Table 1.
Overview of clinical studies in which tissue engineered grafts were applied for bone regeneration
| Bone defect | Tissue-engineered graft preparation | Clinical evaluation | Reference |
|---|---|---|---|
| Segmental defects of long bones (3 patients) | Cultured bone marrow osteoprogenitors; seeding on hydroxyapatite scaffolds | Callus formation and integration 2 months after surgery | [91] |
| Large calvarial defect (1 patient) | Adipose stem cells in fibrin glue, with autologous cancellous bone | New bone formation and calvarial continuity 3 months after surgery | [92] |
| Maxillary sinus augmentation (2 patients) | Cultured mandibular periosteal cells; seeding and culture on polymer fleece under osteogenic conditions | Tight interface of bone and dental implant, new mineralized trabecular bone and remnants of biomaterial 4 months after surgery | [93] |
| Maxillary sinus augmentation (27 patients) | Cultured mandibular periosteal cells; seeding and culture on polymer fleece in osteogenic conditions | 18 patients: presence of mineralized trabecular bone, remnants of biomaterial and no resorption 3 months after surgery 8 patients: absence of bone formation, resorption, connective tissue 3 months after surgery 1 patient: infection after surgery, removal of the graft |
[94] |
| Posterior mandible augmentation (1 patient) | Mandibular periosteal cells on polymer fleece | Enhanced transverse ridge dimensions, dense lamellar bone 6 months after surgery | [95] |
| Maxillary sinus augmentation (13 patients) | Group 1: cultured mandibular periosteal cells; seeding and culture on collagen scaffold in osteogenic conditions (8 patients) | Group 1: vital woven and partially mature lamellar bone 6 months after surgery, little remaining biomaterial | [96] |
| Group 2a: cultured maxillary osteoblasts; seeding and culture on natural bone mineral scaffold (2 patients) | Group 2a: new bone and remnants of biomaterial at former sinus floor 8 months after surgery, poorly vascularized connective tissue, remnants of biomaterial | ||
| Group 2b: natural bone mineral scaffold alone (3 patients) | Group 2b: new bone and remnants of biomaterial 8 months after surgery; significantly lower bone density than in groups 1 and 2a | ||
| Maxillary sinus augmentation (20 patients) | Group 1: autologous iliac crest bone (10 patients) | Group 1: 29% bone resorption rate 3 months after surgery | [97] |
| Group 2: cultured mandibular periosteal cells; seeding and culture on polymer fleece in osteogenic conditions (10 patients) | Group 2: 90% graft resorption rate 3 months after surgery, graft density corresponding to connective tissue in all but one augmentation | ||
| Maxillary sinus augmentation (3 patients) | Cultured mandibular periosteal cells; seeding and culture on polymer fleece in osteogenic conditions; implanted with xenograft bone | New fibrous bone and remnants of xenograft bone 4 months after surgery; some maturation into lamellar bone; presence of osteoclasts 6 months after surgery; increased bone height 18 months after surgery | [98] |
| Maxillary sinus augmentation (7 patients) | Cultured bone marrow stem cells seeding and 1-day culture on calcium phosphate ceramic scaffold | New bone formation and remnants of biomaterial 3 months after surgery; increased bone height 3 and 12 months after surgery | [99] |
| Lumbar segmental fusion (24 patients) | Group 1: autologous iliac crest cancellous bone (11 patients) Group 2: cultured mandibular periosteal cells; seeding and culture on polymer fleece in osteogenic conditions (13 patients) |
Lower donor site morbidity in group 2; higher fusion rate in group 2 compared to group 1 in the period 3 to 9 months after surgery; comparable clinical and radiological results (80% fusion in group 1, 90% fusion in group 2) 12 months after surgery | [100] |