Expanding therapeutic boundaries: Stem cells and tissue engineering

Over the last decade, research in dentistry has been evolving expressively in the field of tissue engineering. The search for means to achieve tissue repair, or the generation of new tissue, has the goal to broaden dramatically the therapeutic possibilities over different areas. Tissue engineering is a very promising option for providing tissue for craniofacial repair.5 When added up, the incidence of incisor pre-foramen fissures, which involve the alveolar ridge, and of incisor transforamen fissures, the presence of a full or partial alveolar cleft affects something like 70% of the cleft lip and palate patients. From an orthodontic therapy point of view, the presence of an alveolar cleft represents the greater management challenge for limiting dental movement in the area adjacent to the cleft. It is paramount to be aware to the constraints imposed by this condition to patients rehabilitation.1,2,11,12 Aimed at facing this difficulty, the use of secondary alveolar bone graft has been considered the first choice of treatment. Although its efficacy has been largely registered by both literature and clinical practice, this procedure involves complex issues such as cost, general anesthesia, the need for an orthopedic practitioner when the donor site is the iliac crest, morbidity, amongst others. New discoveries have been pointing out towards the development of less invasive and equally efficacious strategies. The American Association of Orthopaedic Surgeons suggests that, given the high demand for grafting procedures, the development and supply of ?substitutes for conventional bone grafts? should be a priority. In a recent study,5 embryonic stem cells have been differentiated into cartilage cells and implanted on artificially created cranial osseous defects. In comparison to the control group, the group that received the implanted tissue had a significantly faster response rate. […]