Lateral Ramus Cortical Bone Plate in Alveolar Cleft Osteoplasty with Concomitant Use of Buccal Fat Pad Derived Cells and Autogenous Bone: Phase I Clinical Trial.

Arash Khojasteh,Masoud Soleimani,Azita Tehranchi,Hossein Behnia,Pantea Nazeman,Lida Kheiri,Nasser Nadjmi

doi:10.1155/2017/6560234

Abstract

Tissue regeneration has become a promising treatment for craniomaxillofacial bone defects such as alveolar clefts. This study sought to assess the efficacy of lateral ramus cortical plate with buccal fat pad derived mesenchymal stem cells (BFSCs) in treatment of human alveolar cleft defects. Ten patients with unilateral anterior maxillary cleft met the inclusion criteria and were assigned to three treatment groups. First group was treated with anterior iliac crest (AIC) bone and a collagen membrane (AIC group), the second group was treated with lateral ramus cortical bone plate (LRCP) with BFSCs mounted on a natural bovine bone mineral (LRCP+BFSC), and the third group was treated with AIC bone, BFSCs cultured on natural bovine bone mineral, and a collagen membrane (AIC+BFSC). The amount of regenerated bone was measured using cone beam computed tomography 6 months postoperatively. AIC group showed the least amount of new bone formation (70 ± 10.40%). LRCP+BFSC group demonstrated defect closure and higher amounts of new bone formation (75 ± 3.5%) but less than AIC+BFSC (82.5 ± 6.45%), suggesting that use of BFSCs within LRCP cage and AIC may enhance bone regeneration in alveolar cleft bone defects; however, the differences were not statistically significant. This clinical trial was registered at clinicaltrial.gov with NCT02859025 identifier.

Highlights

The most common facial congenital malformation, cleft lip and palate, can disturb patient functions and cause psychological problems [1, 2]
Mandibular lateral ramus provides an accessible intraoral cortical bone and is BioMed Research International routinely administered in preimplant ridge augmentation [9, 10] but the amount is limited comparing to the iliac crest [11] long term hospitalization, pain, donor site morbidities, and great cost [12] are the primary disadvantages of alveolar cleft autografting [12]
The new regenerated bone in the lateral ramus cortical bone plate (LRCP) healing space appeared healthy with adequate stability during drilling sequence (Figures 12(a)–12(d))

Summary

Introduction

The most common facial congenital malformation, cleft lip and palate, can disturb patient functions and cause psychological problems [1, 2]. Seventy-five percent of all cleft lip and palate variations are accompanied by alveolar bone defects [3,4,5]. Mandibular lateral ramus provides an accessible intraoral cortical bone and is BioMed Research International routinely administered in preimplant ridge augmentation [9, 10] but the amount is limited comparing to the iliac crest [11] long term hospitalization ( for iliac crest harvesting), pain, donor site morbidities, and great cost [12] are the primary disadvantages of alveolar cleft autografting [12]

Objectives

Methods

Results

Conclusion