Abstract
Tissue engineering is a promising alternative that may facilitate bony regeneration
in small defects in compromised host tissue as well as large mandibular defects. This
scoping systematic review was therefore designed to assess in vivo research on its
use in the reconstruction of mandibular defects in animal models. A total of 4524
articles were initially retrieved using the search algorithm. After screening of the
titles and abstracts, 269 full texts were retrieved, and a total of 72 studies included.
Just two of the included studies employed osteonecrosis as the model of mandibular
injury. All the rest involved the creation of a critical defect. Calcium phosphates,
especially tricalcium phosphate and hydroxyapatite, were the scaffolds most widely
used. All the studies that used a scaffold reported increased formation of bone when
compared with negative controls. When combined with scaffolds, mesenchymal stem cells
(MSC) increased the formation of new bone and improved healing. Various growth factors
have been studied for their potential use in the regeneration of the maxillofacial
complex. Bone morphogenic proteins (BMP) were the most popular, and all subtypes promoted
significant formation of bone compared with controls. Whilst the studies published
to date suggest a promising future, our review has shown that several shortfalls must
be addressed before the findings can be translated into clinical practice. A greater
understanding of the underlying cellular and molecular mechanisms is required to identify
the optimal combination of components that are needed for predictable and feasible
reconstruction or regeneration of mandibular bone. In particular, a greater understanding
of the biological aspects of the regenerative triad is needed before we can to work
towards widespread translation into clinical practice.
Keywords
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Published online: April 01, 2020
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© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
