This new technique, using cord blood stem cells, is being performed in Colombia as part of reconstructive surgery when the child is a few months old. It’s already showing good results in growing new bone, potentially avoiding the need for later bone graft surgery.
A case report, written by Dr Alejandro Garcia Botero, MD, of Hospital De San José, Bogota, Colombia outlined how cord blood stem cells were used as part of reconstructive surgery for an infant born with a cleft lip and palate.
A ultrasound before her birth showed she had alveolar cleft, involving an area of bone where teeth are located.
Right after her delivery, her cord blood stem cells were collected and stored for her future 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.
For the first few months, the infant underwent a nonsurgical “nasoalveolar shaping” procedure to align the soft tissues of the upper jaw. Then at 5 months old, her cord blood stem cells were used in the “boneless bone grafting” surgery (gingivoperiostioplasty).
They were 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 surgery to correct the cleft lip (cheiloplasty).
Dr Botero reports that ongoing follow-up of the patient confirmed that new bone has been formed to close the cleft palate, providing good position and support for normal eruption of the teeth. Imaging scans taken when the little girl was five years old showed good thickness of the upper jaw bone in the area where the cleft had been.
The study is the first to use stem cells as part of primary surgery to repair cleft palate in an infant. Dr. Botero and colleagues note that their patient will need further monitoring to ensure adequate bone thickness in the upper jaw. The researchers emphasize the need for further studies evaluating 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.
But a major potential advantage of the stem cell procedure is that it would avoid the need for later bone grafting surgery – currently the standard technique for closing the cleft. This procedure uses bone taken from elsewhere in the child’s body, typically the hip. Bone grafting has potential complications and subjects the child to one or more additional surgeries.
The original article can be viewed here.