Tissue Engineering for Oral Mucosa Biofabrication: A Systematic Review and Meta-Analysis

Tissue engineering of oral mucosa has emerged as a promising alternative for reconstructing oral lesions. This systematic review and meta-analysis evaluated advancements in the biofabrication of artificial oral mucosa, focusing on its components, methods, and outcomes. A total of 57 studies were included, primarily preclinical in vitro research. The predominant cell sources were primary oral keratinocytes and fibroblasts, with collagen being the most utilized biomaterial. The immersion and air technique was the main biofabrication method. The meta-analysis revealed an average epithelial thickness of 73.18 μm and a maturation score of 5.13/6. In vivo studies indicated a trend toward greater epithelial stratification compared with in vitro studies. The presence of cellularized stroma, decellularized scaffolds, and custom growth factors correlated with increased epithelial thickness although without statistically significant differences. This study provides a comprehensive overview of the current state of tissue-engineered oral mucosa, highlighting its clinical potential.Impact StatementThis systematic review and meta-analysis provides the most comprehensive synthesis to date of biofabrication strategies for tissue-engineered oral mucosa (TEOM). By critically evaluating 57 studies, it evaluates key design variables-such as biomaterials, cell sources, and culture techniques-and their influence on epithelial thickness and maturation. The findings highlight the translational relevance of TEOM for future clinical applications.