Autologous bone grafts provide the golden standard for closure of oronasal fi stulas in the cleft palate. Augmentation may be performed also by homografts and various xenogenic or alloplastic materials to prevent morbidity at the donor site but they may cause many problems (transmission of infections, immune response etc.). All the mentioned approaches also often reveal recurrences of the fi stulas and prolong suffering of the cleft patients. Combination of mesenchymal stem cells (MSCs) and so called "platelet gel" seems to be a perspective method in this way. The platelet gel contains hydroxyapatite particles mixed with platelet rich plasma coagulated under effect of the calcium ions. The MSCs from the pelvic bone marrow aspirate are cultivated on a scaffold (collagen membrane) for 3 -4 weeks before placement into the cleft defect. The method provides promising results in the alveolar clefts. Authors document a successful case of the secondary surgery in 25-year-old man with the unilateral complete cleft (Fig. 5, Ref. 10). Full Text in PDF www.elis.sk.

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In patients with atrophy of the alveolar ridge of classes V and VI according to Cawood and Howell, the distraction osteogenesis (DO) is the only possibility of reconstruction connected with subsequent dental implants. This method was introduced by Ilizarov (1989), a Russian doctor. In the past few years, the distraction devices have undergone several changes and technical improvements. The usage of platelet-rich plasma (PRP) and autologous bone-platelet gel (ABPG) serving as the source of growth factors is considered a signifi cant progress. The increase in the level of growth factors leads to new bone formation and in soft tissues enhances the healing around the bone and bone wound, lowers the risk of postoperative complications such as pain, swelling and bleeding as well as enables fast placement of implants (Ref. 19).

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