Sinus augmentation using human mesenchymal stem cells loaded into a beta-tricalcium phosphate/hydroxyapatite...

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Posterior maxillary implant placement is challenging due to limited bone volume and proximity to the maxillary sinus.
• Sinus floor augmentation is a common surgical procedure to address this bone deficiency.
• Adult mesenchymal stem cells (MSCs) offer potential for enhanced bone regeneration.

Purpose of the Study:

• To evaluate the clinical and radiographic effectiveness of biphasic hydroxyl apatite/beta-tricalcium phosphate (HA/TCP) scaffold loaded with adult mesenchymal stem cells (MSCs) for sinus elevation.
• To assess the success rate of dental implants placed in augmented maxillary sinuses with this biomaterial combination.

Main Methods:

• Six patients with initial bone height less than 3 mm underwent sinus elevation using MSCs and HA/TCP.
• Mesenchymal stem cells were cultured from patient bone marrow aspirates.
• Radiographic and core biopsy evaluations were performed at 3 and 9 months post-surgery; implant placement occurred after 3 months.

Main Results:

• 93% (28/30) of implants were clinically successful; two were removed due to mobility.
• Histological analysis of biopsies showed significant osteoid and bone formation with HA/TCP, and no inflammatory infiltrate.
• Mean bone regeneration was 41.34%, with mean bone heights of 12.08 mm (3 months) and 10.08 mm (12 months) post-grafting.

Conclusions:

• Sinus grafting with HA/TCP combined with MSCs is a viable therapeutic option for maxillary implant placement.
• The addition of MSCs to bone substitute materials appears to enhance bone formation in the maxillary sinus.
• Further studies with control groups are necessary to fully establish this method as a clinical solution.