Regenerative medicine for craniomaxillofacial surgery.

Regenerative medicine has recently seen much activity in basic and translational research. These advances are now making their way into surgical practice. A convergence of technologies has afforded opportunities previously not available with conventional surgical reconstructive techniques. Patients requiring complex reconstructive surgery in the craniomaxillofacial region typically benefit from local or regional flaps, nonvascularized grafts, microvascular tissue transfer, or substitute alloplastic materials to restore function and form. In these clinical situations, grafting procedures or alloplastic substitute materials provide best-case replacements for resected, injured, or congenitally missing tissues. However, ideal reconstructive goals, such as a complete return to original form and function, are frequently not completely achieved. Regenerative techniques now in clinical use and at the translational research stage hold promise for custom-tailored constructs with the potential to regenerate tissue in the host without significant donor site morbidity. These techniques may provide better structure, aesthetics, and function than the best currently available options. This article presents the latest concepts in craniomaxillofacial regenerative medicine and reviews the multipronged approach to restoring architecture using novel "smart" multifunctional scaffolds, cellular technologies, growth factors, and other novel regenerative medical strategies. Copyright (c) 2010 Elsevier Inc. All rights reserved.