CRANIOFACIAL AND DENTAL TISSUE - 3D Bioprinting and Nanotechnology in Tissue Engineering and Regenerative Medicine - page 185

CHAPTER

9

CRANIOFACIAL AND DENTAL
TISSUE

Michael Larsen, Ruchi Mishra, Michael Miller and David Dean
Department of Plastic Surgery, The Ohio State University, Columbus, OH, USA

9.1 INTRODUCTION
Craniofacial and dental structures are complex tissues that perform vital functions, such as seeing,
hearing, breathing, chewing, tasting, speaking, and protecting the brain and eyes ( Costello et al., 2010 ).
Standard-of-care craniofacial and dental regenerative medicine consists largely of musculoskeletal re-
constructive techniques analogous to orthopedic and general surgical reconstructive techniques, with
special attention to the complex 3D structure ( Figure 9.1 ) ( Sanchez-Lara and Warburton, 2012 ). Most
of these procedures are aimed at restoring function (e.g., mastication) and structure in an aesthetically
appropriate reconstruction. What has changed over the past decade is the expected role that tissue en-
gineering has and will have in regenerative medicine. This is illustrated by the conceptual move away
from research in whole organ regeneration to structure- and defect-specific “regenerative medicine,”
which includes elements of grafting, bone and dental substitute materials, and off-the-shelf or custom
devices. Initial research success in all three of these areas is being translated to the repair of particular
tissue deficits with a focus on the restoration of function through the augmentation of standard-of-care
procedures. Many if not most reconstructive procedures continue to involve transplantation and allo-
plastic hardware or tissue substitutes.
Tissue engineering remains a scientific activity that has the potential to improve therapies for spe-
cific indications. However, tissue engineering has yet to contribute to the craniofacial therapies involv-
ing bone, glands, sense organs, joints, muscles, or dental tissues. Careful study of growth factors and
progenitor cells in restoring failed craniofacial tissues is now done mostly in parallel to research into
surgical therapies, material research, and mass market or patient-specific device research. All of this
research is aimed at improving the treatment of craniofacial patients who suffer from traumatic injuries,
cancer, or congenital deformity.
Custom devices do not yet involve biological components; thus, there is no true “bioprinting” However,
there is initial use of growth factors, such as BMP-2, in some craniofacial therapies. There is much use of
nanotechnology in the development of biomaterials for these implants and other surgical devices. A new
wave of developments is occurring in developing biomaterials with a wide range of properties that can be
rendered in 3D printers. It is likely that those materials will eventually be used as resorbable models, or scaf-
folds, for tissue engineering applications that utilize craniofacially relevant stem cells and growth factors.