Objective To apply rapid prototyping (RP) technology on pre-fabricating nasoalveolar molding (NAM) appliances, and compare clinical outcomes and complications with traditional NAM appliances. Methods Between June 2014 and September 2016, 39 children with unilateral cleft lip and palate were included in study. Seventeen children (test group) had received novel NAM protocol by pre-fabricating NAM appliances using RP technology, and the other 22 children (control group) had received traditional NAM protocol. There was no significant difference in gender, age, the side of cleft lip and palate, and the width of the alveolar cleft gap before treatment between 2 groups (P>0.05). The change of width of the alveolar cleft gap, number of clinic visit, treatment time, and complications were compared between 2 groups. Results The number of clinic visit was less in test group than in control group (P<0.05). There was no significant difference in treatment time between 2 groups (P>0.05). During treatment, there was 16 children (72.2%) of skin irritation, 3 (13.6%) of mucosal ulceration, 1 (4.5%) of intraoral bleeding, 1 (4.5%) of alveolar arch T-shap asymmetry in control group. And there were 11 children (64.7%) of skin irritation, 3 (17.6%) of mucosal ulceration in test group. There was no significant difference in the incidence of complications between 2 groups (P>0.05). After treatment, the anterior alveolar cleft width, horizontal cleft width, sagittal cleft width, antero-medial alveolar ridges angle of the healthy side, angle between anterior alveolar and posterior alveolar baseline of the healthy side, perpendicular distance from buccal frenum point to sagittal line were significantly reduced when compared with the values before treatment (P<0.05). The angle between the anterior segments of two sides, angle between buccal frenum point and posterior baseline were significant increased when compared with the values before treatment (P<0.05). There was no significant difference in the differences between pre- and post-treatment of above indexes between 2 groups (P>0.05). There also was no significant difference in posterior alveolar width, the width between the middle parts of alveolar, vertical cleft width, antero-medial alveolar ridges angle of the affected side, and angle between anterior alveolar and posterior alveolar baseline of the affected side between pre- and post-treatment in each group (P>0.05). Conclusion Clinical outcome of novel approach was equivalent to traditional protocol; however, the number of clinic visit decreased. With improving of RP technology, it would provide a more consistency and convenient way for sequential treatment with cleft lip and palate.
Objective To establ ish a two-dimensional biological printing technique of hBMSCs so as to control the cell transfer process and keep cell viabil ity after printing. Methods Bone marrow (5 mL) was obtained from healthy volunteer. The hBMSCs were regularly subcultured to harvest cells at passage 2, which were adjusted to the single cell suspensionat a density of 1 × 106/mL. The experiment was divided into 3 groups: printing group 1 in which cells underwent propidium iodide (PI) fluorescent label ing, then were transferred by rapid prototype biological printer (interval in x-axis 300 μm, interval in y-axis 1 500 μm), and laser scanning confocal microscope was appl ied to observe cell fluorescence; printing group 2 in which cells received no PI label ing and were cultured for 2 hours after transfer, Live/Dead viabil ity Kit was adopted to detect cell viabil ity and laser scanning confocal microscope was appl ied to observe cell fluorescence; half of the cells in printing group receiving no Live/Dead viabil ity Kit detection were cultured for 7 days, then inverted microscope was used to observe cell morphology, routine culture was conducted after the adherence of cells, the growth condition of cells was observed dynamically; control group in which steps were the same as the printing group 2 except that cell suspension received no printing. Results Laser scanning confocal microscope observation on the cells in printing group 1 revealed the “cell ink droplets” were distributed regularly and evenly in the two-dimensional layer and each contained 15-35 cells, meeting the requirement of designing two-dimensional cell printing. The cells in printing group 2 went through cell viabil ity test, laser scanning confocal microscope observation showed the fluorescence of cells 30 minutes after cell incubation. There was no significant difference between the control group and the printing groups in terms of cell viabil ity. The printed cells presented normal adherence, good morphology and good growth state 7 days after routine culture. Conclusion Biological printing technique can real ize the oriented, quantificational and regulardistribution of hBMSCs in the two-dimensional plane and lays the foundation for the construction of three-dimensional cellprinting or even organ printing system.