Adipose Stem Cells Used to Reconstruct 13 Cases With Cranio-Maxillofacial Hard-Tissue Defects

TLDR

Isolated reports of cranio‑maxillofacial hard‑tissue reconstruction exist, but multi‑patient series are lacking. The study reviewed 13 consecutive cranio‑maxillofacial hard‑tissue defect cases across four sites (frontal sinus, cranial bone, mandible, nasal septum). Autologous adipose tissue was harvested, ASCs expanded, and seeded onto resorbable scaffolds (bioactive glass or β‑tricalcium phosphate, sometimes with BMP‑2) under GMP conditions for reconstruction. Over 12–52 months follow‑up, 10 of 13 constructs integrated successfully; two cranial cases required revision due to resorption, and one septal perforation failed because of patient picking.

Abstract

Abstract Although isolated reports of hard-tissue reconstruction in the cranio-maxillofacial skeleton exist, multipatient case series are lacking. This study aimed to review the experience with 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 tissue was harvested from the anterior abdominal wall, and adipose-derived stem cells were cultured, expanded, and then seeded onto resorbable scaffold materials for subsequent reimplantation into hard-tissue defects. The defects were reconstructed with either bioactive glass or β-tricalcium phosphate scaffolds seeded with adipose-derived stem cells (ASCs), and in some cases with the addition of recombinant human bone morphogenetic protein-2. Production and use of ASCs were done according 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.