Regenerative Medicine for Jawbone

This paper outlines tissue engineering of the jawbone and introduces a new method of jawbone regeneration using poly(L-lactide) (PLLA) mesh and bone marrow grafting. This method utilizes particulate cancellous bone and marrow (PCBM) from the ilium as the source of bone precursor cells and a PLLA mesh tray as the scaffold or framework for bone formation. The PLLA mesh tray is gradually degraded and absorbed after bone formation by PCBM. The procedure has been clinically applied in 62 cases, with a success rate of 84%. Resorption of regenerated bone was relatively rare, rather, ossification tended to progress among patients having achieved an early recovery in occlusion as a result of denture insertion or dental implantation. This method is preferable in that it enables regeneration of the physiological mandibula and is minimally invasive, but is awkward to indicate in post-radiotherapy patients and elderly subject who usually have diminished bone precursor cells. Concomitant use of bioactive factors that stimulate angiogenesis and bone formation is advisable in such cases.