Are Buccal Fat Pad-Derived Stem Cells Effective in Adults for Maxillary Bone Regeneration? A Systematic Review

Critical-size bone defects in the maxillofacial region remain a major challenge. Although autografts are widely used, they are limited by donor-site morbidity and graft availability. Tissue engineering with mesenchymal stem cells, particularly buccal fat pad-derived stem cells (BFPSCs), offers a promising alternative due to their accessibility and osteogenic potential. This systematic review assesses clinical evidence on the use of BFPSCs for regenerating oro-maxillofacial bone defects in adults. A systematic search was conducted in PubMed/MEDLINE, EMBASE, and Cochrane databases for studies from January 2015 to September 2025. Inclusion criteria were in vivo human studies using BFPSCs for maxillofacial bone regeneration. Excluded were in vitro, animal studies, cell-free BFP applications, and non-original articles. Two reviewers independently screened studies; discrepancies were resolved by a senior reviewer. The level of evidence was assessed using Oxford CEBM criteria. Out of 375 identified articles, 6 clinical studies (including one randomized trial) involving 49 patients met inclusion criteria. BFPSCs were applied alone or with autologous bone. All studies reported favorable clinical and radiologic outcomes; some included histologic data confirming new bone formation. BFPSCs demonstrate promising potential for maxillofacial bone regeneration. However, high-quality studies are needed to confirm effectiveness and define standardized protocols.