BackgroundAutologous grafting, despite some disadvantages, is still considered the gold standard for reconstruction of maxillofacial bone defects. The aim of this study was to evaluate bone regeneration using bone marrow-derived mesenchymal stromal cells (MSCs) in a clinical trial, a less invasive approach than autologous bone grafting. This comprehensive clinical trial included subjects with severe mandibular ridge resorption.MethodsThe study included 11 subjects aged 52–79 years with severe mandibular ridge resorption. Bone marrow cells were aspirated from the posterior iliac crest and plastic adherent cells were expanded in culture medium containing human platelet lysate. The MSCs and biphasic calcium phosphate granules as scaffolds were inserted subperiosteally onto the resorbed alveolar ridge. After 4–6 months of healing, new bone formation was assessed clinically and radiographically, as were safety and feasibility. Bone at the implant site was biopsied for micro-computed topography and histological analyses and dental implants were placed in the newly regenerated bone. Functional outcomes and patient satisfaction were assessed after 12 months.ResultsThe bone marrow cells, expanded in vitro and inserted into the defect together with biphasic calcium phosphate granules, induced significant new bone formation. The regenerated bone volume was adequate for dental implant installation. Healing was uneventful, without adverse events. The patients were satisfied with the esthetic and functional outcomes. No side effects were observed.ConclusionsThe results of this comprehensive clinical trial in human subjects confirm that MSCs can successfully induce significant formation of new bone, with no untoward sequelae. Hence, this novel augmentation procedure warrants further investigation and may form the basis of a valid treatment protocol, challenging the current gold standard.Trial registrationEudraCT, 2012-003139-50. Registered on 21 August 2013. ClinicalTrials.gov, NCT 02751125. Registered on 26 April 2016.

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– A non‐destructive, in vivo method of measuring the enamel hardness directly on patients is described. Normal values on 39 students arc given and compared with those of five patients, one of whom suffered from abnormal oral acid concentration, and the others from the effects of various degrees of hyposialosis caused by radiologic treatment of tumors in head and neck. The difference between the two groups was significant below the 0.1% level. It was suggested that the method may be used to test the degree of salivary gland inactivation after radiologic treatment and the efficiency of different saliva substitutes used to alleviate the effects of hyposialosis.

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Hovedbudskap Kronisk sinusitt har relativt hyppig odontogen årsak. Fremmedlegemer som disloseres til sinus maxillaris under tannbehandling kan gi kronisk sinusitt som trenger kirurgisk behandling. Tannleger har en naturlig rolle i utredning og behandling av pasienter med kronisk maxillarsinusitt.