Periosteum-derived micro-grafts for tissue regeneration of human maxillary bone

Abstract

The bone regeneration is one of the most important challenges for regenerative medicine. In maxillo-facial area, bone resorption of the alveolar crest occurs after tooth extraction and leads to several risks for rehabilitation treatments, including dental implants procedures. Goal of our study was to demonstrate the efficacy of an innovative clinical protocol of bone tissue engineering called Rigenera protocol, aimed to create and optimize bio-complexes constituted by collagen biomaterial and human autologous periosteum-derived micro-grafts. We assessed the capacity of these bio-complexes to prevent the bone resorption in the alveolar crest with respect to simple collagen performing histological evaluations of neo-formed osseous tissue. We demonstrated that autologous bio-complexes significantly reduced the bone resorption of both horizontal and vertical dimension of alveolar crest when compared to collagen alone. We also showed that these bio-complexes accelerate the ossification process triggering the formation of new osseous tissue after 45 days from treatment and increasing the calcified matrix after 60 days and until to 120 days with respect to collagen alone. Taken together, these data showed the efficacy of bio-complexes composed by periosteum-derived micro-grafts and collagen in the alveolar ridge preservation through a reduction of bone resorption and an enhancement of new osseous tissue formation.

Cell-Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review

“…After assessment of the full papers, a further 56 records were excluded. Therefore, a total of 18 publications corresponding to 16 original studies were included for qualitative analysis. One of the included studies reported follow‐up data from a previously published study , whereas another one was a correction of a previous report .…”

“…There was a total of 11 randomized controlled trials (RCTs) and 5 non‐randomized controlled original trials included for qualitative analysis. All RCTs incorporated a parallel design, whereas CCTs included reports with either a parallel or a “split mouth” design.…”

“…We identified cell‐based therapies according to the type of MSCs harvested and the donor tissue. Seven studies reported the use of bone marrow stem cells (BMSCs) harvested from posterior iliac crest aspiration , two studies investigated the performance of dental pulp stem cells (DPSCs) harvested from the dental pulp of extracted teeth , five of the included publications involved the harvesting of periosteum‐derived stem cells (PdSCs) from gingival connective tissue samples , one report produced periodontal ligament‐derived stem cells (PdlSCs) “cell sheets,” and another publication used the adipose‐stromal vascular fraction from adipose tissue samples obtained via lipo‐aspiration . In line with the definition from the European Medicines Agency Regulation (EC) no 1394/2007 , we further subcategorized the techniques in another two groups: (a) “minimal manipulation” of tissues/cells or (b) “substantial manipulation” otherwise (Table ).…”

Cell therapy for orofacial bone regeneration: A systematic review and meta‐analysis

“…One research group has reported the use of a proprietary chair‐side mechanical tissue disaggregation system (Rigenera ® , Human Brain Wave srl, Turin, Italy) to isolate cell fractions termed “autologous micrografts” from dental pulp (d'Aquino et al., ; Monti et al. 2016) and periosteal tissues (D'Aquino et al., ; Rodriguez et al., ). Significantly greater histological and/or radiographic bone regeneration was observed with dental pulp or periosteum micrograft‐loaded versus cell‐free scaffolds in SP and SA.…”

In Vitro and In Vivo Studies of Alar-Nasal Cartilage Using Autologous Micro-Grafts: The Use of the Rigenera® Protocol in the Treatment of an Osteochondral Lesion of the Nose

“…Using the Rigenera ® protocol, in just one surgical time, the patient is the donor and the acceptor of calibrated micro-grafts. Several authors demonstrated that: (i) Rigenera ® improves the healing of bone lesions as suggested by the use of micro-grafts obtained by periosteum in combination with collagen sponge [36]; (ii) Rigenera ® is effective in the process of wound healing, improving the superficialization of the wound and reducing wound size [25]; (iii) Rigenera ® opens new surgical strategies for rhinoplasty [29,30]. In this manuscript, we demonstrated with in vitro tests that micro-grafts isolated from murine and human auricular cartilage consisted of living single cells and clusters with mesenchymal properties.…”