Hard Tissue Engineering
Hard tissues in craniomaxillofacial (CMF) area include bone, cartilage, and teeth. The need for tissue engineering comes from ablation of tissues due to tumors (both benign as well as malignant), trauma, or congenital defects.
In CMF hard tissue reconstruction, two important principles need to be considered. The form and function must be restored together with good esthetic outcome. The CMF skeleton is very complex structure, and hence, symmetry, volume, shape, and bone continuity must be restored. If cartilage in the temporomandibular joint is missing, ideally that should be reconstructed as well. Engineering missing teeth remains currently a challenge. Soft tissue engineering, which sometimes is needed simultaneously to cover the hard tissue reconstruct, is discussed in Chap. 5.
Optimal result in CMF tissue engineering will enable several functions like mimics, mastication, swallowing, and articulation. The reconstruction should be considered as marriage of both esthetic and reconstructive objectives.
Hard tissue engineering in carried out in patients who do not benefit from traditional methods, such as free flaps, to reconstruct lost tissue. The defect might have been caused by tumor ablation, trauma, or it can be congenital, such as cleft lip and palate.
Hard tissue engineering is usually carried out from mesenchymal stem cells (bone marrow or adipose tissue-derived), together with biomaterials and regulating factors, such as growth factors. 3D printing will most likely be used in the future to produce even more accurate form for the reconstruct.
KeywordsBone Cartilage Tooth Tissue engineering Mesenchymal stem cells Biomaterials
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