A group of researchers including Hongli Sun, associate professor in the Department of Oral and Maxillofacial Surgery; Kyungsup Shin, associate professor of orthodontics and director of clinical research; and Xuan Song, assistant professor of Industrial and Systems Engineering have are co-principal investigators working together to develop a novel strategy for orofacial cleft reconstruction.

Iowa has long been a leader in all aspects of orofacial cleft research, from investigating the genetic and epigenetic causes of orofacial clefting to finding more effective treatments for orofacial reconstruction. 

Currently, the gold standard treatment for patients with cleft palate with an alveolar cleft is to take a bone from elsewhere in the patient's body, and use it to augment bone repair in the affected areas. The problem with such approaches is that appropriate bone tissue is limited because it has to come from a young patient, it is invasive and requires surgery to extract the bone tissue, and often detrimentally affects the larger bone structure where the tissue was removed from.

The team have come up with a new approach to orofacial cleft reconstruction using tissue engineering with stem cells-like secretome delivered via an innovative, personalized, and precise 3D-composite scaffold that is able to be customized to the unique contours of irregular bone defects as it harnesses and amplifies the patient's own innate healing abilities to effectively improve bone regeneration.

What makes this approach unique is that they have found a way to address major problems with other, similar approaches using bioengineered scaffolds to deliver stem cells and growth factors.

First, they are developing a way to 3D-print a unique and precise scaffold that is both absorbs drugs or growth factors for local and sustained release, and also is fit to the contours of the bone defect without the use of a support structure. Other approaches use a support structure during the printing process, which makes the resulting scaffolds have poorer mechanical properties and more likely to break.  Xuan Song's innovative support structure-free 3D printing provided the vital development here. 

Second, they will draw insights from human gingival fibroblasts, which is similar to stem cells and play a key role in helping oral wounds heal quickly and scar free. The team has found a way to further promote their healing ability by using biomimetic conditions and nanoparticles to control the rate at which these  regenerative secretome are released so that they maximize the speed and effectiveness of healing. Here, Hongli Sun is bringing his bioengineering research on drug delivery to the table.

And Shin is bringing his expertise in clinical research and cleft palate reconstruction to ensure that the approach is an effective strategy to improve treatments for cleft lip and palate patients.

This novel approach to orofacial reconstruction could transform how oral cleft and palate patients are treated.