Craniofacial tissue injuries, diseases,
and defects, including
those within bone, dental, and periodontal tissues and salivary glands,
impact an estimated 1 billion patients globally. Craniofacial tissue
dysfunction significantly reduces quality of life, and successful
repair of damaged tissues remains a significant challenge. Blood vessels
and nerves are colocalized within craniofacial tissues and act synergistically
during tissue regeneration. Therefore, the success of craniofacial
regenerative approaches is predicated on successful recruitment, regeneration,
or integration of both vascularization and innervation. Tissue engineering
strategies have been widely used to encourage vascularization and,
more recently, to improve innervation through host tissue recruitment
or prevascularization/innervation of engineered tissues. However,
current scaffold designs and cell or growth factor delivery approaches
often fail to synergistically coordinate both vascularization and
innervation to orchestrate successful tissue regeneration. Additionally,
tissue engineering approaches are typically investigated separately
for vascularization and innervation. Since both tissues act in concert
to improve craniofacial tissue regeneration outcomes, a revised approach
for development of engineered materials is required. This review aims
to provide an overview of neurovascularization in craniofacial
tissues and strategies to target either process thus far. Finally,
key design principles are described for engineering approaches that
will support both vascularization and innervation for successful craniofacial
tissue regeneration.