新型腭裂组织扩张器和组织工程化腭黏膜对修复腭裂缺损的研究

The aims of cleft repair are to improve feeding, to achieve normal speech, and to minimize maxillary growth restriction. Cleft palate repair is the most important component of cleft surgery not only in that it determines the outcome as far as speech and communication is concerned, but also it that in potentially has the greatest impact on maxillary growth and dental arch relationship. However, the shortage of palatal mucoperiosteal tissue will result in extensive separation between the palatal bone and mucoperiosteum, and even lateral releasing incisions, and further maxillary growth restriction. Studies demonstrated that the sufficient palatal mucoperiosteum in site would promise the normal development and growth of maxilla. Consquently, two efficient methods, tissue expander and tissue engineering mucosa, have been reported by present. Nevertheless, previous researches have not showed which of these are more reliable, meanwhile, the specific techniques should be updated. Our group would like to develop a novel tissue expander which is supposed to be a kind of hydrogel, anisotopic, soluble and with controlled rate and extent, as well as tissue engineering mucosa of porcine small intestinal submucosa(SIS) with cultured autologous oral mucosal epithelial cells(OMECs) for cleft palate repair. Furthermore, the short-term effects on soft palatal tissue and the long-term influences on the maxillary growth will be measured from cellular, organic and animal aspects by using molecular biology and imageology techniques, after these devices are implanted in animals. Finally, patients with cleft palate will have their palate repaired with tissue expander or tissue engineering mucosa, and standards will be established to evoluate the safety and practicality, in order to find a better way for cleft palate treatment.

腭裂整复中常常由于上腭粘骨膜组织量不足而行广泛骨膜下分离，甚至松弛切口遗留裸露骨面，对上颌骨生长发育造成严重的负面影响。国内外研究已证实，足量硬腭原位组织的存在是预防硬腭裸露骨面颌骨生长受限有效途径，且可行的方法有组织扩张技术和构建组织工程化黏膜法，但具体技术有待更新和提高，更不清楚何种方法更为有效。本课题组拟通过研制定向膨胀、程度可控、时相可控的水凝胶组织扩张器和构建以猪小肠黏膜下层为支架、口腔黏膜上皮细胞为种子细胞的组织工程化黏膜，并将其植入实验动物体内，利用分子生物学等技术从细胞、器官、动物实验等体内体外多角度来探讨新型组织扩张器和组织工程化黏膜对腭部软组织的短期影响、对上颌骨生长发育的长期影响及其生物相容性。进而应用于临床，观察其实际应用的可行性，制定评价标准，筛选出一条腭裂治疗的最佳途径。