Oral and Maxillofacial Tissue Engineering with Adipose-Derived Stem Cells

Oral and maxillofacial tissues are a complex array of bone, cartilage, soft tissue, nerves and vasculature. Damage to these structures, even when minimal, usually leads to noticeable deformities. Therefore, the repair of large segmental bone defects of the jaw or mandible due to trauma, inflammation, or tumor surgery remains a major clinical problem. For many years, simple autogenic, allogenic, or xenogenic bone grafts, or combinations thereof, have been the mainstay for tissue replacement [1]. However, when large bone defects are present, advanced approaches such as free tissue transfer with microvascular reanastomosis of vascularized flaps from distant sites including the fibula, iliac crest, scapula, and radius are needed to repair or regenerate a functionally complex tissue such as maxillofacial tissue [2, 3]. While these procedures have proven to be reliable and effective, they require extended hospitalization, and a secondary donor site with the associated morbidity and complications. As an alternative to current surgical techniques or approaches, developments in tissue engineering using the gene therapy and stem cell biology strive to utilize cells, biomaterial scaffolds and cell signaling factors to regenerate large oral and maxillofacial tissues defect with precise replication of normal body contours. A tissue engineering approach offers several potential benefits, including a decrease in donor site morbidity, a decrease in technical sensitivity of the repair, and the ability to closely mimic the in vivo microenvironment in an attempt to recapitulate normal craniofacial development [1].