Periodontal regeneration by autologous bone marrow mononuclear cells embedded in a novel thermo reversible gelation polymer.
Periodontal regeneration by autologous bone marrow mononuclear cells embedded in a novel thermo reversible gelation polymer.
复制标题
通过嵌入新型热可逆凝胶聚合物中的自体骨髓单核细胞进行牙周再生。
作者：
Seshadri Sankaranarayanan;Nadeem Jetty;J. S. Gadagi;S. Preethy;S. Abraham
牙周病引起的骨缺损的再生对临床医生来说仍然是一个挑战。在动物模型中已经报道了不同组织来源的干细胞和支架的再生应用，但长期随访的临床研究有限。在此，我们报告了自体骨髓单核细胞（BMMNCs）包埋在热可逆凝胶化聚合物（TGP）中用于牙周再生的三年随访。我们选择了一名23岁的女性晚期牙周炎患者（IV级牙龈退缩，探测袋深度（PPD）相对于下颌侧切牙和中切牙分别为5 mm和6 mm，临床附着水平（CAL）为13 mm）与x线片证据相关，严重水平骨丢失延伸至下颌门牙尖。清创后，植入TGP浸透的bmmnc。每隔6个月、12个月、24个月、36个月进行临床参数和影像学评价。6个月时，观察到临床参数有显著改善（PPD减少到2mm，临床附着水平提高了6mm）。36个月时，x线片显示骨再生，垂直和水平骨高度改善。bmmnc在新型TGP中移植是安全的，并且在水平牙槽骨缺损中具有相对显著和稳定的临床结果。
Regeneration of bony defects caused by periodontal disease continues to be a challenge for clinicians. Application of stem cells from different tissue sources and scaffolds for regeneration have been reported in animal models but clinical studies with long term follow-ups are limited. Herein we report the three years follow-up of the application of autologous bone marrow mononuclear cells (BMMNCs) embedded in a thermo-reversible gelation polymer (TGP) for periodontal regeneration. A 23-year female patient with advanced periodontitis (class IV gingival recession, probing pocket depth (PPD) of 5 mm and 6 mm in relation to mandibular lateral and central incisors respectively, and clinical attachment level (CAL) of 13 mm) correlated with radiographic evidence of severe horizontal bone loss extending up to the apex of mandibular incisors was selected for the treatment. After debridement, the defect was implanted with BMMNCs impregnated in TGP. Then the clinical parameters and radiographic evaluation were made at periodic intervals of 6, 12, 24 and 36 months. At six months, significant improvement with the clinical parameters (PPD had reduced to 2 mm, clinical attachment level had improved by 6 mm) was observed. At 36 months, the radiograph revealed bone regeneration with improvement in vertical and horizontal bone height. Transplantation of BMMNCs in a novel TGP is safe and results in a relatively significant and stable clinical outcome in horizontal alveolar bony defects.