Regeneration, Reconstruction & Restoration (Triple R)

Abstract

Introduction: Classic bone tissue engineering involves use of osteogenic cells, growth factors, and bone scaffolds to generate a graft material to replace the gold standard which is autogenous bone graft. Several modifications have been applied to the classic approach but none of them can fully regenerate bone defects. The current study reviewes the literatures in applications of bone tissue engineering both in vivo and in vitro.

Materials and Methods: An electronic search in MEDLINE was conducted and both in vivo and in vitro studies were included using bone scaffolds with or without osteogenic growth factors or stem cells. In vitro studies which did not investigate cell-scaffold interactions and in vivo studies which did not measure new bone formation were excluded.

Results: Of 86 studies, 38 concerned in vitro and 48 in vivo studies. These studies were divided into six groups based on scaffold which they used: Synthetic, natural, polymers (non-ceramics), composites (polymer+ceramic), metal-based and nano-scaffolds. The results of the studies were compared in a qualitative manner. In vitro studies were mostly conducted on polymers, while relatively more animal and clinical studies were performed on ceramics. The most commonly used scaffolds, stem cells and growth factor were synthetic ceramics, bone marrow stem cells and bone morphgenic protein 2, respectively.

Conclusion: Determination of the most successful approach was not possible due to the presence of several variable and variances in analyzing methods and data report. However, studies which used all three components of BTE, including scaffolds, growth factors and stem cells, showed good results both in vitro and in vivo.