Engineered Prevascularization for Oral Tissue Grafting: A Systematic Review.

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Oral and Maxillofacial Surgery

Background:

• Dental and periodontal defects often have limited regenerative capacity.
• Current tissue engineering approaches for oral tissues lack robust vascularization, hindering graft integration.
• Developing vascularized oral grafts is crucial for successful regeneration and personalized treatments.

Purpose of the Study:

• To systematically review critical factors and techniques for engineering prevascularized oral tissue grafts.
• To analyze strategies enhancing vascular network formation and host tissue integration in oral tissue engineering.
• To identify optimal methods for creating vascularized oral grafts for potential clinical application.

Main Methods:

• Systematic literature search of PubMed, Cochrane Library, and SCOPUS (last 5 years).
• Inclusion of 24 studies based on strict criteria, focusing on host vasculature connection.
• Analysis of cell types (endothelial, stromal), coculture ratios, preculturing times, and fabrication technologies.

Main Results:

• Coculture of endothelial cells (human umbilical vein) and oral/mesenchymal stem cells (1:1 ratio) was common.
• Preculturing grafts for up to 3 weeks promoted vascular network formation.
• Prevascularized grafts demonstrated significantly faster and higher connection to host vasculature compared to controls, with denser vessels and increased blood flow.

Conclusions:

• Engineered prevascularization is a promising approach to improve oral graft integration with host vasculature.
• Specific cell types, scaffold properties, and fabrication techniques are critical for successful prevascularization.
• Further research in larger animals and human studies is needed for clinical translation of voluminous oral grafts.