Clinical reasoning of application of stem cells in the treatment of gingival recession

Abstract

The aim of the study is to improve the results of complex treatment of patients with gingival recession on the basis of validation of new, highly effective methods using autologous mesenchymal stem cells. A complex treatment was conducted in 93 patients with an anatomical recession of the gum in combination with dentoalveolar anomalies at the age of 20 to 29 years. Patients were divided into 3 groups depending on the treatment used. All patients underwent periodontological treatment. In the 2nd group, patients underwent periodontological treatment including orthodontic equipment, in the 3rd group, they underwent orthodontic treatment, and a cell transplant based on a mixture of autologous mesenchymal stem cells and sterile bioplastic collagen material “Collost” was used. A comprehensive assessment of the periodontal tissue of the three groups showed that among the patients who received the standard treatment complex, a good condition of the periodontal tissues in 1 to 2 years after treatment was noted only in 16.7 % of the patients of the 1st group. Inclusion of orthodontic treatment made it possible to obtain good results in 25 % of patients in the 2nd group, which is 8 % more than in the 1st group. At the same time, good treatment results were revealed in 94 % of the 3rd group patients, who underwent periodontological and orthodontic treatment using autologous mesenchymal stem cells, which confirms the need for measures aimed to normalize the position of teeth, dentition and bite with the use of small orthodontic long-acting forces, to improve the microcirculation of periodontal tissues, and to restore the contour of marginal dreams. Inclusion of autologous mesenchymal stem cells in the complex treatment of patients with gingival recession is accompanied by a 1.6-fold decrease in the prevalence and gum recession (1.15 mm), and a 2.6-fold increase in the tissue volume, by the stimulation of periodontal microcirculation processes (the capillary periodontal pressure is increased by a factor of 1.1 time and the intensity of periodontic microcirculation is increased by a factor of 3.1 times), as well as by the normalization of the position of teeth, dentition and occlusion, which allowed one to obtain good long-term results in 94 % of patients.