Intrauterine Oberkieferrekonstruktion am Beispiel der Lippen-Kiefer-Gaumenspalten beim Schafmodell

Abstract

Aim: The purpose of this study was to evaluate the usefulness of fetal bone grafts and bone-regenerating implant material in the therapy of surgically created cleft lip and palate (CLP) in the pregnant sheep model. Material and Methods: Seventeen pregnant sheep at 75 to 100 days of gestational age (GA; term = 145 – 150 days GA) were used. For the closure of the surgically created alveolar defect a fetal bone graft from the iliac crest (Group I; n = 4) and from the ulna (Group II; n = 3) was used. This bone graft was also used, being covered by a membrane (Group III; n = 4), as it was used also in group IV with collagen-lyophilisate (n — 4). At 140 – 145 days of GA animals underwent second look operation. Results: The phenotypic analysis revealed no to slight asymmetry of the upper lip and the maxilla, with some notching and thinning at the repaired-side. Two-dimensional maximal intensity projection (2D-MIP) findings confirmed healing of the alveolar defect without callus formation in 66.6% of the cases, and the histological analysis the scarless healing in all, and bone healing without callus formation in 16.6%. Discussion and Conclusion: The intrauterine treatment of the alveolar defect by cleft lip is technically feasible. Healing occurs without scar or callus formation.