Compositions and Structural Geometries of Scaffolds Used in the Regeneration of Cleft Palates: A Review of the Literature

Abstract

Cleft palate (CP) is one of the most common birth defects, presenting a multitude of negative impacts on the health of the patient. It also leads to increased mortality at all stages of life, economic costs and psychosocial effects. The embryological development of CP has been outlined thanks to the advances made in recent years due to biomolecular successions. The etiology is broad and combines certain environmental and genetic factors. Currently, all surgical interventions work off the principle of restoring the area of the fissure and aesthetics of the patient, making use of bone substitutes. These can involve biological products, such as a demineralized bone matrix, as well as natural-synthetic polymers, and can be supplemented with nutrients or growth factors. For this reason, the following review analyzes different biomaterials in which nutrients or biomolecules have been added to improve the bioactive properties of the tissue construct to regenerate new bone, taking into account the greatest limitations of this approach, which are its use for bone substitutes for large areas exclusively and the lack of vascularity. Bone tissue engineering is a promising field, since it favors the development of porous synthetic substitutes with the ability to promote rapid and extensive vascularization within their structures for the regeneration of the CP area.

Keywords: cleft palate; manufacturing technique; three-dimensional scaffolding; tissue engineering.

Figure 1

Polymeric scaffolds with osteoinductive properties seeded with mesenchymal stem cells to obtain an osteogenic tissue construct for cleft palate regeneration.

Figure 2

A 3D-printed PCL scaffold seeded with pig dental pulp stem cells using calcein–AM and live and dead assays (live assay shown in green) (courtesy of L.M. Rodríguez-Lorenzo from the Department of Polymeric Nanomaterials and Biomaterials, Institute of Science and Technology of Polymers (ICTP-CSIC, Madrid, Spain). The image is taken from a fluorescence microscope at 10× magnification.

Figure 3

Polyurethane scaffold seeded with dental pulp stem cells (nuclear staining using DAPI). Image taken from a fluorescence microscope showing cell proliferation in the scaffold matrix for bone regeneration (courtesy of J.V. Cauich-Rodríguez from CICY, Mérida, Yucatán, México).

Figure 4

SEM micrograph: structure of a PU–titanium particle scaffold with interconnected pores, which promotes cell proliferation towards the interior of the scaffold (courtesy of Fernando Javier Aguilar-Perez from CICY, Mérida, Yucatán, Mexico).