Enhance Mandibular Symphyseal Surface Bone Growth with Autologous Mesenchymal Stem Cell Sheets: An Animal Study

  • Lei Shi
  • Boon Ching Tee
  • Leighann Cotter
  • Zongyang SunEmail author
Original Paper Basic science/Experimental



The size and shape of the chin strongly influence facial profile and harmony. The current correction of chin deficiency mostly relies on genioplasty surgery involving osteotomy. To avoid osteotomy, one possible alternative is to enhance bone growth at the mental protuberance area with cell sheet transplantation. This study was undertaken to evaluate the efficacy of this approach in a pig model.

Materials and Methods

Five 4-month-old pigs were included for mandibular bone marrow aspiration and MSC isolation. Triple-layer MSC sheets were then fabricated and utilized using culture-expanded MSCs. Four weeks after bone marrow aspiration, subperiosteal pockets were created on the labial symphyseal surface, followed by transplantation of autogenous MSC sheets to one randomly chosen side with the other side (control) receiving no transplantation. Six weeks after the surgery, the pigs were euthanized and the specimens from both sides were collected for computed tomography (CT) and histological and immunohistochemical analysis. Measurements between the experimental and control sides were compared using paired t tests.


MSC sheet fabrication and transplantation were reliably conducted. The labial cortical bone thickness increased significantly with MSC sheet transplantation by an average of 2 mm (p = 0.0001). The average measurements of mineral apposition rate and cell proliferation at the cell sheet side tended to be higher than the control side although the differences did not reach statistical significance (p = 0.1–0.2). Tissue mineral density measurements from CT images and bone volume fraction (BV/TV) measurements from histologic images were identical between the two sides (p > 0.5).


These data provide a proof of concept that autologous MSC sheets may be transplanted to the subperiosteal region of the mandibular symphysis to stimulate local surface bone growth.

No Level Assigned

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Chin deficiency Mesenchymal stem cells Bone growth Cell sheets Pig 



LS contributed to data acquisition, analysis and interpretation, manuscript drafting and revision; BCT contributed to study design, data acquisition and statistical analysis; LC contributed to data acquisition, analysis and interpretation; ZS contributed to study conception and design, statistical analysis, data interpretation and critical manuscript revision.


The study was funded by the American Association of Orthodontists Foundation.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

Ethical Approval

All applicable institutional and national guidelines for the care and use of animals were followed.

Informed Consent

For this type of study, informed consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Department of Pediatric Dentistry, Ninth People’s HospitalShanghai Jiaotong University, School of MedicineShanghaiChina
  2. 2.Division of Orthodontics, College of DentistryThe Ohio State UniversityColumbusUSA
  3. 3.Division of Biosciences, College of DentistryThe Ohio State UniversityColumbusUSA
  4. 4.College of Arts and SciencesThe Ohio State UniversityColumbusUSA

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