Stem Cell-Based Tissue Engineering for Cleft Defects: Systematic Review and Meta-Analysis
The Cleft Palate-Craniofacial Journal, vol. 61, pp. 1439–1460
Abstract
This study aimed to analyze the efficacy of stem cell-based tissue engineering for the treatment of alveolar cleft (AC) and cleft palate (CP) defects in animal models. Systematic review and meta-analysis. Preclinical studies on alveolar cleft repair in maxillofacial practice. Electronic search was performed using PubMed, Embase, and Cochrane databases. Pre-clinical studies, where stem cell-based tissue engineering was used in the reconstruction of AC and CP in animal models were included. Quality of the selected articles was evaluated using SYRCLE (SYstematic Review Centre for Laboratory animal Experimentation). Review of alveolar cleft bone augmentation interventions in preclinical models. Outcome parameters registered were new bone formation (NBF) and/or bone mineral density (BMD). Thirteen large and twelve small animal studies on AC (21) and CP (4) reconstructions were included. Studies had an unclear-to-high risk of bias. Bone marrow mesenchymal stem cells were the most widely used cell source. Meta-analyses for AC indicated non-significant benefits in favor of: (1) scaffold + cells over scaffold-only (NBF P = .13); and (2) scaffold + cells over empty control (NBF P = .66; BMD P = .31). Interestingly, dog studies using regenerative grafts showed similar to superior bone formation compared to autografts. Meta analysis for the CP group was not possible. AC and CP reconstructions are enhanced by addition of osteogenic cells to biomaterials. Directions and estimates of treatment effect are useful to predict therapeutic efficacy and guide future clinical trials of bone tissue engineering.
Authors 7
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Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam · Hasanuddin University
Affiliation as printed
Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Academic Center for Dentistry Amsterdam · Ministry of Health · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Oral and Maxillofacial Surgery, Fujairah Hospital, Ministry of Health, Fujairah, UAE
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam · Hasanuddin University
Affiliation as printed
Department of Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Health Sciences University of Hokkaido
Affiliation as printed
Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
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Affiliation as printed
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
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Tymour Forouzanfar Aachen Department of Oral & Maxillofacial Surgery (Chair: Prof. Dr. JPR van Merkesteyn)
Leiden University · Leiden University Medical Center · Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Marco N. Helder corresponding
Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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