Tissue Engineering and Regenerative Medicine AdiposeStemCellsUsed toReconstruct 13 CasesWith Cranio-Maxillofacial Hard-Tissue Defects

Although isolated reports of hard-tissue reconstruction in the cranio-maxillofacial skeletonexist,multipatient case series are lacking. This study aimed to review the experiencewith 13 consecutive cases of cranio-maxillofacial hard-tissue defects at four anatomically different sites, namely frontal sinus (3 cases), cranial bone (5 cases), mandible (3 cases), and nasal septum (2 cases). Autologous adipose tissuewasharvested fromtheanterior abdominalwall, andadipose-derived stemcellswere cultured, expanded, and then seeded onto resorbable scaffold materials for subsequent reimplantation into hard-tissue defects. The defects were reconstructed with either bioactive glass orb-tricalcium phosphate scaffolds seededwith adipose-derived stem cells (ASCs), and in some caseswith the addition of recombinant humanbonemorphogenetic protein-2. Production anduseofASCsweredoneaccording to good manufacturing practice guidelines. Follow-up time ranged from 12 to 52 months. Successful integration of the construct to the surrounding skeleton was noted in 10 of the 13 cases. Two cranial defect cases in which nonrigid resorbable containment meshes were used sustained bone resorption to the point that they required the procedure to be redone. One septal perforation case failed outright at 1 year because of the postsurgical resumption of the patient’s uncontrolled nasal picking habit. STEM CELLS TRANSLATIONAL MEDICINE 2014;3:530–540