Mandibular distraction osteogenesis assisted by cell-based tissue engineering: A systematic review

Abstract

Objectives: To review the advances and limitations of recent investigations on mandibular distraction osteogenesis (MDO) assisted by mesenchymal stem cell (MSC) transplantation. Materials and Methods: Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, the PubMed, Scopus, and Cochrane electronic databases were systematically searched and screened from their inception through August 2014. Searching terms included the following: 'distraction osteogenesis', 'mandible OR mandibular OR jaw', and 'cells', without any other limitations. Results: Nineteen studies meeting the eligibility criteria were selected from 227 published articles and used for qualitative synthesis. Fifteen of the studies used small animal models (rats or rabbits), while the other four used large animal models (dogs, pigs or sheep). Among these studies, large variations exist in MDO protocol, cell transplantation time, route and quantity, as well as methodology of outcome assessment. Additionally, all studies had certain biases. Nevertheless, the majority of studies found that MSC transplantation enhanced MDO bone regeneration. Conclusion: Evidence from animal studies indicates that MDO may be enhanced by mesenchymal stem cell transplantation, but many questions related to animal models, MDO protocols, and cell transplantation remain to be investigated.