Inadequate bone quantity is commonly encountered in implant dentistry, often as a consequence of long standing tooth loss. These defects can be of considerable size, and often currently available techniques can provide unpredictable treatment outcomes. This means that novel methods are required, and tissue engineering is one such technique. Tissue Engineering is a multidisciplinary field, which incorporates engineering, cellular molecular science, and clinical specialties. It involves the fabrication of tissues outside the body for implantation into the body. There are several essential components of Tissue Engineer constructs. These are, the presence of appropriate numbers of responsive progenitor cells. Furthermore, we require the correct extracellular matrix or scaffold, and finally, we need the appropriate levels and sequence of regulatory signals. Essentially, the aim of Tissue Engineering is to manufacture human replacement parts In terms of the cell component, immature and undifferentiated progenitors, it means the stem cells are ideal for tissue engineering because of their favourable proliferative properties and ability to differentiate into multiple cell types. Furthermore, several important features need to be considered in regards to scaffolds for bone tissue engineering The requirements for these scaffolds are, the correct form, an ability to fill complex three-dimensional bone defects. We also need to consider the function and the ability to provide temporary mechanical load bearing. Fixation is also very important in terms of achieving secure attachment, task-eliminating motion. And most importantly, we need to be able to enhance bone formation by providing appropriate mass transport environments, allowing perfusion, and delivering osteoinductive factors, including cells, proteins, and/or genes. Providing an appropriate environment for tissue engineering is essential for the maturation of the scaffold A suitable environment for tissue engineering can be achieved by adding growth factors and other extracellular matrix molecules such as bone morphology proteins. In this slide, we can see conceptually how a tissue engineering construct can be used to regenerate a major defect in the mandible, which is a commonly encountered problem in dental implantology. The advantages of this approach are that there is no need for autogenous grafting and the associated morbidity of this procedure. Furthermore, we have greater control of the biological processes in vitro and a mature construct can be implanted in vivo with defined properties. This is particular desirable where we want to have controlled temporal and spatial maturation process as well as when we want to incorporate bio-elective molecules. Finally, I would like to look into the future, hopefully, not to far into the future and present a clinically plausible approach to making customized tissue engineered constructs. We would commence by obtaining a precise image of the bone defect. This will be followed by the use of a computer-assisted design to make an accurate digital replica of the missing tissue, and then bioprinting will be utilized to manufacture and visualize construct that precisely replicates the missing bone. This construct would then be inserted into the patient.
