Bone regeneration for augmentation of the floor of the maxillary sinus ||
Clinical application of mesenchymal "stem" cells

Bone defects, in particular the periodontal ones, cause a competitive growth between the residual bone and the neighbouring connective tissues.
Attempts to stimulate periodontal bone regeneration have concentrated on filling the defect
with either synthetic material, autologous bone or allogeneic cadaveric material.
In some cases these strategies were combined with the utilization of stimulating growth factors, including platelet rich plasma (PRP).
Platelet rich plasma is obtained from the patient's own blood (10-50cc). The fraction that containes the PRP is isolated in a sterile way by slow centrifugation and at the time of utilization a small amount of calcium chloride is added. That converts fibrinogen into fibrin in a few minutes, a whitish clot which is rich in growth factors.
Expansion of mesenchymal "stem" cells

Morphology of mesenchymal "stem" cell culture, differentiated into bone tissue

Mesenchymal "stem" cells obtained by aspiration of autologous bone marrow represent a powerful physiologic strategy to promote the regeneration of periodontal tissue.
Our methodology includes the utilization of trabecular bone tissue from bone marrow which contains mesenchymal "stem" cells to elevate the floor of the maxillary sinus and allows the insertion of the material essential for dental implants.
The multiple puncture biopsies of bone marrow from the iliac bone, are performed in a sterile way, under local anesthesia and are transported to the laboratory for processing.
The injection of this material into the bone defect takes place preferentially the same day as the laboratory processing. To seal the cavity which is filled with the suspension of mesenchymal "stem" cells, PRP could also be used.

Multiple biopsies of the mandible to obtain grinded bone   Biopsies of bone marrow for mesenchymal "stem" cell culture
Removal of the mucosa and invasion
of the maxillary sinus
Insertion of biomaterial and cells

Filling the floor of the maxillary sinus, bone regeneration and implantation

Filling the floor of the maxillary sinus, bone regeneration and implantation.
Radiologic monitoring

The photographic material was kindly provided by the group Prometeo
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