Regenerative medicine in the treatment of alveolar cleft defect: A systematic review of the literature

Despite a possible risk of donor site morbidity, autogenous bone grafting is considered the gold standard treatment for human alveolar cleft defect. Tissue engineering methods have recently been investigated with the aim of minimizing donor site morbidities. Here we systematically review the various tissue engineering methods applied to human alveolar cleft defects. An electronic search was conducted in the PubMed database up to March 2014. Tissue engineering studies on human alveolar subjects were included, and experiments that did not report quality or quantity of new regenerated bone were excluded. Twenty human experiments were included in our review. Regenerative techniques for alveolar cleft bone reconstruction were divided into cell therapy, growth factor application, and a combination of both cell therapy and growth factor. Using these three regenerative methods, a wide range of new bone formation percentages were reported. Due to insufficient evidence and controlled clinical trials, the treatment efficacy of tissue engineering in alveolar cleft bone defects could not be determined. Well-designed controlled studies are needed so that detailed outcomes can be properly compared.