|Year : 2020 | Volume
| Issue : 1 | Page : 42-46
A case of gingival stem cell administration using adipose tissue-derived stem cells
Omotesando Helene Clinic, Minato City, Tokyo, Japan
|Date of Submission||02-Oct-2019|
|Date of Acceptance||02-Dec-2019|
|Date of Web Publication||24-Jan-2020|
Omotesando Helene Clinic, Minato City, Tokyo
Source of Support: None, Conflict of Interest: None
Adipose tissue-derived stem cells (ASCs) are reported to be capable of differentiating into all of mature cells, including bones and cartilage as same as bone marrow mesenchymal stem cells. In this study, we examined to treat periodontal disease using autologous ASCs to avoid rejection by transplantation. After autologous ASCs were injected into the gingiva, X-ray examination, periodontal pocket examination, and bleeding on probing were good results, and we obtained regeneration of periodontal tissue. Autologous ASCs are also easy to collect. Compared with other periodontal regeneration treatments, the burden on patients with less risk of postoperative infection is also less. In future, we hope to consider combined use with growth factors to aim at the alveolar bone and periodontal tissues regeneration. Moreover, we hope to conduct further investigations with a large number of cases over a long period of time.
Keywords: Adipose tissue-derived stem cells, periodontal disease, periodontal tissue regeneration
|How to cite this article:|
Suzuki Y. A case of gingival stem cell administration using adipose tissue-derived stem cells. J Oral Res Rev 2020;12:42-6
|How to cite this URL:|
Suzuki Y. A case of gingival stem cell administration using adipose tissue-derived stem cells. J Oral Res Rev [serial online] 2020 [cited 2020 Jul 3];12:42-6. Available from: http://www.jorr.org/text.asp?2020/12/1/42/276709
| Introduction|| |
Mesenchymal stem cells contain a number of cell growth factors and are deeply involved in wound healing. Adipose tissue-derived stem cells (ASCs) and the method of adapting to wounds have been clinically applied to soft tissues such as skin and mucous membranes.,
In recent years, stem cells have been shown to be safe and effective in various indications, and mesenchymal stem cells are also known to differentiate into bone and cartilage.,,,,,,,,,,,
In addition, it is reported that mesenchymal stem cells not only differentiate into vascular endothelial cells but also secrete vascular endothelial growth factor in large quantities.,
As ASCs have the same multipotency as bone marrow mesenchymal stem cells, adipose tissue has been reported to be a source of stem cells that replace bone marrow.,
As for alveolar bone, a complex of mesenchymal stem cells and extracellular matrix has been reported to be effective for periodontal tissue regeneration in periodontal disease in beagle dogs.
There are many experimental results in periodontal tissue regeneration in animal models, but there are few reports of autologous stem cells. There are many reports using scaffolds, but none have been injected into the human gingiva.
ASCs have also been reported to be able to differentiate into mature cells of all bones and cartilage.
One of the reasons for using mesenchymal stem cells by the patient is that other cells (allogeneic) are rejected by transplantation. Again, autologous mesenchymal stem cells are rejected by transplantation. It has been reported that it is established without using immunosuppressive agents.,
Adipose tissue is easy to collect because it can be collected under local anesthesia, is less invasive than bone marrow stem cell collection, has very little pain after collection, and is very deformed or missing on the donor side. There is also an advantage that it can be done less.
In this study, we report the results of adipose-derived mesenchymal stem cell administration in the treatment of periodontal disease.
| Case Report|| |
A 50-year-old male presented with a chief complaint of feeling of teeth floating for some year.
Current medical history
In February 2019, right lower molar tooth was pointed out, and caries treatment was not performed. A few years ago, he had noticed gingival swelling, pain, and a feeling of floating teeth throughout the jaw but left it unattended.
Previous medical history and family history
No special mentioned and no smoking history was noted.
In the oral cavity, the periodontal pocket was 4 mm or more in all jaws, and bleeding on probing (BOP) was observed in many teeth. A deep periodontal pocket was found in the left lower premolar part.
Preoperative panoramic X-ray findings and dental X-ray findings
Panoramic X-rays and dental X-ray images showed strong atrophy of the left upper molar alveolar bone [Figure 1], [Figure 2], [Figure 3], [Figure 4].
Diagnosis and treatment policy
Based on the above examination results, it was diagnosed with chronic periodontitis, and it was judged that stem cell administration was necessary to the upper left first molar part and the lower left second premolar part.
Treatment and progress
- Subcutaneous fat was collected after invasive anesthesia and entrusted with mesenchymal stem cell culture to STEMCEL (STEMCELL, Tokyo)
- On May 9, 2019, the whole jaw was scaled and periosteal infiltration anesthesia (1/100.000 epinephrine-added lidocaine hydrochloride), then the upper left first molar teeth buccal gingiva and lower left second ASCs were administered from STEMCELL Co., Ltd. diluted in 0.9 cc of physiological saline to the buccal gingiva of the premolar region
- At 12 weeks after stem cell administration, panoramic X-rays and dental X-rays were taken, and a basic periodontal examination was performed.
| Results|| |
- X-ray images 12 weeks after the administration of stem cells showed an increase in bone mass at the alveolar crest [Figure 5], [Figure 6], [Figure 7]
- BOP clearly decreased [Figure 8]
- A decrease in periodontal pockets was observed [Figure 8].
|Figure 8: Periodontal basic examination 3 months after stem cell administration|
Click here to view
| Discussion|| |
It is widely known that growth factors such as platelet-derived growth factor and transforming growth factor-β contained in ASCs promote wound healing.,
ASCs have been successfully applied to the skin and mucous membranes, have shown good results, and have shown the ability to increase periodontal tissue regeneration. And ASCs have providing safe treatment methods in regenerative medicine approaches.
Therefore, we examined the usefulness of ASCs in the treatment of human periodontal disease, where regenerative medicine related to periodontal disease treatment shows how much periodontal tissue has been regenerated after surgery and the results of periodontal examination. Even if the engraftment of ASCs is recognized, it cannot be said that the periodontal tissue does not improve, and hence, it cannot be said to be successful. In addition, regeneration and improvement in periodontal tissue, especially soft tissue, were observed, which proved useful.
The administration of ASCs uses autologous cells and plasma in the autologous blood and is safe and well-tolerated in the body, so there is less possibility of complications such as infection. When the guided bone regeneration method is applied to a partial periodontal disease progression site like this time, the exposure of the membrane and blood flow to the wound are blocked, healing is delayed, and complications such as infection are likely to occur. The ASCs are superior in bone wound healing and will be used in combination with transplant materials containing growth factors such as bone morphogenetic protein that have strong osteoinductive ability in future. It is thought that effective bone grafting can be performed.
| Conclusion|| |
In this study, we used ASCs locally for the treatment of periodontal disease and we reported early periodontal tissue regeneration for periodontal disease.
Infusions of autologous ASCs are safe and feasible in patients with periodontal disease to verify the potential therapeutic effect of this procedure in future, more long-term data, a larger number of samples are necessary.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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