Intraoral Grafting of <I>Ex Vivo</I> Produced Oral Mucosa Equivalents (EVPOME) Applied to Patients with Cleft Lip and Palate

DOI 12 References
  • IIDA Akihiko
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • YOSHIZAWA Michiko
    Division of Reconstructive Surgery for Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences
  • KOYAMA Takahiro
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • SAITO Taro
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • TAKAGI Ritsuo
    Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • SAITO Chikara
    Division of Reconstructive Surgery for Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences
  • SAITO Isao
    Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences
  • ONO Kazuhiro
    Division of Dental Hygiene and Health Promotion, Niigata University Graduate School of Medical and Dental Sciences
  • IZUMI Kenji
    Division of Oral Anatomy, Niigata University Graduate School of Medical and Dental Sciences

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Other Title
  • 培養複合口腔粘膜移植を応用した口唇口蓋裂の2例

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Description

This report presents the use of ex vivo produced oral mucosa equivalent (EVPOME) applied to an oral mucosa defect in two patients with cleft lip and palate. Autologous keratinocytes were placed and propagated in a chemically-defined, animal product and a xenogeneic feeder layer free culture system. Cells were then seeded and cultured on an acellular dermal substrate, AlloDerm®, which provides strength, durability, and elasticity to the graft.<br>In case 1, a 20-year-old female underwent closure of the oronasal fistula in the midline of the hard palate using a rotational palatal flap. A circular EVPOME graft (approximately 20 mm in diameter) was grafted onto the bone surface of the donor site of the flap. In case 2, a 16-year-old male underwent vestibuloplasty in the premaxilla region. After trimming, two circular EVPOME grafts were placed over the intact periosteum.<br>The grafts were easily fixed in place to the surrounding scarred mucosa. Although the underlying tissue of the EVPOME graft sutures was scarred, graft adherence was achieved within a week. The successful clinical outcome reported here suggests the efficacy of EVPOME grafts onto a less-vascularized, scarred tissue, and that the use of EVPOME grafts is highly applicable for patients with cleft lip and palate. EVPOME grafting could be extended especially toward pediatric patients with cleft lip and palate for reconstruction of oral mucosa defects by using cryopreserved autologous keratinocytes and by developing a novel material to ensure a steady supply of scaffold instead of the man-made AlloDerm®.

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