Clinical, Histomorphometric and Radiographic Evaluation of Dental Extraction Sockets Treated with Autologous Stem Cells

Autologous bone marrow has mesenchymals stem cells that can differentiate into osteoblasts. Therefore, the use of these cells in bone reconstruction therapy is becaming promising.

The first aim of this study was to evaluate the potential of autologous bone marrow graft aspirate containing mesenchymal stem cells in preserving the alveolar ridges following tooth extraction. A second aim was to clinically and radiographically evaluate the outcomes of dental implants installed in the healed sockets after one year in function.

13 healthy patients requiring upper anterior teeth extractions were enrolled in this study. They were randomized into two groups: Test group: 7 patients (n = 15 teeth); Control group: 6 patients (n = 15 teeth). 5 ml of autologous bone marrow from the iliac posterior crest were collected by haematologists immediately before the extractions and it was placed in alveolar sockets right after the teeth extractions in the test group. Nothing was grafted in the control sites. Following tooth extraction and evaluation of a buccal full-thickness flap, titanium screws were positioned throughout the buccal to the palatal plate and were used as reference points for measuring purposes. After 6 months, the sites were re-opened and bone loss measurements for thickness and height were taken. Additionally, prior to implant placement, bone cores were harvested and prepared for histologic and histomorphometric evaluation. Data of clinical probing and radiographic analysis were done in all sites after 1 year of follow up.

The test group had better results in preserving alveolar ridges for thickness showing 1.14+0.87mm of bone loss compared with the control group that showed 2.46+0.4mm (P<0.05). The test group showed also a less height of bone loss on the buccal plate, 0.62+0.51 and 1.17+0.26mm, respectively (P<0.05). Complimentary procedures were required before install the implants in five sites in the control group, but not, in the test group. The histomorphometric analysis showed similar amounts of mineralized bone in both control and test groups, 42.87+11.33% and 45.47+7.21% respectively (P>0,05). The results of 1 year clinical probing follow-up showed deeper probing depths around the control group dental implants when compared to the test group, 4.45+1.58mm and 3.78+1.58mm, respectively (P< 0,05). Radiographic analysis showed more marginal bone level loss in the control group when compared to test group, 3.44+3.39mm and 1.05+0.9mm, respectively (P<0,05).

These findings suggest that the autologous bone marrow graft can contribute to alveolar bone repair after tooth extraction and can also minimize the dental implants attachment loss. This study indicate that the participation of mesenchymal stem cell in the alveolar bone healing should be better understanding to explain this process of repairement.

No relevant conflicts of interest to declare.