INDICATIONS FOR CELL THERAPY
One of the most common periodontal diseases, accompanied by a violation of the dentoepithelial attachment, remains the recession (root migration) of the marginal gum. The regenerative method for treating gingival recession involves local transplantation of BMCP based on autologous MSCs immobilized on a collagen gel. The main therapeutic effects of MSCs on gum tissue are associated with the release of various growth factors, acceleration of cell proliferation and stimulation of collagen synthesis. MSCs also secrete substances that eliminate inflammation and prevent further destruction of periodontal tissues.
EFFICIENCY AND SAFETY
With local BMCP transplantation, MSCs are transformed into profibroblasts, and bioplastic collagen material serves as a matrix for the formation of fibrous tissue. Thus, atrophic and dystrophic changes in the gums are leveled, the mechanical component is strengthened, the depth of the gingival pocket is reduced, the ligamentous apparatus of the tooth is strengthened, the inflammatory process is stopped and the progression of periodontal disease slows down. The severity and duration of the regenerative effect is determined by the degree of damage to the periodontal tissues.
Various congenital and genetic pathologies, autoimmune, infectious and oncological diseases (even in the case of their successful treatment in the past) significantly reduce the effectiveness of cell therapy. Chronic heart diseases, blood coagulation disorders, alcohol and drug addiction seriously affect the clinical outcome.
The safety of the method against autoimmune, allergic and infectious complications is ensured by using the patient’s own cells, their use is not associated with the risks of transplant rejection and transmission of vector-borne infections. Currently, in the scientific literature not a single case of the development of cancer due to the use of autologous MSCs has been described.
Despite the comprehensive prevention of complications, during and after manipulation it is possible to develop some general and local complications: hematoma formation, allergic reactions to collagen gel.
Stage 1 - consultation and examination
To develop treatment tactics and determine the dose of BMCP, a specialist-periodontist consults with the Department of Regenerative Medicine and Cell Therapy. A compulsory medical examination is also required.
- biomaterial sampling
Adipose tissue serves as a biomaterial for obtaining native MSCs. Admission (explantation) of adipose tissue (5 - 10 g) is a slightly traumatic surgery under local anesthesia and suggests a good cosmetic result without visible scars. The operation is performed on an outpatient basis, a repeated visit of the patient for dressings or removal of sutures is not required.
Stage 3 - BMCP production
Based on the patient’s biomaterial, a biomedical cell product is produced in the laboratory of the Institute of Biophysics and Cell Engineering of the National Academy of Sciences of Belarus, which contains a therapeutic dose of autologous MSCs, which takes about 30 days.
- BMCP transplantation
The therapeutic dose for one transplant is 1 million MSCs per tooth, and the course of treatment involves a double transplant with an interval of 10-14 days. The timing of the repetition of the treatment course depends on the severity of the lesion and the effect achieved.
The procedure of local injection transplantation is a less traumatic procedure, performed under local anesthesia in a dental office. Immediately after transplantation, the patient is observed for 1 to 2 hours in a ward.