Engineered mucoperiosteal scaffold for cleft palate regeneration towards the non-immunogenic transplantation

Rizzo, Maria Ida; Tomao, Luigi; Tedesco, Stefano; Cajozzo, Marta; Esposito, Mariacristina; Stefanis, Cristiano De; Ferranti, Andrea Maurizio; Mezzogori, Daniele; Palmieri, Annapina; Pozzato, Gianantonio; Algeri, Mattia; Locatelli, Franco; Leone, Lucia; Zama, Mario

doi:10.1038/s41598-021-93951-w

Cited by 7 publications

(3 citation statements)

References 48 publications

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“…The results showed that the collagen mesh was preserved, causing an increase in the osteoinductive potential of the mesenchymal precursor cells. This scaffold has a potential impact on palatal bone regeneration, which could lead to future clinical applications in humans [ 90 ].…”

Section: Biomaterials Applied In the Regeneration Of The Cleft Palatementioning

confidence: 99%

Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature

2022

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Cleft palate (CP) is one of the most common birth defects, presenting a multitude of negative impacts on the health of the patient. It also leads to increased mortality at all stages of life, economic costs and psychosocial effects. The embryological development of CP has been outlined thanks to the advances made in recent years due to biomolecular successions. The etiology is broad and combines certain environmental and genetic factors. Currently, all surgical interventions work off the principle of restoring the area of the fissure and aesthetics of the patient, making use of bone substitutes. These can involve biological products, such as a demineralized bone matrix, as well as natural–synthetic polymers, and can be supplemented with nutrients or growth factors. For this reason, the following review analyzes different biomaterials in which nutrients or biomolecules have been added to improve the bioactive properties of the tissue construct to regenerate new bone, taking into account the greatest limitations of this approach, which are its use for bone substitutes for large areas exclusively and the lack of vascularity. Bone tissue engineering is a promising field, since it favors the development of porous synthetic substitutes with the ability to promote rapid and extensive vascularization within their structures for the regeneration of the CP area.

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Section: Biomaterials Applied In the Regeneration Of The Cleft Palatementioning

confidence: 99%

Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature

2022

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“…SCs seem to present as a favorable option for bone regeneration in the oro-maxillofacial region with potential use in alveolar defect regeneration and reducing defect sizes by new bone formation [ 23 , 25 , 26 ], with less postoperative morbidity compared to autogenous bone grafting [ 27 ]. It also seems that teeth in the defect area tend to erupt in their proper position [ 28 ].…”

Section: Relevant Sectionsmentioning

confidence: 99%

Applications of Biotechnology to the Craniofacial Complex: A Critical Review

et al. 2022

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Background: Biotechnology shows a promising future in bridging the gap between biomedical basic sciences and clinical craniofacial practice. The purpose of the present review is to investigate the applications of biotechnology in the craniofacial complex. Methods: This critical review was conducted by using the following keywords in the search strategy: “biotechnology”, “bioengineering”, “craniofacial”, “stem cells”, “scaffolds”, “biomarkers”, and ”tissue regeneration”. The databases used for the electronic search were the Cochrane Library, Medline (PubMed), and Scopus. The search was conducted for studies published before June 2022. Results: The applications of biotechnology are numerous and provide clinicians with the great benefit of understanding the etiology of dentofacial deformities, as well as treating the defected areas. Research has been focused on craniofacial tissue regeneration with the use of stem cells and scaffolds, as well as in bioinformatics with the investigation of growth factors and biomarkers capable of providing evidence for craniofacial growth and development. This review presents the biotechnological opportunities in the fields related to the craniofacial complex and attempts to answer a series of questions that may be of interest to the reader. Conclusions: Biotechnology seems to offer a bright future ahead, improving and modernizing the clinical management of cranio-dento-facial diseases. Extensive research is needed as human studies on this subject are few and have controversial results.

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“…Clinicians and researchers have been working together to search for applicable stem cell-based tissue engineering to overcome these challenges [14,15,51]. Unlike alveolar cleft, stem cell-based tissue engineering technology for cleft palate is still in process for future clinical human application [52]. In addition, the application of new technologies for oral cleft treatments is often hampered by limited healthcare settings where many patients are left untreated until they reach adult age [11].…”

Section: Discussionmentioning

confidence: 99%

Towards tissue engineering application for cleft defects

Natsir Kalla

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The main objective of this thesis was to investigate the current clinical practice and associated difficulties in treating cleft lip and palate, the state-of-the-art tissue engineering techniques for the reconstruction of oral clefts, and to assess the safety and efficacy of novel tissue engineering approaches for alveolar cleft defects. In Chapter 2, we compared the costs and complication rates of Secondary Alveolar Bone Grafting (SABG) outcomes in alveolar cleft patients treated either in daycare or with multiple day hospitalization (MDH). Daycare had marginally, but not substantially, higher rates of complications, the majority of which were classified by Clavien Dindo as Grade I (mild). According to the study, daycare after alveolar cleft surgery is about as safe as MDH, although much less expensive. In Chapter 3, we investigated intraoperative and early postoperative blood loss using the buccal fat pad (BFP) during cleft lip and/or cleft palate (CL/P) surgery that resulted in weight, and the procedure length can cause more blood loss during palatoplasty, which suggests that younger patients will have better results from their procedures. In Chapter 4, we conducted a systematic review and meta-analysis to assess the effectiveness of stem cell-based tissue engineering for the treatment of alveolar cleft (AC) and cleft palate (CP) deformities in animal models, which concluded that adding cells to biomaterials improves AC and CP reconstructions. In Chapter 5, a second systematic review and meta-analysis of controlled clinical trials utilizing regeneration materials for alveolar cleft repairs was carried out. The review also took the risk of bias (RoB) into account. According to the meta-analysis, the regenerative materials and iliac crest grafts did not differ significantly. Additionally, this review's findings indicated that control trials' high RoB indicated the need for quality improvement in control trials. In Chapter 6, we presented a clinical trial protocol to assess the feasibility and safety of a novel calcium-polyphosphate-complexed bone-inducing graft material for alveolar cleft reconstructions known as Ca-polyP microparticles (Ca-polyP MPs). Following the trial's conclusion, the findings regarding safety, feasibility, and bone formation using polyP as a graft material will be published. In Chapter 7, we described in great detail the outcomes of a single-blinded, parallel, prospective clinical pilot research using Ca-polyP MPs for alveolar cleft repairs with 8 adolescent patients (ages 13 to 34), of which the protocol was described in Chapter 6. Our research showed that both transplants may be used safely. However, compared to Ca-polyP alone, the combination of Ca-polyP + BCP graft demonstrated more excellent stability in alveolar cleft reconstruction, as measured by the Bergland scale. It is advised that future clinical trials include a bigger sample size. In Chapter 8, we presented a clinical trial design to assess the viability and safety of combining biphasic calcium phosphate (BCP) with microfragmented fat (MFAT) for alveolar cleft repairs. This prospective, non-blinded, first-in-human clinical research will include eight patients with alveolar clefts. Regardless of the trial's findings, the safety, feasibility, and efficacy of the BCP-MFAT combination in promoting bone formation will be disclosed. In Chapter 9, we described in detail the results of a first-in-man prospective non-blind clinical pilot study of alveolar cleft reconstructions using a BCP-MFAT combination, which included 8 adult patients. No local or systemic side effects, allergic reactions, or other adverse events were noticed. The Bergland scale had radiographic examinations from I through III. In summary, the BCP-MFAT grafts seem to be secure and practical for alveolar cleft reconstruction.

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Engineered mucoperiosteal scaffold for cleft palate regeneration towards the non-immunogenic transplantation

Cited by 7 publications

References 48 publications

Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature

Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature

Applications of Biotechnology to the Craniofacial Complex: A Critical Review

Towards tissue engineering application for cleft defects

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