Regenerative Strategies for Craniofacial Disorders

Abstract

Craniofacial disorders present markedly complicated problems in reconstruction because of the complex interactions of the multiple, simultaneously affected tissues. Regenerative medicine holds promise for new strategies to improve treatment of these disorders. This review addresses current areas of unmet need in craniofacial reconstruction and emphasizes how craniofacial tissues differ from their analogs elsewhere in the body. We present a problem-based approach to illustrate current treatment strategies for various craniofacial disorders, to highlight areas of need, and to suggest regenerative strategies for craniofacial bone, fat, muscle, nerve, and skin. For some tissues, current approaches offer excellent reconstructive solutions using autologous tissue or prosthetic materials. Thus, new “regenerative” approaches would need to offer major advantages in order to be adopted. In other tissues, the unmet need is great, and we suggest the greatest regenerative need is for muscle, skin, and nerve. The advent of composite facial tissue transplantation and the development of regenerative medicine are each likely to add important new paradigms to our treatment of craniofacial disorders.

Skin Equivalent Tissue-Engineered Construct: Co-Cultured Fibroblasts/ Keratinocytes on 3D Matrices of Sericin Hope Cocoons

“…Moreover to various intrinsic and extrinsic stimuli such as to temperature, pH, nutrient absorption, transport and differentiation, cells react and behave more like as in vivo conditions [7]. Recently co-cultured grafts comprising of dermal and epidermal modules capable of autologous skin replacement are of prime interest due to their accelerated healing processes [8]. Skin wound healing basically comprises epidermal tissue regeneration regulated by interaction of cytokines and growth factors with controlled functional behaviour of keratinocytes and dermal fibroblasts [9-11].…”

Parasympathetic neurons originate from nerve-associated peripheral glial progenitors

“…Even the most sophisticated reconstructive methods do not fully reproduce the fine complex function and shape that is the hallmark of craniofacial anatomy and physiology. Regenerative approaches might be expected to recapitulate the cellular interactions of the ectoderm, mesoderm and endoderm, as well as the generation of the important population of cranial neural crest cells (Figure 1ab) (Garland and Pomerantz, 2012).…”

Early Fat Grafting for Augmentation of Orbitozygomatic Region in Treacher Collins Syndrome

“…Moreover, its integration as a living tissue can result in beneficial interactions with the surrounding tissues because of improved vascularization. 11 Although injected fat is reabsorbed to some degree, if it is injected in areas of the face with reduced or zero mobility, such as the malar area, the rate of fat reabsorption is reduced. 12 Pinski and Roenigk 13 suggested that FG longevity can be achieved when it is used for the treatment of less mobile facial cosmetic defects.…”