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Journal of Dental Research
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*Cleft Lip and Palate
*Head and Brain Malformations
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CRITICAL REVIEWS IN ORAL BIOLOGY & MEDICINE

Myofibroblasts in Palatal Wound Healing: Prospects for the Reduction of Wound Contraction after Cleft Palate Repair

H.E. van Beurden1, J.W. Von den Hoff1, R. Torensma2,*, J.C. Maltha1 and A.M. Kuijpers-Jagtman1

1 Department of Orthodontics and Oral Biology, and 2 Department of Tumor Immunology. Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands;

Correspondence: * corresponding author, r.torensma{at}ncmls.ru.nl

The surgical closure of orofacial clefts is considered to impair maxillary growth and dento-alveolar development. Wound contraction and subsequent scar tissue formation, during healing of these surgical wounds, contribute largely to these growth disturbances. The potential to minimize wound contraction and subsequent scarring by clinical interventions depends on the surgeon’s knowledge of the events responsible for these phenomena. Fibroblasts initiate wound contraction, but proto-myofibroblasts and mature myofibroblasts are by far the most important cells in this process. Myofibroblasts are characterized by their cytoskeleton, which contains alpha-smooth-muscle actin. Additionally, their contractile apparatus contains bundles of actin microfilaments and associated contractile proteins, such as non-muscle myosin. This contractile apparatus is thought to be the major force-generating element involved in wound contraction. After closure of the wound, the myofibroblasts disappear by apoptosis, and a less cellular scar is formed. A reduction of contraction and scarring might be obtained by inhibition of myofibroblast differentiation, stimulation of their de-differentiation, stimulation of myofibroblast apoptosis, or impairment of myofibroblast function. In this review, we will discuss all of these possibilities, which ultimately may lead to a better outcome of cleft palate surgery.

Key Words: cleft palate • wound healing • myofibroblasts • wound contraction.

Journal of Dental Research, Vol. 84, No. 10, 871-880 (2005)
DOI: 10.1177/154405910508401002
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