Abstract

The success of restorative surgical treatment of periodontal inflammatory diseases is largely determined by the processes of reparative regeneration of bone tissue of the patient. Analysis of the causes of unsuccessful treatment of such patients suggests that the ways of overcoming them consist both in improving the technology of the surgical intervention itself and in creating optimal conditions for regeneration of bone tissue.
 One of the most promising directions for correcting the regeneration process is the transplantation of stem cells of various origin.
 Using the method of directed regeneration of bone tissue of the alveolar process with the addition of autologous stem cells in periodontal surgery in the treatment of generalized periodontitis II and III degree of severity will not only eliminate the inflammatory process, but also anatomically restore the structural components of the periodontal, in particular, the alveolar bone.
 The purpose of the study was to compare the osteogenic properties of bone marrow and adipose tissue cells.
 A complex of experimental and clinical research has been carried out. In experimental studies on the effects of rabbit's autologous cells derived from bone marrow and adipose tissue, rabbits-male Chinchilla breeds of 1 year old were used to heal the pustular defects of the alveolar process; the animals were divided into 8 ordinal groups.
 Under thiopental anesthesia a defect of bone tissue was created at a depth of the cortical plate in the size of 0.027 cm3, which was filled as follows: a defect under the cluster; Defect and Collapan L; defect, 100000 units bone marrow stem cells, Collapan L.; defect, 500000 units Stem cells of adipose tissue, Collapan L, defect, 1 million units. CCMC, Collapan L.; defect, 100000 units SCJT, Collapan L.; defect, 500000 units SCJT, Collapan L.; defect, 1 million units. SCJT, Collapan L., after which the wound was sutured. Animals were brought out from the experiment by air embolism for 42 or 90 days.
 In the initial survey, the average indexes of periodontal disease in patients of both groups were equal.
 Radiologically, in patients of the experimental group, an increase in the height of interalveolar septal walls was determined at 1-1.5 mm, in comparison with preoperative orthopantomograms. There was an increase in the density of the spongy bone of the interdental partitions, an increase in its X-ray contrast.
 The use of autologous stem cells at the surgical stage of complex treatment of periodontal diseases has evident advantages over the traditional surgical methods of treating these diseases, since restoration of the periodontal structure is restored, periodontal pockets are eliminated, long remission is established, which is confirmed by the improvement of the level of oral hygiene, the normalization of the index assessment of the periodontal condition, processes of bone tissue regeneration.
 Thus, we have proved that the use of autologous stem cells at the surgical stage of complex treatment of periodontal diseases has evident advantages over traditional surgical methods of treatment of these diseases, since restoration of periodontal structure is restored, periodontal pockets are eliminated, long-term remission is established.
 Аs a result of the evaluation of the dynamics regeneration of bone defects of the mandible in case of the introduction of stem cells with Collapan into the defect zone, we found that the course was most favorable for the administration of bone tissue stem cells comparing to the introduction of adipose tissue stem cells.

Highlights

  • The success of restorative surgical treatment of periodontal inflammatory diseases is largely determined by the processes of reparative regeneration

  • Analysis of the causes of unsuccessful treatment of such patients suggests that the ways

  • them consist both in improving the technology of the surgical intervention

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Summary

Харківська медична академія післядипломної освіти

Успіх відновного хірургічного лікування запальних хвороб пародонта багато в чому визначається процесами репаративної регенерації кісткової тканини пацієнта. Використання методу направленої регенерації кісткової тканини альвеолярного відростка з додаванням аутологічних стовбурових клітин у пародонтальній хірургії при лікуванні генералізованого пародонтиту ІІ і ІІІ ступенів тяжкості дозволить не тільки припинити запальний процес, а й анатомічно відновити структурні компоненти пародонта, насамперед альвеолярну кістку [4;5]. В експериментальних дослідженнях з вивчення впливу аутологічних клітин кролика, отриманих із кісткового мозку і жирової тканини, на загоєння дірчастих дефектів альвеолярного відростка були використані кролики-самці породи Шиншила віком 1 рік; тварини були розподілені на 8 серійних груп по 4 кролики в кожній. Стовбурових клітин кісткового мозку, «Коллапан» Л; дефект, 500000 од. Стовбурових клітин жирової тканини, «Коллапан» Л, дефект, 1 млн. Тварин виводили з експерименту методом повітряної емболії на 42 або 90 добу

Морфометричні дослідження
Клінічні методи дослідження
Грануляційна тканина
Рухомість зубів за шкалою
Summary
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