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

Cleft lip and palate (CL/P) is the most prevalent craniofacial birth defect in humans. None of the surgical procedures currently used for CL/P repair lead to definitive correction of hard palate bone interruption. Advances in tissue engineering and regenerative medicine aim to develop new strategies to restore palatal bone interruption by using tissue or organ-decellularized bioscaffolds seeded with host cells. Aim of this study was to set up a new natural scaffold deriving from a decellularized porcine mucoperiosteum, engineered by an innovative micro-perforation procedure based on Quantum Molecular Resonance (QMR) and then subjected to in vitro recellularization with human bone marrow-derived mesenchymal stem cells (hBM-MSCs). Our results demonstrated the efficiency of decellularization treatment gaining a natural, non-immunogenic scaffold with preserved collagen microenvironment that displays a favorable support to hMSC engraftment, spreading and differentiation. Ultrastructural analysis showed that the micro-perforation procedure preserved the collagen mesh, increasing the osteoinductive potential for mesenchymal precursor cells. In conclusion, we developed a novel tissue engineering protocol to obtain a non-immunogenic mucoperiosteal scaffold suitable for allogenic transplantation and CL/P repair. The innovative micro-perforation procedure improving hMSC osteogenic differentiation potentially impacts for enhanced palatal bone regeneration leading to future clinical applications in humans.

Sequelae of congenital oropharyngeal teratoma in the oral cavity of the child

Congenital oropharyngeal teratoma is a rare tumor subtype with cells from the three germ layers, majorly being benign. Whereas teratoma develops early in intrauterine life, thus affecting the growth and development of adjacent structures, the purpose of this case report is to present the sequelae of this tumor in a child's oral cavity. Female child, 2 years and 3 months old referred by the otorhinolaryngologist for dental evaluation. The mother´s main complaint was the the child could not close her mouth. According to the child's medical record, at 34th week of gestation, during the routine ultrasound examination, the presence of the anechoic tumor mass was observed without Doppler signal, presenting a 3.2cm x 2.4cm diameter outside through the oral cavity. At 17 and 32 days of life, respectively, the excision of the largest and residual tumor located on the floor of the mouth was performed. Upon anatomopathological examination, the tumor with was classified as a mature teratoma. In the intraoral examination, a deep and atresia palate incomplete cleft palate, bone growth in the region of the posterior alveolar ridge of the maxilla, and in the posterior region of the mandible on the left side, "V" shaped mandible and microglossia, crowding were observed dental agenesis of the lower lateral incisors, absence of caries lesions, gingivitis and enamel development defects. The child will remain under the regular dental pediatric follow-up. Several sequelae were observed in the child's oral cavity and the need for multi-professional follow-up after excision of congenital oropharyngeal teratoma.

Alveolar bone grafting

ABSTRACTIn patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.

A case of brachygnathis inferior and palatoschisis in a reindeer calf

The mandibles were abnormally short and there was an opening in the hard palate, extending from the mandibular junction (corpus mandibulae) to the anterior rim of the palate bone. No other pathological findings were observed.

I. On the relations of the vomer, ethmoid, and intermaxillary bones

The author commences by describing the connexions of the vomer in mammalia generally, and states that of these by far the most constant in occurrence and invariable in its nature is one to which he believes he has been the first to attract attention, viz. that by which it comes in contact with the lateral masses of the ethmoid. He states that this connexion is effected by the alæ of the vomer being continued into two laminæ which pass beneath the turbinations of the ethmoid, and are united to the framework of the lateral masses at a point corresponding to the margins of the sphenopalatine foramina. These laminae he calls the “ethmovomerine laminæ,” and for the sphenopalatine foramen he adopts the term “nasal foramen of the palate-bone,” because it is not the sphenoid, but the ethmoid, which completes that foramen in cases where it is not quite encircled by the palate-bone.