Fifteenth Annual Grant Winners 2014-2015
In Vivo Efficacy of Gingival Mesencyhmal Stem Cells in Alveolar Cleft Grafting
Linda Niessen, DMD, MPH, MPP
Anthony Silvagni, DO, Pharm.D.
Faculty and Students
Jason E. Portnof, DMD (HPD-DEN)
Umadevi Kandalam, Ph.D. (HPD-DEN)
Robert Contrucci, DO (HPD-OST)
Cleft alveolus is a critical size bony defect of the maxilla seen in patients with cleft lip, alveolus, and palate (CLAP). Repair of these defects often seeks a continuous and symmetric maxilla, capable of supporting dentition and the alar base of the nose while closing any oralnasal communication. This defect is traditionally restored in the child’s mixed dentition stage using an autogenous bone graft. Complications including donorsite morbidities, graft failure, and additional operating room cost and time vary between donor sites but exist as a feature of all autogenous grafts. In recent years the study of tissue engineering has started the search for a superior allogenic grafting material to rival or surpass autogenous grafts. Allogenic graft materials however lack a source of osteogenic precursors to proliferate osteoblasts. An appealing source of stem cells which mimics the cells that would naturally fill an alveolar cleft is the use of Gingival derived Mesenchymal stem cells (GMSC). These GMSCs can be easily harvested and grown in the lab, can be guided into osteogenic precursors, are immune privileged, and are anti-inflammatory making them excellent choices for allogenic grafting. The objective of this study is to show the efficacy of a novel hypothesized tissue engineering solution for delivery of stem cells in the bony defect. This graft consists of a demineralized bone matrix (DBM) a natural bone graft material acting as a carrier and a scaffold for the GMSCs. This will be accomplished through three specific aims: 1). To show the plausibility of the cells being harvested and grown in a chemically defined medium free of animal serum. A necessity if the cells are to progress into clinical applications. 2). To develop a representative rat model of alveolar defects for tissue engineering assessment. 3). To show if the GMSCs and carrier system for these cells are capable of repairing alveolar cleft defects. This will be assessed by radiographic density using CBCT and histological examination.