Subscribe to RSS
DOI: 10.1055/s-0043-1769808
Tissue Engineering: Current Technology for Facial Reconstruction
![](https://www.thieme-connect.de/media/fps/202305/lookinside/thumbnails/10-1055-s-0043-1769808_2023040056oa-1.jpg)
Abstract
Facial reconstruction is a complex surgical process that requires intricate three-dimensional (3D) concepts for optimal functional and aesthetic outcomes. Conventional reconstruction of structural facial anomalies, such as those including cartilage or bony defects, typically rely on hand-carving autologous constructs harvested from a separate donor site, and shaping that cartilage or bone into a new structural framework. Tissue engineering has emerged in recent decades as a potential approach to mitigate the need for donor site morbidity while improving precision in the design of reconstructive construct. Computer-aided design and computer-aided manufacturing have allowed for a digital 3D workflow to digitally execute the planned reconstruction in virtual space. 3D printing and other manufacturing techniques can then be utilized to create custom-fabricated scaffolds and guides to improve the reconstructive efficiency. Tissue engineering can be paired with custom 3D-manufactured scaffolds to theoretically create an ideal framework for structural reconstruction. In the past decade, there have been several compelling preclinical studies demonstrating the capacity to induce chondrogenesis or osteogenesis in a custom scaffold. However, to date, these preclinical data have not yet translated into significant clinical experience. This translation has been hindered by a lack of consensus on the ideal materials and cellular progenitors to be utilized in these constructs and a lack of regulatory guidance and control to enable clinical application. In this review, we highlight the current state of tissue engineering in facial reconstruction and exciting potential for future applications as the field continues to advance.
Publication History
Article published online:
08 June 2023
© 2023. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Green H, Kehinde O, Thomas J. Growth of cultured human epidermal cells into multiple epithelia suitable for grafting. Proc Natl Acad Sci U S A 1979; 76 (11) 5665-5668
- 2 Berthiaume F, Maguire TJ, Yarmush ML. Tissue engineering and regenerative medicine: history, progress, and challenges. Annu Rev Chem Biomol Eng 2011; 2: 403-430
- 3 Chung JJ, Im H, Kim SH, Park JW, Jung Y. Toward biomimetic scaffolds for tissue engineering: 3D printing techniques in regenerative medicine. Front Bioeng Biotechnol 2020; 8: 586406
- 4 Chan BP, Leong KW. Scaffolding in tissue engineering: general approaches and tissue-specific considerations. Eur Spine J 2008; 17 (Suppl 4, Suppl 4): 467-479
- 5 Kwon SG, Kwon YW, Lee TW, Park GT, Kim JH. Recent advances in stem cell therapeutics and tissue engineering strategies. Biomater Res 2018; 22: 36
- 6 Ren X, Zhao M, Lash B, Martino MM, Julier Z. Growth factor engineering strategies for regenerative medicine applications. Front Bioeng Biotechnol 2020; 7: 469
- 7 Cao Y, Vacanti JP, Paige KT, Upton J, Vacanti CA. Transplantation of chondrocytes utilizing a polymer-cell construct to produce tissue-engineered cartilage in the shape of a human ear. Plast Reconstr Surg 1997; 100 (02) 297-302 , discussion 303–304
- 8 Nyirjesy SC, Heller M, von Windheim N. et al. The role of computer aided design/computer assisted manufacturing (CAD/CAM) and 3- dimensional printing in head and neck oncologic surgery: a review and future directions. Oral Oncol 2022; 132: 105976
- 9 Yoon M, Chougule P, Dufresne R, Wanebo HJ. Localized carcinoma of the external ear is an unrecognized aggressive disease with a high propensity for local regional recurrence. Am J Surg 1992; 164 (06) 574-577
- 10 Popko M, Bleys RL, De Groot JW, Huizing EH. Histological structure of the nasal cartilages and their perichondrial envelope. I. The septal and lobular cartilage. Rhinology 2007; 45 (02) 148-152
- 11 Lavernia L, Brown WE, Wong BJF, Hu JC, Athanasiou KA. Toward tissue-engineering of nasal cartilages. Acta Biomater 2019; 88: 42-56
- 12 Zopf DA, Mitsak AG, Flanagan CL, Wheeler M, Green GE, Hollister SJ. Computer aided-designed, 3-dimensionally printed porous tissue bioscaffolds for craniofacial soft tissue reconstruction. Otolaryngol Head Neck Surg 2015; 152 (01) 57-62
- 13 Shafiee A, Seyedjafari E, Sadat Taherzadeh E, Dinarvand P, Soleimani M, Ai J. Enhanced chondrogenesis of human nasal septum derived progenitors on nanofibrous scaffolds. Mater Sci Eng C 2014; 40: 445-454
- 14 Chiesa-Estomba CM, Aiastui A, González-Fernández I. et al. Three-dimensional bioprinting scaffolding for nasal cartilage defects: a systematic review. Tissue Eng Regen Med 2021; 18 (03) 343-353
- 15 Fulco I, Miot S, Haug MD. et al. Engineered autologous cartilage tissue for nasal reconstruction after tumour resection: an observational first-in-human trial. Lancet 2014; 384 (9940): 337-346
- 16 Hoshi K, Fujihara Y, Saijo H. et al. Three-dimensional changes of noses after transplantation of implant-type tissue-engineered cartilage for secondary correction of cleft lip-nose patients. Regen Ther 2017; 7: 72-79
- 17 Kamil SH, Kojima K, Vacanti MP, Bonassar LJ, Vacanti CA, Eavey RD. In vitro tissue engineering to generate a human-sized auricle and nasal tip. Laryngoscope 2003; 113 (01) 90-94
- 18 Shieh SJ, Terada S, Vacanti JP. Tissue engineering auricular reconstruction: in vitro and in vivo studies. Biomaterials 2004; 25 (09) 1545-1557
- 19 Chang B, Cornett A, Nourmohammadi Z. et al. Hybrid three-dimensional-printed ear tissue scaffold with autologous cartilage mitigates soft tissue complications. Laryngoscope 2021; 131 (05) 1008-1015
- 20 Uto S, Hikita A, Sakamoto T. et al. Ear cartilage reconstruction combining induced pluripotent stem cell-derived cartilage and three-dimensional shape-memory scaffold. Tissue Eng Part A 2021; 27 (9-10): 604-617
- 21 Zhou G, Jiang H. Yin Z, et al. In vitro regeneration of patient-specific ear-shaped cartilage and its first clinical application for auricular reconstruction. EBioMedicine 2018; 28: 287-302
- 22 Shen Z, Hu Y, Zhou C. et al. ESRRG promoter hypermethylation as a diagnostic and prognostic biomarker in laryngeal squamous cell carcinoma. J Clin Lab Anal 2019; 33 (06) e22899
- 23 Chen J, Shen Y, Shen Z, Cheng L, Zhou S. Tissue engineering of the larynx: a contemporary review. J Clin Lab Anal 2021; 35 (02) e23646
- 24 Ansari T, Lange P, Southgate A. et al. Stem cell-based tissue-engineered laryngeal replacement. Stem Cells Transl Med 2017; 6 (02) 677-687
- 25 Nyirjesy SC, Yu J, Dharmadhikari S. et al. Successful early neovascularization in composite tracheal grafts. Otolaryngol Head Neck Surg 2023; DOI: 10.1002/ohn.350.
- 26 Kasper FK, Melville J, Shum J, Wong M, Young S. Tissue engineered prevascularized bone and soft tissue flaps. Oral Maxillofac Surg Clin North Am 2017; 29 (01) 63-73
- 27 Petrovic V, Zivkovic P, Petrovic D, Stefanovic V. Craniofacial bone tissue engineering. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114 (03) e1-e9
- 28 Aghali A. Craniofacial bone tissue engineering: current approaches and potential therapy. Cells 2021; 10 (11) 10
- 29 Yadav P, Roychoudhury A, Kumar RD, Bhutia O, Bhutia T, Aggarwal B. Total alloplastic temporomandibular joint replacement. J Maxillofac Oral Surg 2021; 20 (04) 515-526
- 30 Wolford LM, Pitta MC, Reiche-Fischel O, Franco PF. TMJ Concepts/Techmedica custom-made TMJ total joint prosthesis: 5-year follow-up study. Int J Oral Maxillofac Surg 2003; 32 (03) 268-274
- 31 Ângelo DF, Gil FM. Tissue engineering in temporomandibular joint reconstruction. Atlas Oral Maxillofac Surg Clin North Am 2022; 30 (02) 235-246
- 32 Abukawa H, Terai H, Hannouche D, Vacanti JP, Kaban LB, Troulis MJ. Formation of a mandibular condyle in vitro by tissue engineering. J Oral Maxillofac Surg 2003; 61 (01) 94-100
- 33 Kokemueller H, Spalthoff S, Nolff M. et al. Prefabrication of vascularized bioartificial bone grafts in vivo for segmental mandibular reconstruction: experimental pilot study in sheep and first clinical application. Int J Oral Maxillofac Implants 2010; 39 (04) 379-387
- 34 Weiss II RO, Wong PE, Reddy LV. Immediate reconstruction of segmental mandibular defects via tissue engineering. Proc Bayl Univ Med Cent 2022; 35 (03) 391-393
- 35 Cao SS, Li SY, Geng YM. et al. Prefabricated 3D-printed tissue-engineered bone for mandibular reconstruction: a preclinical translational study in primate. ACS Biomater Sci Eng 2021; 7 (12) 5727-5738
- 36 Dey M, Ozbolat IT. 3D bioprinting of cells, tissues and organs. Sci Rep 2020; 10 (01) 14023
- 37 VanKoevering KK, Zopf DA, Hollister SJ. Tissue engineering and 3-dimensional modeling for facial reconstruction. Facial Plast Surg Clin North Am 2019; 27 (01) 151-161
- 38 Orash Mahmoud Salehi A, Heidari-Keshel S. Poursamar SA, et al. Bioprinted membranes for corneal tissue engineering: a review. Pharmaceutics 2022; 14 (12) 2797
- 39 Zhang J, Xu W, Li C. et al. Tissue engineering microtissue: construction, optimization, and application. Tissue Eng Part B Rev 2022; 28 (02) 393-404