Tissue engineering combines cells, scaffolds, and growth factors to regenerate tissues and organs. The three main components are mesenchymal stem cells harvested from sources like bone marrow and dental pulp, biodegradable scaffolds for cells to attach to and grow through, and signaling molecules like BMPs and FGF to stimulate cell growth. Applications in oral and maxillofacial surgery include bone regeneration using stem cells and scaffolds with growth factors to repair mandibular defects, cartilage regeneration for tissues like the TMJ, and soft tissue engineering for constructs like oral mucosa equivalents. Stem cell transplantation also offers possibilities for treating conditions like thalassemia and cancer.
2. IN A NUTSHELL
Tissue engineering is an interdisciplinary field that applies the principles of
engineering & the life science towards the development of biological substitutes
that restore, maintain, or improve tissue function.
LANGER & J.VACANTI – 1993.
3. STILL THOUSANDS DIE WHILE WAITING FOR A
TRANSPLANT, AND THOUSANDS MORE AREN’T
EVEN ON THE LIST.
4. TISSUE ORIGINS
• EMBRYONIC
CELLS PRESENT
MOLECULES ON
THEIR
MEMBRANES
THAT AID IN THE
EARLY
ORGANIZING
PROCESS
• ECTODERM,
MESODERM,
ENDODERM
5. 4 TYPES OF TISSUE
• EPITHELIAL, CONNECTIVE, MUSCLE, NERVOUS
• THEY’VE ALL GOT AN E.C. MATRIX (ECM)
AROUND THEM.
• WHETHER SOFT AS IN BLOOD, TO HARD AS IN BONE.
• BIG QUESTION: HOW DO THE CELLS KNOW
WHAT TO BECOME, HOW DO THEY KNOW TO
STAY THAT WAY?
6. Tissue engineering is composed of three
pillars: the cells, scaffolds, and growth
factors.
The combination of cells in a suitable
scaffold was designed by the appropriate
biochemical signals
Basic principles of tissue engineering
12. Embryonic stem cells are
capable of multipotential
differentiation but clinical
feasibility is limited due to
ethical issues.
Embryonic stem cells has a
potential to differentiate into
germ layers namely
ectoderm, endoderm and
mesoderm.
13. Adult stem cells are multipotent stem cells.
They have been harvested from different kind of tissues like
bone marrow, umbilical cord, amniotic fluid, brain tissue, liver,
pancreas, cornea, dental pulp, and adipose tissue.
Adult stem cells are comparatively easier to isolate and do not
have any ethical issues
14. Induced pluripotent stem cells(IPS) is an evolving
concept in which 3–4 genes found in the stem cells are
transfected into the donor cells using appropriate
vectors. The stem cells thus derived by culturing will
have properties almost like embryonic stem
cells.
15. Stem cells from oral and maxillofacial region predominantly
contain mesenchymal stem cells.
Stem cells from oral and maxillofacial region .
16. • Dental pulp stem cells (DPSCs)
• Stem cells from exfoliated deciduous teeth (SHED)
• Periodontal ligament stem cells (PDLSCs)
• Stem cells from apical papilla (SCAP)
• Dental follicle progenitor cells (DFPCs)
These dental stem cells have MSC like qualities,
such as self-renewal and differentiation
potential.
17. Regeneration of craniofacial defects!!
Stem cells can be useful correct large craniofacial defects
due to cyst enucleation, tumor resection, and trauma.
18. Adipose derived stem cells was used to treat the calvarial defect (120
cm2) of a 7-year-old girl who had severe head injury.
Autologous adipose stem cells were extracted from gluteal region along
with iliac crest bone graft. Autologous fibrin glue that holds the cells in
place was prepared by cryoprecipitation.
Adipose derived stem cells
19. CANCER TREATMENT
(Stem cell transplantation)
Stem cell transplants replace the stem cells destroyed by
high dose cancer treatment allowing your bone marrow to
produce healthy cells.
20. Moinam was diagnosed Thalassemia when he was barely
one year old. If left untreated, most of the children
inflicted with this disorder do not live beyond the age of
10. Fortuitously, his newborn sister was free from
Thalassemia and her cord blood stem cells were a perfect
match for Moinam, with small amount of bone marrow to
supplement the transplant.
21. SCAFFOLDS
• ALLOW CELL ATTACHMENT AND MIGRATION
• DELIVER AND RETAIN CELLS AND BIOCHEMICAL FACTORS
• ENABLE DIFFUSION OF VITAL CELL NUTRIENTS AND
EXPRESSED PRODUCTS
• EXERT CERTAIN MECHANICAL AND BIOLOGICAL INFLUENCES
TO MODIFY THE BEHAVIOR OF THE CELL PHASE
• NEED A CERTAIN POROSITY, BIODEGRADABILITY,
22. • THIS ANIMATION OF A
ROTATING CARBON NANOTUBE
SHOWS ITS 3D STRUCTURE.
24. • QUESTIONS HOW TO GET THE
GROWTH HORMONES AND
CELLS TO THE SCAFFOLD IN
THE RIGHT CONC. AT THE
RIGHT TIMES.
• NOTE: THIS MOUSE DIDN’T
GROW THE EAR, A SCAFFOLD
WAS PLACED IN IT, AND THE
CELLS GREW AROUND THE
SCAFFOLD.
26. BIO REACTORS
• SYSTEMS THAT SUPPORT
BIOLOGICALLY ACTIVE
ENVIRONMENT
• DEVICE FOR GROWING
CELLS
• LOTS OF VARIABLES TO
CONTROL
• NASA’S DESIGNING ONE TO
SEE IF MICROGRAVITY IS A
BETTER ENVIRONMENT TO
GROW TISSUESPEOPLE
NEVER GET OFF THIS
WAITING LIST.
27. ROLE OF TISSUE ENGINEERING IN OMFS.
1.Bone regeneration
2.Cartilage regeneration.
3.Soft tissue regeneration.
4.Salivary gland regeneration.
5.Fat, muscle, & nerve regeneration.
28. Soft tissue engineering.
The engineered full thickness of oral mucosa constucts are commonly referred
to as Ex vivo produced oral mucosa equivalent (EVPOME) & Alloderm are
Commercially available tissue engineered oral mucosa.
Commercially available skin substitutes:Alloderm ( Dead de epidermized
dermis) & Integra ( collagen sponge)
29. In craniofacial region, cartilage present in the Articular disc of TMJ,
Nasal septum, & Ear.
Cartilage regeneration:
Cells with chondrogenic potential like Bone marrow derived
mesenchymal cells, & Periosteum derived mesenchymal cells are
used, with scaffolds such as Carbon fiber Pads, collagen gels,..in
presence of FGF2, FGF-B, bFGF.
30. BONE REGENERATION
Mesenchymal stem cells are best cells as they convert into Osteoblasts &
Osteocalsts. BMP 7, BMP 2, PRP & PDGF are the growth factors with
Scaffolds namely Polymers, Bovine collagen, Tricalcium phosphate.
This regenerated bone can be used in Mandibular defects, Maxillary cleft repair,
Ridge augmentation & Maxillary sinus augmentation.
Editor's Notes
Still thousands die while waiting for a transplant, and thousands more aren’t even on the list.
