implants were integrated. Dental implants and regenerated bone were stable for an average follow-up period of 7 years and 10 months. Conclusions: Although individual variations were observed, the results showed that bone tissue engineering using BMSCs with PRP and β-TCP was feasible for patients with severe atrophic maxilla throughout a long-term follow-up period and was considered safe. However, further studies with a larger number of cases and controls to confirm the efficacy of BMSCs and the development of a protocol to establish a reproducible quality of stem cell-based graft material will be required.Izumi AsahinaHideaki KagamiHideki AgataMasaki J. HondaYoshinori SumitaMinoru InoueTokiko Nagamura-InoueArinobu TojoMDPI AGarticlebone regenerationtissue engineeringmesenchymal stromal cellsbone marrow stromal cellsmesenchymal stem cellsclinical studyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5231, p 5231 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bone regeneration tissue engineering mesenchymal stromal cells bone marrow stromal cells mesenchymal stem cells clinical study Medicine R
spellingShingle	bone regeneration tissue engineering mesenchymal stromal cells bone marrow stromal cells mesenchymal stem cells clinical study Medicine R Izumi Asahina Hideaki Kagami Hideki Agata Masaki J. Honda Yoshinori Sumita Minoru Inoue Tokiko Nagamura-Inoue Arinobu Tojo Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
description	Background: Although bone tissue engineering for dentistry has been studied for many years, the clinical outcome for severe cases has not been established. Furthermore, there are limited numbers of studies that include long-term follow-up. In this study, the safety and efficacy of bone tissue engineering for patients with a severely atrophic alveolar bone were examined using autogenous bone marrow stromal cells (BMSCs), and the long-term stability was also evaluated. Methods: BMSCs from iliac bone marrow aspirate were cultured and expanded. Then, induced osteogenic cells were transplanted with autogenous platelet-rich plasma (PRP) and β-tricalcium phosphate granules (β-TCP) for maxillary sinus floor and alveolar ridge augmentation. Eight patients (two males and six females) with an average age of 54.2 years underwent cell transplantation. Safety was assessed by monitoring adverse events. Radiographic evaluation and bone biopsies were performed to evaluate the regenerated bone. Results: The major population of transplanted BMSCs belonged to the fraction of CD34<sup>−</sup>, CD45<sup>dim</sup>, and CD73<sup>+</sup> cells, which was only 0.065% of the total bone marrow cells. Significant deviations were observed in cell growth and alkaline phosphatase activities among individuals. However, bone regeneration was observed in all patients and the average bone area in the biopsy samples was 41.9% 6 months following transplantation, although there were also significant deviations among each case. No adverse events related to the transplants were observed. In the regenerated bone, 27 out of 29 dental implants were integrated. Dental implants and regenerated bone were stable for an average follow-up period of 7 years and 10 months. Conclusions: Although individual variations were observed, the results showed that bone tissue engineering using BMSCs with PRP and β-TCP was feasible for patients with severe atrophic maxilla throughout a long-term follow-up period and was considered safe. However, further studies with a larger number of cases and controls to confirm the efficacy of BMSCs and the development of a protocol to establish a reproducible quality of stem cell-based graft material will be required.
format	article
author	Izumi Asahina Hideaki Kagami Hideki Agata Masaki J. Honda Yoshinori Sumita Minoru Inoue Tokiko Nagamura-Inoue Arinobu Tojo
author_facet	Izumi Asahina Hideaki Kagami Hideki Agata Masaki J. Honda Yoshinori Sumita Minoru Inoue Tokiko Nagamura-Inoue Arinobu Tojo
author_sort	Izumi Asahina
title	Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
title_short	Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
title_full	Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
title_fullStr	Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
title_full_unstemmed	Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules
title_sort	clinical outcome and 8-year follow-up of alveolar bone tissue engineering for severely atrophic alveolar bone using autologous bone marrow stromal cells with platelet-rich plasma and β-tricalcium phosphate granules
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/78dd12ad4f714fd2a6d7ca0c6cba0e41
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Clinical Outcome and 8-Year Follow-Up of Alveolar Bone Tissue Engineering for Severely Atrophic Alveolar Bone Using Autologous Bone Marrow Stromal Cells with Platelet-Rich Plasma and β-Tricalcium Phosphate Granules

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