Intra oral soft tissue regenration with a tissue engineered metabolic active fibroblast layer

Objectives: Surgical procedures in implantology are in general elective. Therefore the oral regeneration should be patient friendly. To avoid donor site morbidity a living tissue consisting of juvenile fibroblast cells where used to regenerate soft tissue defects in oral mouth. Methods: Juvenil fibroblast cells where seeded on a bio resorbable vicryl mesh and incubated in a closed bioreactor system. Under these conditions the cells form a dermal like tissue wich is called Dermagraft. After tissue formation the layers are frozen at -80 grad celcius and thawed if needed. The tissue was characterized and found to produce an array of growth factors like vascular endothelial growth factor (VEGF), keratinocyte growth factor (KG) as well transforming growth factor alpha, beta1, beta2 among others. 12 patients with variable intra oral soft tissue defects resulting from tumor surgery, praeprosthetic procedures and periodontal diseas were included in this study. To avoid soft tissue harvesting procedures the defects were covered with the fibroblast layer. The fibroblast layer was fixed with sutures over the defect in order to get intense contact between the fibroblast cells and the underlying patient tissue. Results: In all patients the soft tissue defects regenerated in a time period up to 10 days. Histiological biopsy of the regenerated tissue did not show any signs of scar tissue. The formed tissue was clinical functional. The secreted growth of the fibroblast layer over a prologed time period seems to promote soft tissue formation. The effect of the fibroblast layer on bone formation seems to be promising. Conclusion: With means of tissue engeneering it is today possible to produce tissues of living fibroblast cells. Growth factor produced of these cells are able to promote soft tissue formation. Keywords: soft tissue regeneration