TISSUE ENGINEERING AND ANTI-AGING - Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine - page 724

35.3.1 Single-Case Report
The protocol used in this study was approved by the Ethics Com-
mittee of the Nagoya University School of Medicine. Informed con-
sentwasobtainedfromthepatientbeforetissueharvest.A51-year-
old female patient was referred to our hospital for the treatment of
periodontal disease and dental implant. The patient suffered from
severe periodontitis, and all her remaining upper teeth needed to
be extracted. She had a strong gag reflex and could not wear a con-
ventional denture. Accordingly, the patient presented with a typi-
cal concave facial profile after teeth extraction. She also exhibited a
prominent rhytid (nasolabial fold) and irregularly shaped wrinkles
onherupperlip,whichbecamerelativelydeepovertime.Tocorrect
masticatory dysfunction, a treatment with dental implant-based
prosthesis was planned and eight dental implants were inserted to
maxilla. Three months after implant installation, a second surgery
was performed to connect an abutment to the fixtures. Since the
patient complained not only of masticatory dysfunction but also
of aesthetic problems, including deep and irregular wrinkles on
the upper lip and a nasolabial groove, an additional treatment for
soft-tissue augmentation using autologous fibroblast injection was
planned.
At the time of second surgery, a 5 mm gingival biopsy specimen
wasexcisedfromthebuccalsideoftheleftfirstmolarofthepatient,
who received a local anesthetic. The gingiva was sutured with 4-0
vicryl.Theautologousgingivalfibroblastswerepreparedandexam-
ined, as described in the Materials and Methods section, and the
cells were prepared for injection at a final concentration of 1 × 10 7
cells/mL in saline.
Oneweekafterplacementoftheimplantprosthesis,threefibrob-
last injection treatments were performed at two-week intervals.
After an infraorbital nerve block was administered, the cell sus-
pension was injected into both nasolabial grooves, as well as into
the irregular skin wrinkles on the upper lip (Fig. 35.10). The skin
showed faint redness with slight swelling in the area of the injected
sites (Fig. 35.11). The sites were cooled with ice, and the redness
disappeared within onehour after injection.
Appearanceofthepatientprofileafterteethextractionwasatyp-
ical concave shape with deep and irregular wrinkles on the upper