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

The purpose of this study was to evaluate the effects of tissue-engineered bone (TEB) on osteotome technique with simultaneous implant placement that is applied to the severe bone resorption in the maxilla for earlier bone regeneration and minimal invasive operation.

We applied injectable TEB, which was composed of bone marrow-derived mesenchymal stem cells (BMMSCs) as stem cell source and platelet-rich plasma as an autologous scaffold and signal molecules, with osteotome technique for 23 cases. After dental implants were pre-prepared with pilot drills and/or using the Summers Osteotome Kits, TEB was injected and followed by dental implants insertion. The outcomes were evaluated by radiographs. Statistical evaluation was performed by Friedman test and Wilcoxon signed-rank test (P ≤ 0.05).

The grafted BMMSCs possessed a phenotype of mesenchymal stem cells. The lift-up bone height by TEB using BMMSCs showed the increase of 6.1 ± 1.5 mm. Moreover, the mean regenerated bone height was 8.2 ± 1.6 mm and 8.0 ± 1.4 mm, and the average alveolar bone height was 15.6 ± 1.2 mm and 15.1 ± 1.4 mm, at 3 and 6 months, respectively. There were significant differences between pre-operative values and post-operative ones (at 3, 6 months). No perforations of the Schneider membrane were found and the inserted implants were successful after 1 year.

This novel application using osteotome technique with injectable TEB would stably predict the success of bone formation and dental implants, and provide minimally invasive cell therapy.