Combining autologous bone marrow mononuclear cells seeded on collagen sponge with Nano Hydroxyapatite, and platelet-rich fibrin: Reporting a novel strategy for alveolar cleft bone regeneration

Introduction: The aim of this study was to examine and assess the use of autologous bone marrow mononuclear cells (BMMNCs) combined with platelet-rich fibrin (PRF) and nanohydroxyapatite for bone regeneration as an effective technique for alveolar cleft repair. Patients and methods: This study included 20 patients with unilateral alveolar cleft defects and with an age range of 8-15 years. They were divided equally into two groups: Group A, received treatment via the regenerative approach which includes; autologous BMMNCs seeded on a collagen sponge in combination with nanohydroxyapatite and autologous PRF. Group B, received the standard alveolar bone grafting with iliac crest bone. The effectiveness of the new technique was evaluated and compared to the standard grafting technique through a 12-month follow-up via clinical and radiographic assessments. Results: During the 12-month follow-up, Group A exhibited less donor site complications, faster and better soft tissue healing, and less postoperative pain, when compared to group B. 90% of the cases in group A, exhibited complete alveolar bone union verses 70% only in group B. Conclusion: Combination of BMMNCs, nanohydroxyapatite, and PRF greatly promote bone regeneration in alveolar cleft defects providing an alternative novel therapeutic strategy to the standard alveolar bone grafting. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.