A technique using umbilical cord blood stem cells could be a promising new approach for repair of cleft palate in infants, according to a report published in the September issue of the Journal of Craniofacial Surgery.
Performed as part of reconstructive surgery when the infant is a few months old, the procedure provides positive results in growing new bone to close the upper jaw cleft and may avoid the need for later bone graft surgery, according to paper author Alejandro Garcia Botero, MD, of Hospital De San José in Bogota, Colombia.
Dr. Botero and his colleagues reported their experience with the stem cell procedure in an infant with an alveolar cleft. Immediately following delivery, a sample of the infant’s umbilical cord blood was collected to isolate stem cells, which were processed and frozen.
For the first few months, the infant underwent a nonsurgical nasoalveolar shaping procedure to align the soft tissues of the upper jaw. At age five months, the stem cells were thawed for use as part of gingivoperiostioplasty and placed in a pocket of soft tissue bridging the gap in the upper jaw. A small piece of absorbable biomaterial was used a scaffold to guide growth of new bone across the cleft palate. This procedure was performed at the same time as cheiloplasty.
Follow-up confirmed formation of new bone to close the cleft palate, providing good position and support for normal eruption of the teeth. Imaging scans when the patient reached 5 years of age showed good thickness of the upper jaw bone in the area where the cleft had been.
A potential advantage of the stem cell procedure is avoiding the need for later bone grafting surgery, which is currently the standard technique for closing the cleft and has potential complications and subjects the patient to one or more additional surgeries.
The current case study is the first to use stem cells as part of primary surgery to repair cleft palate in an infant. The researchers emphasize the need for further studies to evaluate their stem cell technique in a large number of patients, including steps to confirm that bone formation results from the stem cells and not from the initial “boneless bone graft” surgery.Multi-Page