Repair of alveolar cleft defects: reduced morbidity with bone marrow stem cells in a resorbable matrix.
Harvest of the autogenous iliac crest bone graft for an alveolar cleft defect (the gold standard) may cause short- and long-term pain and sensory disturbances. To determine if a tissue engineering technique with similar bone healing results offered decreased morbidity, we compared techniques for postoperative donor site pain. Traditional iliac crest bone graft had more donor site complications compared with both tissue engineering and minimally invasive iliac crest bone graft. With donor site pain, traditional had the most patients with pain and tissue engineering had the least patients with pain at all time points. The mean pain score, including both intensity and pain frequency, was greatest at all time points in traditional and least at all time points in tissue engineering. Closure of alveolar cleft defects with a resorbable collagen sponge and bone marrow stem cells resulted in reduced donor site morbidity and decreased donor site pain intensity and frequency.
Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
Michael
M
Gimbel
Rebekah K
RK
Ashley
Manisha
M
Sisodia
Joubin S
JS
Gabbay
Kristy L
KL
Wasson
Justin
J
Heller
Libby
L
Wilson
Henry K
HK
Kawamoto
James P
JP
Bradley
D000539:Alveolar Process / Q000601:surgery*; D000543:Alveoloplasty; D000704:Analysis of Variance; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation; D010147:Pain Measurement; D010149:Postoperative Pain; D033581:Stem Cell Transplantation / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods