Uso de fração vascular estromal para reconstrução óssea e cerâmicas

RESUMO

Demonstrar, através de um caso clínico, a recuperação de estruturas ósseas e gengivais em região anterior superior associadas a células para individualização da reabilitação cerâmica. O planejamento reverso foi executado em consenso com o paciente, e a técnica de tunelização com biomaterial xenógeno e L-PRF foi usada para a reconstrução de osso em altura e espessura. A fração vascular estromal (FVE) obtida a partir da biopsia colhida da tuberosidade no dia da cirurgia e encaminhada ao Centro de Processamento Celular foi injetada na área enxertada 72 horas depois do procedimento reconstrutivo. Após consolidação, aos seis meses foram instalados os implantes nos elementos 11, 21 e 22, e o enxerto gengival foi desepitelizado. Por compressão dos pônticos da prótese provisória para reabertura atraumática, aos quatro meses foram instalados componentes protéticos e provisórios sobre implantes para conformação do perfil de emergência. As próteses cerâmicas em infraestruturas de zircônia foram estratificadas na cor A2 e instaladas depois de seis meses dos provisórios sobre implantes. A associação de biomaterial, fibrina leucoplaquetária autóloga e fração vascular estromal demostrou sucesso clínico pela necessidade reconstrutiva para individualização dos elementos dentários com baixa morbidade.

Palavras-chave – Fração vascular estromal; Próteses dentárias; Biomateriais; PRF; Engenharia tecidual.

ABSTRACT

We aimed to demonstrate, through a clinical case description, the recovery of bone and gingival structures in the upper anterior region associated with cells for individualization of ceramic rehabilitation. The reverse treatment planning was performed in consensus with the patient, followed by the tunneling technique with xenogeneic biomaterial and L-PRF for bone reconstruction in height and thickness. After, the stromal vascular fraction (SVF) was obtained from the tuber biopsy on the day of surgery and sent to the Cell Processing Center, being injected into the grafted area 72 hours after the reconstructive procedure. After 6 months of consolidation, dental implants (elements #11, 21, 22) were placed in conjunction with the de-epithelialized gingival graft. Upon soft tissue compression by the temporary pontic prostheses for atraumatic reopening, 4 months later, prosthetic components, and dental implant provisional restorations were installed to configurate the emergence profiles. Finally, the zirconium oxide ceramic infrastructures were veneered with A2 shade and installed six months after the provisional restorations. The association of biomaterials, autologous L-PRF and stromal vascular fraction provided clinical success and low morbidity in this reconstructive task to individualize the prosthetic dental elements.

Key words – Stromal vascular fraction; Dental prostheses; Biomaterials; PRF; Tissue engineering.

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