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Background: Conventional two-flap palatoplasty technique which is a very common technique used including in our center, will result in lateral defects without any periosteal coverage. In this conventional technique, epithelialization of lateral defect was achieved within 3-4 weeks. These denuded lateral defects are prone to contamination and infection. The wound healing process in these wound will involve wound contraction, trigger scar formation, and will result in maxillary growth impairment. In our center, the retrospective study showed that conventional two-flap palatoplasty technique resulted in a fair maxillary growth (mean Goslon score=3.5). Thus, we explore other technique, which is non-denuded mucoperiosteal palatoplasty technique. We intend not to elevate all layers of mucoperiosteal flap in order to gain lateral defect covered by a thin sub-mucosa and periosteal layer. We assume that this technique will precipitate the re-epithelialization process. Faster re-epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. Method: Total 48 patients with unilateral or bilateral cleft palate were divided into 2 groups. Twenty-four patients underwent the non-denuded mucoperiosteal technique (intervention group) and another 24 patients underwent the conventional two-flap palatoplasty technique (control group). Evaluation of lateral defect closure was done in both groups and compared statistically. Result: Faster epithelialization was significantly influenced by age, WBC count and non-denuded mucoperiosteal technique.Summary: The non-denuded mucoperiosteal technique, along with age and WBC count, significantly accelerate the process of epithelialization of lateral defect post palate repair.

Introduction: Systemic Lupus Erythematosus (SLE) has been quite an enigma in medicine. The possibility of the host own defense mechanism attacking itself is still quite difficult to understand. Patients who suffer from this disease tend to have a problem in their qualities of life, especially as the majority affect female in their productive ages. Conservative therapy to manage this disease is widely developed and implemented. Since the known therapies have several side effects and limitation, a need to develop a new strategy that can re-establish the “tolerance” mechanism of our immune system is increasingly needed. Immunotherapy is already a promising field in the strategy against autoimmune cases. In our facility, we developed immunotherapy called ToM (Tolerogenic Macrophage) which similar to Mreg (Regulatory Macrophage) in order to utilise the “tolerance” ability of this immune apparatus.Case: In this study, we present 2 cases of female patients who suffer from SLE, which underwent ToM Therapy in our Cellcure facility in RSPAD Gatot Soebroto Jakarta-Indonesia. After the procedure the patient was monitored one month and one year. Clinical and control parameter such as ANA (IF) and ANA profile was examined again in both patients to measure the effect of this therapy. The ANA titer and the titer of specific antibodies such as dsDNA, Nucleosomes and Histones results show significant reduction, accompanied by the improvement of the symptoms.Conclusion: ToM Therapy seems to have a good efficacy as immunotherapy for SLE. Further study needed to establish this approach.