Soft tissue and hard tissue engineering in oral and maxillofacial surgery

Autologous, allogenic and alloplastic materials for bony reconstruction in the cranio-maxillofacial area have specific drawbacks, thus stimulating the ongoing search for new (bio-) materials. Cultivated skin and mucosa grafts are in routine clinical use in head and neck reconstruction but so far, to the best of our knowledge, no successful clinical application has been described of periosteum-derived tissue-engineered bone for augmentation of the edentulous posterior maxilla. In a pilot clinical study, augmentation of the posterior maxilla was carried out using a bone matrix derived from mandibular periosteum cells on an Ethisorb fleece. In this paper we demonstrate the fabrication of the matrix, its clinical application, and histological results in two patients. Our results suggest that periosteum-derived osteoblasts on a suitable matrix can form lamellar bone within four months after transplantation and provide a reliable basis for implant insertion.