Osteotome technique with injectable tissue-engineered bone and simultaneous implant placement by cell therapy

Area of Science:

• Regenerative Medicine
• Oral and Maxillofacial Surgery
• Biomaterials Science

Background:

• Severe bone resorption in the maxilla presents challenges for dental implant placement.
• Traditional bone grafting methods can be invasive and have limitations.

Purpose of the Study:

• To evaluate the efficacy of injectable tissue-engineered bone (TEB) with the osteotome technique for bone regeneration.
• To assess the success of simultaneous dental implant placement in cases of severe maxillary bone resorption.
• To determine if this method allows for earlier bone regeneration and a minimally invasive procedure.

Main Methods:

• Injectable TEB, comprising bone marrow-derived mesenchymal stem cells (BMMSCs) and platelet-rich plasma, was used in 23 cases.
• The osteotome technique was employed for sinus floor elevation prior to dental implant insertion.
• Radiographic evaluation assessed bone height changes, and statistical analysis (Friedman test, Wilcoxon signed-rank test) was performed.

Main Results:

• Significant increases in bone height were observed: lift-up height of 6.1 ± 1.5 mm, regenerated bone height of 8.2 ± 1.6 mm (3 months) and 8.0 ± 1.4 mm (6 months).
• Average alveolar bone height reached 15.6 ± 1.2 mm (3 months) and 15.1 ± 1.4 mm (6 months).
• All dental implants were successfully integrated after 1 year, with no Schneider membrane perforations.

Conclusions:

• The combination of osteotome technique and injectable TEB offers a predictable and stable method for bone regeneration.
• This approach facilitates minimally invasive cell therapy for dental implantology.
• Successful bone formation and dental implant outcomes were achieved in patients with severe maxillary bone resorption.