Buccal fat pad‐derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: An exploratory prospective clinical study

Abstract

Background Application of adipose‐derived stem cells originated from buccal fat pad (BFP) can simplify surgical procedures and diminish clinical risks compared to large autograft harvesting. Purpose This study sought to evaluate and compare the efficacy of buccal fat pad‐derived stem cells (BFPSCs) in combination with anorganic bovine bone mineral (ABBM) for vertical and horizontal augmentation of atrophic posterior mandibles. Materials and Methods Fourteen patients with atrophic posterior mandible were elected for this prospective exploratory study. BFP (3‐5 mL) was harvested and BFPSCs were isolated and combined with ABBM at 50% ratio. The vertical and horizontal alveolar deficiencies were augmented by 50% mixture of ABBM with either BFPSCs (group 1) or particulated autologous bone (group 2). Titanium mesh was contoured to the desired 3D shape of the alveolar ridge and fixated to the host sites over the graft material of the two groups. At first, the amount of new bone areas was calculated by quantitative analysis of cone beam computed tomography (CBCT) images that were taken 6 months postoperatively according to regenerative techniques (group 1 vs group 2 without considering the type of bone defects). Second, these amounts were calculated in each group based on the type of defects. Results Quantitative analysis of CBCT images revealed the areas of new bone formation were 169.5 ± 5.90 mm2 and 166.75 ± 10.05 mm2 in groups 1 and 2, respectively. The area of new bone formation for vertical defects were 164.91 ± 3.74 mm2 and 169.36 ± 12.09 mm2 in groups 1 and 2, respectively. The area of new bone formation for horizontal deficiencies were 170.51 ± 4.54 mm2 and 166.98 ± 9.36 mm2 in groups 1 and 2, respectively. There were no statistically significant differences between the two groups in any of the pair‐wise comparisons (P > 0.05). Conclusions The findings of the present study demonstrated lack of difference in bone volume formation between BFPSCs and autologous particulate bone in combination with ABBM. If confirmed by future large‐scale clinical trial, BFPSCs may provide an alternative to autogenous bone for reconstruction of alveolar ridge defects.

Aplicabilidade clínica das células-tronco mesenquimais indiferenciadas do tecido adiposo para cirurgias de regeneração óssea de maxila e mandíbula atrófica

“…Após análise da base da busca realizada, chegou-se ao total de nove artigos (Kulakov et al 2008;Prins et al 2016;Khojasteh & Sadeghi et al 2016;Khojasteh et al 2017;Castilho-Cardiel et al 2017;Farré-Guasch et al 2018;Solakoglu et al 2019;Akhlaghi et al 2019;Khojasteh et al 2019) para essa revisão crítica e analítica. A figura 1 demonstra detalhadamente o fluxograma do processo de seleção dos artigos encontrados.…”

“…A literatura investiga sobre a aplicabilidade das células-tronco em associação com os biomateriais (Shang et al, 2021), ou seja, a engenharia tecidual. Devido o osso autógeno possuir células progenitoras, osteoblastos e células-tronco (Nkenke & Neukam 2014), uma possível associação destas células ou fatores de crescimento a um biomaterial osteocondutor poderia resultar em um biomaterial potencialmente osteogênico comparável ao osso autógeno (Froum et al, 2013;Pelegrine et al, 2011;Khojasteh et al 2017;Khojasteh et al 2019;Hernigou et al, 2014).…”

“…A aplicação das células-tronco derivadas da medula óssea ou do tecido adiposo é relatada por diversos estudos clínicos na área da regeneração óssea craniofacial em humanos (Khojasteh et al 2017;Akhlaghi et al 2019;Khojasteh et al 2019;Sauerbier et al, 2010;Pelegrine et al, 2016). Associar essas células aos biomateriais osteocondutores demonstra uma possibilidade devido à união das células e fatores de crescimento quando associada a um arcabouço a fim de potencializar a osteogênese e osteoindução para a formação óssea (Aloise et al, 2015;Pelegrine et al, 2014;Shang et al, 2021) ou seja, otimizando as características desse enxerto.…”

“…O tecido adiposo demonstra ser uma fonte tecidual abundante de células autógenas para enxertia em casos de regeneração tecidual óssea associada com biomateriais (Zhu et al, 2008;Khojasteh et al, 2019;Zannettino et al, 2008). As células-tronco derivadas do tecido adiposo possuem uma capacidade de diferenciação em diversas linhagens celulares, sendo estas, células osteogênicas, adipogênicas, condrogênicas e miogênicas, e por demonstrarem características de auto-renovação, aderência plástica, diferenciação e expressão de marcadores mesenquimais (CD34 + , CD44 + ) (Khojasteh et al, 2019;Khojasteh & Sadeghi 2016).…”

Use of Amniotic Membrane and Its Derived Products for Bone Regeneration: A Systematic Review

“…They are isolated from the intraoral sources of buccal fat pad that ensures low morbidity after retrieval. BFSCs are thus an easily accessible source of autologous stromal cells which can be readily used for regeneration of craniofacial bone defects (Khojasteh et al, 2019 ; Meshram et al, 2019 ). Besides, BFSCs display similar expression level of RUNX-2, osteopontin, osteocalcin, and ALP activity as BMSCs (Ardeshirylajimi et al, 2015 ), which are currently used for bone tissue engineering approaches (Lin et al, 2019 ; Kangari et al, 2020 ).…”