Use of Mesenchymal Stem Cells in Facial Bone Tissue Regeneration: An Overview of the Present.

BACKGROUND

Tissue engineering, particularly utilizing mesenchymal stem cells (MSCs), represents a rapidly advancing strategy for craniofacial bone regeneration. While traditional autologous bone grafting remains the standard, its widespread application is severely limited by donor site morbidity, prolonged recovery, and inconsistent results.

PURPOSE: This scoping review aims to map and evaluate the current clinical evidence regarding the application and efficacy of MSCs in human subjects undergoing craniofacial bone regeneration and rehabilitation surgeries, seeking to answer the following research question: In patients with craniofacial anomalies, does the use of MSCs in surgical rehabilitation improve the quality and amount of bone regeneration compared with traditional surgical approaches without MSCs?

STUDY SELECTION: Conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses-extension for Scoping Reviews guidelines, a Boolean literature search was executed across PubMed, Cochrane Library, and BVS (Virtual Health Library, translated into English). Inclusion criteria focused on primary human clinical studies or reports assessing MSCs for maxillofacial bone defects. Only 2 primary clinical studies met the final inclusion criteria, supplemented by selected clinical reports, which reflects the early stage of high-level evidence in this domain.

RESULTS

Four studies were included in the final analysis-two identified through database searching and 2 through other sources-representing approximately 6.5% of the total records identified (n = 62). The analysis of the 2 primary studies and supporting reports suggests that MSC-based therapies, specifically those using deciduous dental pulp stem cells and bone marrow-derived MSCs, successfully promote clinically relevant bone regeneration. For alveolar cleft repair, deciduous dental pulp stem cells combined with scaffolds achieved bone formation comparable to traditional grafts, but with the key advantages of reduced morbidity. Bone marrow-derived MSCs integrated into resorbable scaffolds showed similar results to iliac crest grafts yet significantly decreased patient pain, hospitalization time, and costs. Furthermore, nasal septum chondroprogenitor cells showed early potential for managing mandibular condylar resorption.

CONCLUSIONS AND RELEVANCE: MSC therapies offer a biologically superior, less invasive approach to craniofacial bone defects in comparison with traditional iliac crest bone grafts, showing promising early results for conditions like cleft lip/palate and TMJ disorders. Their relevance lies in the potential to replace morbid autologous grafts.