Bone repair cells for craniofacial regeneration

Abstract

Reconstruction of complex craniofacial deformities is a clinical challenge in situations of injury, congenital defects or disease. The use of cell-based therapies represents one of the most advanced methods for enhancing the regenerative response for craniofacial wound healing. Both somatic and stem cells have been adopted in the treatment of complex osseous defects and advances have been made in finding the most adequate scaffold for the delivery of cell therapies in human regenerative medicine. As an example of such approaches for clinical application for craniofacial regeneration, Ixmyelocel-T or bone repair cells are a source of bone marrow derived stem and progenitor cells. They are produced through the use of single pass perfusion bioreactors for CD90+ mesenchymal stem cells and CD14+ monocyte/macrophage progenitor cells. The application of ixmyelocel-T has shown potential in the regeneration of muscular, vascular, nervous and osseous tissue. The purpose of this manuscript is to highlight cell therapies used to repair bony and soft tissue defects in the oral and craniofacial complex. The field at this point remains at an early stage, however this review will provide insights into the progress being made using cell therapies for eventual development into clinical practice.

Figure 1. Tissue engineering applications in the craniofacial complex

Several clinical scenarios can benefit from the application of tissue engineering approaches, such as cell therapy. In order to accommodate dental implants deficient maxillary and mandibular alveolar ridges can be expanded horizontally (A, B), vertically (C, D), or both vertically and horizontally (E, F, G, H).

Figure 2. Cell therapy technologies for regenerative medicine

A) Cell therapy provides an additional source of cells in the area of interest. After harvesting a tissue sample, the cells are expanded, manipulated, and loaded onto a carrier. Similarly, Ixmyelocel-T is harvested from the own patient, expanded through a completely automated and closed SPP system and loaded into a scaffolding material (i.e. gelatin foam, β-TCP). When grafted in a bone defect, Ixmyelocel-T promotes enhanced bone regeneration and maturation. B) Injected, particulated, prefabricated solid, or image-based solid scaffolds are available in tissue engineering. Thanks to the integration of these newly available technologies new perspectives for enhanced outcomes in the regeneration of craniofacial structures can be explored.