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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
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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.
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versus |
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Multiple biopsies of the mandible
to obtain grinded bone |
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Biopsies of bone marrow for mesenchymal "stem"
cell culture |
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Removal of the mucosa and invasion
of the maxillary sinus |
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Insertion
of biomaterial and cells |
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Filling the floor of the maxillary sinus,
bone regeneration and implantation
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Filling
the floor of the maxillary sinus, bone regeneration
and implantation.
Radiologic monitoring
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The photographic material was kindly provided by the group Prometeo
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