Dental arch expansion after alveolar cleft repair using autogenous bone marrow derived mesenchymal stem cells versus autogenous chin bone graft

Abstract

Alveolar cleft repair is well established, with bone grafting in mixed dentition phase. Mesenchymal derived stem cells were applied to different kinds of bone substitute and compared in different animal models..This study aimed to evaluate the bone quality and quantity at the alveolar cleft sites that were repaired with autogenous mesenchymal stem cell and its effect on orthodontic dental arch expansion and compare these results with cases treated with autogenous chin bone graft. Patients and methods:16 patients (14 left and 2 right, 9 males and 7 females)with unilateral alveolar cleft were included in this study. The age range was 7-12 yearswithmean age was 9.5 years. The alveolar cleft was repaired surgically and the patients were divided into 2 groups (8 patients in each one)according to surgical technique of repair. Group I (5 males and 3 females) : surgical repair was done by using autogenous bone marrow derived mesenchymal stem cells. Group II (4 males and 4 females): surgical repair was done by using autogenous chin bone grafting. The patients were undergo to orthodontic dental arch expansion and followed up to 18 months clinically and radiographically to evaluate and compare the effect of grafting types on arch expansion. Results: The results of this study revealed that the patients in group I who treated by stem cell technology have a clinical results superior than the patients in group II who treated with chin bone grafting. Radiographic results revealed that in group I the bone quality and quantity were superior than that in group II. Conclusion: The autogenous bone marrow derived mesenchymal stem cells is a good technique in repair of alveolar cleft as it promote the bone healing capacity with high quantity and quality as well as enhance orthodontic arch expansion.

Cell therapy for orofacial bone regeneration: A systematic review and meta‐analysis

“…Ten controlled (and 18 uncontrolled) studies reported the implantation of autologous MSCs from bone marrow or adipose tissues (Table , Supporting Information Table ). Culture‐expanded BMSCs were used in SA (Hernandez Alfero et al., ; Kaigler et al., , ), RA (Bajestan et al., ) or AC repair (Khalifa & Gomaa, ). Of these, the former four studies reported the use of a commercial automated bioreactor system (Replicell ® or Ixymyelocel‐t ® , Aastrom Biosciences Inc., Ann Arbor, MI, USA) for isolation of a mixed population of CD90 + MSCs, HSCs, endothelial and inflammatory cells, termed “tissue repair cells” (TRCs), from the MNC‐fraction of bone marrow (Bartel et al., ).…”

Trends in Alveolar Bone Grafting and the Use of Recombinant Bone Morphogenetic Protein (RhBMP) in the United States

“…The pre-expansion alveolar cleft has a smaller soft tissue and bone defect, and studies have shown that expansion can be successfully performed after grafting. 16,17 Expansion also provides postgraft stimulation that may encourage maturity and decrease resorption of the bone graft. 18…”