Indian Journal of Dental Research

GUEST EDITORIAL
Year
: 2014  |  Volume : 25  |  Issue : 6  |  Page : 683--684

Tissue engineering: Novel opportunities that encourage lateral thinking, outside the box


George K Sandor 
 Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu; BioMediTech, University of Tampere, Tampere, Finland

Correspondence Address:
George K Sandor
Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu; BioMediTech, University of Tampere, Tampere, Finland




How to cite this article:
Sandor GK. Tissue engineering: Novel opportunities that encourage lateral thinking, outside the box.Indian J Dent Res 2014;25:683-684


How to cite this URL:
Sandor GK. Tissue engineering: Novel opportunities that encourage lateral thinking, outside the box. Indian J Dent Res [serial online] 2014 [cited 2020 Apr 3 ];25:683-684
Available from: http://www.ijdr.in/text.asp?2014/25/6/683/152160


Full Text

Tissue engineering was originally defined more than 20 years ago in 1993 by Langer and Vacanti. This pair of scientists described a multidisciplinary field of research which sought to apply both the principles of engineering as well as the processes and phenomena of the life sciences towards the development of biological substitutes that would restore, maintain, or improve tissue function. [1] Since the inception of the concept, tissue engineering has propagated forwards like a tidal wave, leaving a new understanding of stem cells and biomaterials in its wake. In contrast to classic biomaterials approaches taught in both schools of dentistry and medicine, tissue engineering is based on the understanding of tissue formation and regeneration, and aims to induce new functional tissues, rather than simply implanting new replacement or recycled, alloplastic or allogenic spare parts. [2] These tissue engineered cell based therapies have given us the opportunities to think beyond the traditional approaches of merely transplanting organs or tissues, to actually regenerating such tissues de novo and ex vivo. [3]

In order to understand the complex role of the components of tissue engineering, clinicians and scientists should visualize an equilateral triangle where stem cells, resorbable scaffolds and bioactive molecules such as growth factors or cytokines continuously interact with each other. The science of tissue engineering is built upon the understanding of the nature of the interactions between these three key components. [2] Stem cells for example may be considered pluripotent, but can interact with cytokines in order to be stimulated to differentiate along certain cell lineages. Likewise when mesenchymal stem cells come into contact with the unique surfaces of certain scaffolds, they may be induced to differentiate along a variety of directions, forming bone or cartilage tissue for example. It is also important to be able to grow the bone in a three dimensional fashion. This can be achieved by using an appropriately designed scaffold, which enables the growing of custom-made tissues in correct predetermined sizes and shapes. [4]

In Finland the first cell based tissue engineered products were manufactured in 2006. The cell source used for clinical treatments to replace large missing segments of craniomaxillofacial bone has been human adipose-derived stem cells. [5] These cells have been incorporated to two different scaffolds depending on the application: Beta-tricalcium phosphate and bioactive glass. In some patients, bone morphogenetic protein-2 has also been used as a growth factor. [6]

Progress in cell based tissue engineering has continued. Cartilage has been grown ex-vivo in order to manufacture a replacement tissue-engineered airway in Spain. [7] Tissue-engineered skin has been produced in the United Kingdom to treat severely injured burn patients. [8] Crippling graft versus host disease is being managed using allogenic human mesenchymal stem cells. [9] In the future the scaffolds used in tissue engineering may become drug delivery vehicles to treat various neoplastic diseases. In our own arena dental researchers will harness stem cells in future endodontic and periodontal regenerative therapies.

In order for these treatments to be realized as clinical reality, certain principles had to be followed by its pioneers. First and foremost researchers recognized the possibilities offered by the principles described by Langer and Vacanti and embraced the opportunities offered by change. Researchers also learned to engage nontraditional lateral thinking and think "outside-the-box" in designing their novel innovations.

References

1Langer R, Vacanti JP. Tissue engineering. Science 1993;260:920-6.
2Sándor GK. Tissue engineering: Propagating the wave of change. Ann Maxillofac Surg 2013;3:1-2.
3Sándor GK. Tissue engineering of bone: Clinical observations with adipose-derived stem cells, resorbable scaffolds, and growth factors. Ann Maxillofac Surg 2012;2:8-11.
4Sándor GK, Bujtár P, Wolf J. Three-dimensional computer-aided surgical workflow to aid in reconstruction: From diagnosis to surgical treatment. Ann Maxillofac Surg 2014;4:128-31.
5Wolff J, Sándor GK, Miettinen A, Tuovinen VJ, Mannerström B, Patrikoski M, et al. GMP-level adipose stem cells combined with computer-aided manufacturing to reconstruct mandibular ameloblastoma resection defects: Experience with three cases. Ann Maxillofac Surg 2013;3:114-25.
6Sándor GK, Numminen J, Wolff J, Thesleff T, Miettinen A, Tuovinen VJ, et al. Adipose stem cells used to reconstruct 13 cases with cranio-maxillofacial hard-tissue defects. Stem Cells Transl Med 2014;3:530-40.
7Macchiarini P, Jungebluth P, Go T, Asnaghi MA, Rees LE, Cogan TA, et al. Clinical transplantation of a tissue-engineered airway. Lancet 2008;372:2023-30.
8MacNeil S. Progress and opportunities for tissue-engineered skin. Nature 2007;445:874-80.
9Chen GL, Paplham P, McCarthy PL. Remestemcel-L for acute graft-versus-host disease therapy. Expert Opin Biol Ther 2014;14:261-9.