Tissue engineering in oral and maxillofacial surgery: From lab to clinics

Abstract

Tissue engineering has been considered as a third treatment modality complementing medicine and surgery. It was first defined in 1993 by Langer and Vacanti (Science 260:920-926, 1993). Today it is a rapidly growing field of research expanding to all disciplines in medicine. Currently, it is possible to engineer both hard and soft tissues in oral and maxillofacial surgery. Tissue engineering consists usually of three components: scaffolds, cells, and regulating factors. Scaffolds are preferably biodegradable, i.e., they resorb when they are no longer needed, while regenerated tissue fills the space of resorbed material. Different types of cells can be used depending on the type of required tissue. Both stem cells and differentiated cells have been used, while regulating factors are most often growth factors. The growth of vascularization, to enable adequate delivery of nutrients and oxygen, must also be taken into account when constructs are of large size and diffusion is not enough to keep the construct vital. Regulating factors can be proteins, such as growth factors, culture media ingredients, and structural or physical elements. The required tissue can be manufactured either in the body, on the site of the defect, or ectopically, for example, in the muscular environment from where it is transplanted later, when mature enough, to the defect site. In this chapter, the past and the present of tissue engineering in oral and maxillofacial surgery will be elaborated, not forgetting the future perspectives.