TREATMENT OUTCOMES OF THE ALVEOLAR RIDGE REGRESSIVE TRANSFORMATION USING AUTOLOGOUS ADIPOSE-TISSUE DERIVED STROMAL VASCULAR FRACTION

Aim. The study was performed in order to assess the size, structure and chewing ability of the maxillary ridge reconstructed using autologous adipose-tissue derived stromal vascular fraction (ATD SVF) in a long-term study (10 years).

Materials and methods. The study involved 141 patients (61 men, 80 women) aged from 45 to 78 years (mean age 57 years) with a regression transformation of the alveolar ridge of the upper and lower jaw. In the test group (TG), 112 osteoplastic surgeries were performed using autologous adipose-tissue derived stromal vascular fraction (ATD SVF) followed by the installation of 297 dental implants into the reconstructed ridge to restore the chewing function. The control group (CG) comprised 117 surgeries performed according to generally accepted methods followed by the installation of 323 artifi cial supports. The size of the alveolar ridge and the support function of the reconstructed bone were evaluated during the period of up to 10 years. In the histological and histomorphometric study, 27 trephine biopsy specimens of reconstructed bone obtained during dental implantation were studied. The resulting digital material was processed by conventional methods of variation statistics.

Results. The results of a comparative study have confi rmed the advantages of the proposed approach with the use of ATD SVF over current generally accepted methods for the reconstruction of the jaw alveolar ridge. The use of ATD SVF in the composition of osteoplastic material allows the required degree of augmentation of the atrophied bone area to be achieved with a minimal risk of complications and reoperations (8% and 21% of cases in TG and CG, respectively, p = 0.231), along with the optimal morphological characteristics of the regenerate (40.14 ± 3.36 and 24.23 ± 2.63 percent of viable mineralized bone tissue on sections of trephine biopsy specimens from TG and KG, p = 0.001). These results ensure reliable osseointegration of artifi cial supports in the reconstructed alveolar ridge and a high effi ciency of orthopedic treatment with implant supports during the period of up to 10 years (97% and 88% in TG and CG, respectively, r˂0.001).

Conclusion. The proposed innovative approach can be recommended as a basis for a surgical protocol with a pronounced regression transformation of the jaw alveolar ridge. This will allow the chewing function to be restored more successfully and predictably with the use of artifi cial supports in the reconstructed bone in this category of patients.