Bioprinting for craniofacial reconstruction: A review of advancements, clinical use, and challenges

Craniofacial reconstructive surgery faces significant challenges due to complex anatomy, intricate vascularization requirements, and the limitations of traditional grafts. Recent advancements in three-dimensional (3D) bioprinting technology present a promising paradigm shift, offering precise, patient-specific solutions for repairing critical zygomatic, orbital, nasal, and mandibular defects. This review systematically examines the latest breakthroughs in bioprinting methods, including extrusion-based, laser-assisted, stereolithography, magnetic bioprinting, spheroid rapid printing, and artificial intelligence integration. Through detailed analysis of clinical applications, we highlight successful case studies demonstrating enhanced surgical outcomes and patient satisfaction, particularly in complex zygomatic reconstructions and delicate orbital floor repairs. Furthermore, we explore the novel bioink formulations, emphasizing hydrogel composites and biofunctional materials optimized for craniofacial tissue regeneration, while addressing persistent technical and biological challenges such as vascularization, immune compatibility, and regulatory hurdles. Finally, we outline strategic pathways for advancing clinical translation, advocating for interdisciplinary collaboration, standardization, and innovative integration of artificial intelligence-driven optimization to accelerate the adoption of bio-printed constructs into clinical practice. Overall, 3D bioprinting represents a transformative frontier in craniofacial reconstruction, poised to significantly improve patient outcomes and reshape surgical approaches to complex head and neck defects.