New technique uses umbilical cord stem cells for early repair of cleft palate

Performed as part of reconstructive surgery when the infant is a few months old, the stem cell procedure provides good results in growing new bone to close the upper jaw cleft — and may avoid the need for later bone graft surgery, according to the case report by Alejandro Garcia Botero, MD, of Hospital De San José, Bogota, Colombia, and colleagues.

Dr. Botero and colleagues report their experience with the stem cell procedure in an infant with cleft lip and palate, diagnosed by ultrasound before birth. The baby girl had an alveolar cleft, involving an area of bone where teeth are located.

Immediately after delivery, a sample of the infant’s umbilical cord blood was collected to isolate stem cells, which were processed and frozen to preserve them for later use. Umbilical cord blood is a rich source of various types of stem cells, which have the potential to develop into many different types of specialized cells, including bone and cartilage.

“Since the age is that of the newborn, have a greater potential to regenerate the organism,” Dr. Botero and coauthors write. 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 “boneless bone grafting” surgery (gingivoperiostioplasty). The stem cells were placed in a pocket of soft tissue bridging the gap in the upper jaw. A small piece of absorbable biomaterial (Gelfoam) was used a scaffold to guide growth of new bone across the cleft palate. This procedure was performed at the same time as surgery to correct the cleft lip (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 was five years old showed good thickness of the upper jaw bone in the area where the cleft had been.

SOURCE: sciencedaily.com (10/2018)