Autologous bone marrow aspirate concentrate (BMAC) for treatment of keratocystic odontogenic tumour (KCOT)-a case report.

Q1 Biochemistry, Genetics and Molecular Biology
Stem cell investigation Pub Date : 2021-08-16 eCollection Date: 2021-01-01 DOI:10.21037/sci-2020-059
Manimaran Kanakaraj, Sangeetha Manoharan, Sivashankaran Srinivas, Marudhamani Chinnannan, Avinash Gandhi Devadas, Rashmi Jain, Sathish Muthu, Madhan Jeyaraman
{"title":"Autologous bone marrow aspirate concentrate (BMAC) for treatment of keratocystic odontogenic tumour (KCOT)-a case report.","authors":"Manimaran Kanakaraj,&nbsp;Sangeetha Manoharan,&nbsp;Sivashankaran Srinivas,&nbsp;Marudhamani Chinnannan,&nbsp;Avinash Gandhi Devadas,&nbsp;Rashmi Jain,&nbsp;Sathish Muthu,&nbsp;Madhan Jeyaraman","doi":"10.21037/sci-2020-059","DOIUrl":null,"url":null,"abstract":"<p><p>Management of keratocystic odontogenic tumor (KCOT) has always remained a conundrum due to its aggressive behavior, indicating wide resection. Achieving an esthetically and functionally acceptable reconstruction remains a challenge. Herein, we present a novel and less invasive technique for the treatment of KCOT. A 55-year-old female presenting with pain in the lower jaw for the past 3 months was diagnosed with a large KCOT extending from 35 to 47 region. CT images revealed buccal and lingual cortical bone erosion. Management was done in two stages: cyst curettage and chemical cauterization, followed by application of Bone Marrow Aspirate Concentrate (BMAC) with a delay of two months, to increase the thickness of eroded cortical bone. On follow-up at one year, ossification of the defect was observed. BMAC is a cocktail of mesenchymal stromal cells, hematopoietic stem cells, fibroblasts, mononuclear cells, macrophages, endothelial cells, progenitor cells, growth factors and cytokines. BMAC cocktail provide an anti-inflammatory, anti-fibrotic, anti-apoptotic, and immunomodulatory environment. Autologous platelet rich plasma provides various growth factors (TGF-β, PDGF, EGF, HGF, NGF, IGF-1) and cytokines. Addition of PRP in BMAC cocktail enhance the regeneration of tissues, where PRP act as a functional regenerative scaffold for cell integration, proliferation, and differentiation that can expedite macroscale musculoskeletal tissue healing. Autologous BMAC with corticocancellous bone acts as an osteoconductive scaffold capable of regenerating the large bone defect created by the curettage of KCOT.</p>","PeriodicalId":21938,"journal":{"name":"Stem cell investigation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413135/pdf/sci-08-2020-059.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stem cell investigation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21037/sci-2020-059","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Biochemistry, Genetics and Molecular Biology","Score":null,"Total":0}
引用次数: 1

Abstract

Management of keratocystic odontogenic tumor (KCOT) has always remained a conundrum due to its aggressive behavior, indicating wide resection. Achieving an esthetically and functionally acceptable reconstruction remains a challenge. Herein, we present a novel and less invasive technique for the treatment of KCOT. A 55-year-old female presenting with pain in the lower jaw for the past 3 months was diagnosed with a large KCOT extending from 35 to 47 region. CT images revealed buccal and lingual cortical bone erosion. Management was done in two stages: cyst curettage and chemical cauterization, followed by application of Bone Marrow Aspirate Concentrate (BMAC) with a delay of two months, to increase the thickness of eroded cortical bone. On follow-up at one year, ossification of the defect was observed. BMAC is a cocktail of mesenchymal stromal cells, hematopoietic stem cells, fibroblasts, mononuclear cells, macrophages, endothelial cells, progenitor cells, growth factors and cytokines. BMAC cocktail provide an anti-inflammatory, anti-fibrotic, anti-apoptotic, and immunomodulatory environment. Autologous platelet rich plasma provides various growth factors (TGF-β, PDGF, EGF, HGF, NGF, IGF-1) and cytokines. Addition of PRP in BMAC cocktail enhance the regeneration of tissues, where PRP act as a functional regenerative scaffold for cell integration, proliferation, and differentiation that can expedite macroscale musculoskeletal tissue healing. Autologous BMAC with corticocancellous bone acts as an osteoconductive scaffold capable of regenerating the large bone defect created by the curettage of KCOT.

Abstract Image

自体骨髓浓缩液治疗角化囊性牙源性肿瘤1例。
角化囊性牙源性肿瘤(KCOT)的治疗一直是一个难题,因为它具有侵袭性,需要广泛切除。实现美学和功能上可接受的重建仍然是一个挑战。在此,我们提出一种治疗KCOT的新颖且侵入性较小的技术。一名55岁女性,以过去3个月的下颌疼痛为表现,被诊断为从35到47区域的大KCOT。CT显示颊部及舌部皮质骨侵蚀。治疗分两个阶段进行:囊肿刮除和化学烧灼,然后延迟两个月应用骨髓抽吸浓缩液(BMAC),以增加侵蚀皮质骨的厚度。随访一年,观察缺损骨化情况。BMAC是间充质基质细胞、造血干细胞、成纤维细胞、单核细胞、巨噬细胞、内皮细胞、祖细胞、生长因子和细胞因子的混合物。BMAC鸡尾酒提供抗炎、抗纤维化、抗凋亡和免疫调节环境。自体富血小板血浆提供多种生长因子(TGF-β、PDGF、EGF、HGF、NGF、IGF-1)和细胞因子。在BMAC鸡尾酒中添加PRP可以增强组织的再生,其中PRP作为细胞整合、增殖和分化的功能性再生支架,可以加速大尺度肌肉骨骼组织的愈合。自体皮质松质骨BMAC作为一种骨导电性支架,能够再生因KCOT刮除造成的大面积骨缺损。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Stem cell investigation
Stem cell investigation Biochemistry, Genetics and Molecular Biology-Developmental Biology
CiteScore
5.80
自引率
0.00%
发文量
9
期刊介绍: The Stem Cell Investigation (SCI; Stem Cell Investig; Online ISSN: 2313-0792) is a free access, peer-reviewed online journal covering basic, translational, and clinical research on all aspects of stem cells. It publishes original research articles and reviews on embryonic stem cells, induced pluripotent stem cells, adult tissue-specific stem/progenitor cells, cancer stem like cells, stem cell niche, stem cell technology, stem cell based drug discovery, and regenerative medicine. Stem Cell Investigation is indexed in PubMed/PMC since April, 2016.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信