Tissue Engineering in Oral and Maxillofacial Surgery: From Lab to Clinics

Regenerative medicine aims at the functional restoration of tissue malfunction, damage or loss, and can be divided into three main approaches. Firstly, the cell-based therapies, where cells are administered to re-establish a tissue either directly or through paracrine functions. Secondly, the often referred to as classical tissue engineering, consisting of the combined use of cells and a bio-degradable scaffold to form tissue. Thirdly, there are material-based approaches, which have made significant advances which rely on biodegradable materials, often functionalized with cellular functions (De Jong et al. 2014).
In 1993, Langer and Vacanti, determined tissue engineering as an “interdisciplinary field that applies the principles of engineering and the life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function”. They published this definition in Science in 1993.
Tissue engineering has been classically thought to consist of three elements: supporting scaffold, cells and regulating factors such as growth factors (Fig. 1). Depending on the tissue to be regenerated, all three vary. Currently, it is known, that many other factors may have an effect on the outcome of the regenerate. These include factors enabling angiogenesis, physical stimulation, culture media, gene delivery and methods to deliver patient specific implants (PSI) (Fig. 2).
During the past two decades, major obstacles have been tackled and tissue engineering is currently being used clinically in some applications while in others it is just taking its first baby steps.