Establishment of new treatment for cleft lip and palate patients-basic research for the application of in vitro hybrid artificial bone-

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Currently, autograft of iliac crest cancellous bone has become the most commonly utilized method for restoration of the alveolar cleft. In recent years, we have identified the cleft / nasal cavity ratio analyzed by presurgical frontal cephalograms and the residual cortical bone ratio, which was analyzed by CT taken at 3 months after SBG, as parameters affecting the clinical outcome of the autograft of iliac crest cancellous bone. However, several clinical outcomes of autograft of iliac crest cancellous bone for cleft lip and palate patients, were not corresponded to our previously studies. Therefore, it is of imperative importance to investigate the new donor materials, such as the artificial bone which might be a new method for restoration of the alveolar cleft. The stromal cells of rabbit bone marrow were three-dimensionally cultured in collagen sponge treated with four cytokines (FGF2, BMP-2, 4, 7) in vitro. The collagen sponge treated with FGF-2 showed increased matrix mineralization as compared with BMP-2, 4, 7. Furthermore, in order to confirm the effect of FGF-2 in vivo, stromal cells of rabbit bone marrow were injected into collagen sponge treated with or without FGF-2 and these complexes were grafted in round defects (diameter; 7.0 mm) artificially created in rabbit calvarial bone. Longitudinal evaluation of grafted site showed significant ossification of collagen sponge treated with FGF2. Therefore, these results suggested that new treatment method utilized FGF2 might be useful in the treatment of cleft lip and palate patients.