Morphopathogenic aspects of tissue factors in bone of primary osteoplasty and rhinoplasty in cleft lip palate patients

Cleft lip palate (CLP) is a disruption of facial structure. CLP can cause considerable morbidity to affected children. The last research indicates the identification of tissue remodeling factors, cytokines, and local immunity factors in the pathogenesis of CLP. In this study, we determined a relative number and appearance of the tissue factors in the bone of patients with CLP during the first time plastic alveolar osteoplasty or rhinoplasty. We performed immunohistochemistry with matrix metalloproteinase-8 (MMP-8), matrix metalloproteinase-9 (MMP-9), osteopontin (OPN), osteocalcin (OC), beta-defensin-2 (βdef-2), beta-defensin-3 (βdef-3), interleukin-1 alpha (IL-1α), and interleukin-10 (IL-10). For the quantification of structures, the semi-quantitative census method was used. Spearman rank-order correlation coefficient and Mann-Whitney U test were used for statistical analysis. We observed a significantly higher number of OPN positive osteocytes in the CLP group when compared to the control group (p=0.002). The number of OC positive osteocytes (p=0.000) and βdef-2 positive osteocytes (p=0.003) was significantly lower in the CLP group in comparison to the control group. We detected strong, positive correlations between IL-10 and OC (rs=0.608; p=0.002), IL-1α and MMP-9 (rs=0.666; p=0.000), OPN and MMP-8 (rs=0.620; p=0.002) in the CLP group. Increased appearance of OPN positive osteocytes in the bone of the CLP patients shows increased bone homeostasis on the basis of seriously decreased mineralization, which could indicate a compensatory reaction to decreased quality of postsurgical bone. A tendency for the increased appearance of MMP-8, MMP-9 positive osteocytes of the CLP patients, suggests the elevated bone tissue remodeling properties. The low appearance of IL-10, βdef-2 and βdef-3, and positive osteocytes in the bone of the CLP patients indicate the tendency for reduced anti-inflammatory mechanisms.