The Use of Expanded Mesenchymal Stem Cells (MSCs...
Transcript of The Use of Expanded Mesenchymal Stem Cells (MSCs...
Pattern of bone resorption after extraction
2/ 3 in
first 3
months
50% in
1st
year
Reich KM, Huber CD, Lippnig WR, Um C, Watzek G, Tangl S . (2011, 17) . Atrophy of Residual Alveolar Ridge following
tooth loss in an historical population , Oral Diseases, 17, 33-44.
Vertical Alveolar deficiency
3 dimensional Defect (3D bone reconstruction)
The larger the defect the
greater is the tension
Soft tissue tension increase
resorption of graft
Wound Dehiescence(infection, loss of graft)
Le, B., Rohrer, M. D., & Prassad, H. S. (2010, 02). Screw “Tent-Pole” Grafting Technique for Reconstruction of Large
Vertical Alveolar Ridge Defects Using Human Mineralized Allograft for Implant Site Preparation. Journal of Oral and
Maxillofacial Surgery, 68(2), 428-435.
Management of vertical alveolar ridge deficiency
Donor site morbidity
Higher rate of bone resorption
Wound Dehiscence
Zhang, Z. (2011, 12). Bone regeneration by stem cell and tissue engineering in oral
and maxillofacial region. Front. Med. Frontiers of Medicine, 5(4), 401-413.
Stem Cell Based Alveolar Regeneration
Cells
Scaffold
Growth Factor
Cells Scaffold
Growth
Factor
Mechanical
Environment
Nie e Nie, H., Lee, C. H., Tan, J., Lu, C., Mendelson, A., Chen, M., . . . Mao, J. J. (2012, 03). Musculoskeletal tissue
engineering by endogenous stem/progenitor cells. Cell Tissue Res Cell and Tissue Research, 347(3), 665-676.
t al., 2012 9
Cells
Stable with extended
passaging
Ease of isolationMultipotency
Rapid expansion
Egusa, H., Sonoyama, W., Nishimura, M., Atsuta, I., & Akiyama, K. (2012, 10). Stem cells in dentistry – Part II: Clinical
applications. Journal of Prosthodontic Research, 56(4), 229-248.
Cells- Proliferation
& differentiation - Migration & chemotaxix-Provide cell attachment- Maintain phenotye
Tissue -Biocompatible-Biodegradable - Mechanical
strength before degradation
-Angiogenesis & vasculogenesis- Hydrophillic
Surgeon -cost effective
- easily handled
-available in relevant
quantities
Bose, S., Roy, M., & Bandyopadhyay, A. (2012, 10). Recent advances in bone tissue engineering scaffolds. Trends in
Biotechnology, 30(10), 546-554.
Fibrin Scaffold in Bone tissue Engineering
BM-MSCs in treatment of articular cartilage defects.
BM- MSCs in treatment of alveolar bone defects in
rats.
FG PRP PRF
Dohan, D. M., Choukroun, J., Diss, A., Dohan, S. L., Dohan, A. J., Mouhyi, J., & Gogly, B. (2006, 03). Platelet-rich fibrin (PRF): A second-
generation platelet concentrate. Part II: Platelet-related biologic features. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and
Endodontology, 101(3).
PRF in Bone Tissue Engineering
- Ehrenfest, D. M., Diss, A., Odin, G., Doglioli, P., Hippolyte, M., & Charrier, J. (2009, 09). In vitro effects of Choukroun's PRF (platelet-rich
fibrin) on human gingival fibroblasts, dermal prekeratinocytes, preadipocytes, and maxillofacial osteoblasts in primary cultures. Oral Surgery,
Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 108(3), 341-352.
- Ehrenfest, D. M., Doglioli, P., Peppo, G. M., Corso, M. D., & Charrier, J. (2010, 03). Choukroun's platelet-rich fibrin (PRF) stimulates in vitro
proliferation and differentiation of human oral bone mesenchymal stem cell in a dose-dependent way. Archives of Oral Biology, 55(3), 185-194.
- Wu, C., Lee, S., Tsai, C., Lu, K., Zhao, J., & Chang, Y. (2012, 05). Platelet-rich fibrin increases cell attachment, proliferation and collagen-
related protein expression of human osteoblasts. Australian Dental Journal, 57(2), 207-212.
Stimulation of cellular adhesion and Proliferation of human
gingival fibroblast, dermal prekeratinocyte, preadipocyte and
maxillofacial osteoblast and also osteoblastic differentiation
Dose dependant stimulation of Proliferation & differentiation of
BM-MSCs
Stimulate cellular adhesion and proleferation of rat osteoblasts,
human osteoblasts, human periodontal ligament fibroblasts, and
human pulp fibroblasts.
Stem Cell Isolation, Characterization
and expansion
Stage II
Animal Scarify
Stage I
A- In-Vivo
B- In-Vitro
Defect induction
Gingival harvesting
Augmentation
Procedures
Stage II
Augmentation Procedures
Group I (PRF + MSCs)
Group II (PRF + MSCs + Bi-phasic
Ca- Ph block)
Group III (PRF + Bi- phasic
Ca- Ph block)
In-vitro
MSCs in Culture
Multi-lineage
Differentiation
Cell Surface Marker
Expression
Osteogenic
Chondrogenic
Bone formation
in center
Bone Interface
Bone
Trabeculae
Reversal
LinesOsteocytes Osteoclasts
Histological Results
H & E
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
Gp 1 Gp2 Gp3
75.98
81.91
35.35
Mean area percent of Mature Bone
0.00
10.00
20.00
30.00
40.00
50.00
60.00
Gp 1 Gp2 Gp3
12.56
50.17
10.60
Perc
ent
Mean area percent of Bone Matrix
PRF membranes loaded with MSCs could induce early
bone formation and maturation in vertical alveolar defects.
PRF couldn't support osteogensis process in vertical
alveolar ridge defects till complete bone formation and
restoration of the whole bone volume.
The combined use of Bi-phasic calcium phosphate block
together with PRF loaded with MSCs is superior to single
use of PRF loaded with MSCs in treatment of vertical
alveolar ridge defects.
The combined use of Bi-phasic calcium phosphate block
together with MSCs loaded PRF yields promising results in
treatment of vertical alveolar ridge defects