Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects.

中文翻译：

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腭裂组织工程中的创新分子和细胞疗法

唇裂和/或腭裂是最普遍的口面部出生缺陷，发生在全世界约 1:700 的活人出生中。早期的产后手术干预是广泛的，分阶段进行，以实现腭架的最佳生长和融合。严重的裂隙缺损对仅通过手术进行矫正提出了挑战，导致并发症和后遗症需要终生的多学科护理。材料科学创新方面取得的进展，包括用于精密组织工程的基于支架的输送系统，现在为在腭裂手术矫正部位刺激骨形成提供了新途径。在这项研究中，我们回顾了目前关于可能在腭发育过程中出错的关键发育事件的科学文献，以及常见的手术实践和在纠正裂隙缺陷方面面临的挑战。在翻译到人类的背景下讨论了与腭发生有关的关键骨诱导途径如何为腭裂矫正结构的设计和优化提供信息。最后，我们强调了新的成骨药物和创新的递送系统，它们有可能被用于基于工程的治疗方法中，以纠正腭缺陷。