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Adult Mesenchymal Stem Cells: Biological Properties, Characteristics, and Applications in Maxillofacial Surgery

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Background

Bone marrow (BM) is a complex, heterogeneous cellular milieu comprised of HSCs, adipocytes, osteoblasts, endothelial cells, smooth muscle cells, and MSCs. BM was traditionally recognized for its role in hematopoiesis.30 In a pioneering study conducted over 30 years ago, Friedenstein et al31 proposed that BM of postnatal organisms contained adherent fibroblastic cells capable of giving rise to bone and cartilage-like colonies. Originally named “colony forming unit-fibroblast (CFU-F),” these

Cell-Based Tissue Engineering

Tissue deficiencies in the maxillofacial region most frequently arise as a result of postcancer ablative surgery, infection, trauma, deforming skeletal diseases, or congenital malformations,67, 68 leaving the reconstructive surgeon with the great challenge of repairing the defects with the use of alloplastic materials or limited autogenous tissues, each of which with inherent limitations, including hemorrhage, nerve damage, cosmetic disability, pain, infection, and loss of function.69 Tissue

Craniofacial Skeleton

The repair of bony defects in the craniofacial skeleton is a major challenge in maxillofacial surgery, for traditional grafting techniques require substantial time and effort with associated risk of morbidity. The issue of bone regeneration is at the forefront of current tissue engineering applications.43 To date a number of delivery vehicles (eg, porous ceramics of hydroxyapatite, and β-tricalcium phosphate) loaded with MSCs have been employed to heal critical-sized segmental bone defects.85

Future Directions

Multipotent MSCs derived from adult tissues present an exciting cell source for applications in the regeneration of tissues in the maxillofacial region. Future therapeutic modalities using MSCs may include direct implantation and/or in vitro/ex vivo tissue engineering, in combination with biomimetic/biocompatible biomaterials and/or natural or recombinantly derived biologics.43 These cells may also be considered clinically for their ability to deliver genes or gene products. Immediate

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