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Tissue-Engineered Grafts for Orofacial Cleft Repair: A Scoping Review From Bench to Bedside
Joshua Khorsandi1, Adam Jaouhari1, Abu-Bakr Ahmed1
1Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, Las Vegas, NV, USA.
Summary
Tissue-engineered grafts show promise for orofacial cleft repair, but autologous bone remains the standard. Recombinant human bone morphogenetic protein-2 (rhBMP-2) shows potential as an alternative, though further research is needed.
Area of Science:
- Regenerative Medicine
- Craniofacial Surgery
- Biomaterials Science
Background:
- Orofacial clefts require complex surgical reconstruction.
- Autologous bone grafting is the current gold standard for alveolar cleft repair.
- Limitations of autologous bone grafting include donor-site morbidity and limited availability.
Purpose of the Study:
- To synthesize translational evidence on tissue-engineered grafts for orofacial cleft repair.
- To evaluate scaffold technologies, cellular therapies, and growth-factor strategies.
- To identify barriers to clinical adoption of these novel therapies.
Main Methods:
- Scoping review of PubMed, Embase, and Scopus.
- PRISMA-style study selection.
- Inclusion of human clinical studies, systematic reviews, and high-impact preclinical studies.
Main Results:
- 48 studies met inclusion criteria; autologous iliac crest bone is the benchmark.
- rhBMP-2 shows promise as an alternative or adjunct, especially with supportive constructs.
- Cell- and scaffold-based therapies are feasible but limited by heterogeneity and short follow-up.
Conclusions:
- Tissue-engineered grafts are advancing but have not replaced autologous bone grafting.
- Standardized endpoints are crucial for future clinical evaluation.
- Further research needed to define durable, scalable, and equitable clinical use.
