title: Adipose stem cells used to reconstruct 13 cases with cranio-maxillofacial hard-tissue defects.
abstract: Although isolated reports of hard-tissue reconstruction in the cranio-maxillofacial skeleton exist, multipatient case series are lacking. This study aimed to review the experience with 13 consecutive cases of cranio-maxillofacial hard-tissue defects at four anatomically different sites, namely frontal sinus (3 cases), cranial bone (5 cases), mandible (3 cases), and nasal septum (2 cases). Autologous adipose tissue was harvested from the anterior abdominal wall, and adipose-derived stem cells were cultured, expanded, and then seeded onto resorbable scaffold materials for subsequent reimplantation into hard-tissue defects. The defects were reconstructed with either bioactive glass or β-tricalcium phosphate scaffolds seeded with adipose-derived stem cells (ASCs), and in some cases with the addition of recombinant human bone morphogenetic protein-2. Production and use of ASCs were done according to good manufacturing practice guidelines. Follow-up time ranged from 12 to 52 months. Successful integration of the construct to the surrounding skeleton was noted in 10 of the 13 cases. Two cranial defect cases in which nonrigid resorbable containment meshes were used sustained bone resorption to the point that they required the procedure to be redone. One septal perforation case failed outright at 1 year because of the postsurgical resumption of the patient's uncontrolled nasal picking habit.
authors.affiliation: Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere, Tampere, Finland; Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland; Department of Otolaryngology, Head and Neck Surgery and Oral Diseases and Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland; Department of Oral and Maxillofacial Surgery, Central Hospital of Central Finland Health Care District, Jyväskylä, Finland; Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland.
authors.forename: George K
authors.initials: GK
authors.lastname: Sándor
authors.forename: Jura
authors.initials: J
authors.lastname: Numminen
authors.forename: Jan
authors.initials: J
authors.lastname: Wolff
authors.forename: Tuomo
authors.initials: T
authors.lastname: Thesleff
authors.forename: Aimo
authors.initials: A
authors.lastname: Miettinen
authors.forename: Veikko J
authors.initials: VJ
authors.lastname: Tuovinen
authors.forename: Bettina
authors.initials: B
authors.lastname: Mannerström
authors.forename: Mimmi
authors.initials: M
authors.lastname: Patrikoski
authors.forename: Riitta
authors.initials: R
authors.lastname: Seppänen
authors.forename: Susanna
authors.initials: S
authors.lastname: Miettinen
authors.forename: Markus
authors.initials: M
authors.lastname: Rautiainen
authors.forename: Juha
authors.initials: J
authors.lastname: Öhman
mesh_terms: D000273:Adipose Tissue / Q000166:cytology* / Q000378:metabolism; D000328:Adult; D053687:Adult Stem Cells / Q000166:cytology* / Q000378:metabolism / Q000637:transplantation*; D000368:Aged; D064592:Autografts; D055396:Bone Morphogenetic Protein 2 / Q000096:biosynthesis; D002130:Calcium Phosphates / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D005898:Glass; D006801:Humans; D008297:Male; D019767:Maxillofacial Abnormalities / Q000378:metabolism / Q000601:surgery*; D008875:Middle Aged; D033581:Stem Cell Transplantation
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate
keywords: Adipose stem cells; Bioactive glass; Bone morphogenetic protein; β-Tricalcium phosphate