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

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 contract...

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Bibliographic Details
Published in:Journal of Dental Research 2005-10, Vol.84 (10), p.871-880
Main Authors: van Beurden, H.E., Von den Hoff, J.W., Torensma, R., Maltha, J.C., Kuijpers-Jagtman, A.M.
Format: Article
Language:English
Subjects:
Animals
Apoptosis - physiology
Cell Differentiation - physiology
Cell Lineage
Cicatrix - pathology
Cleft Palate - surgery
Contractile Proteins - physiology
Dentistry
Fibroblasts - cytology
Granulation Tissue - cytology
Granulation Tissue - physiology
Maxillofacial Development
Myoblasts - cytology
Treatment Outcome
Wound Healing - physiology
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Summary: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.
ISSN:0022-0345
1544-0591
DOI:10.1177/154405910508401002