Tissue engineering: applications in oral and maxillofacial surgery and periodontics

  • S. E. Lynch,
  • M. Nevins,
  • R. E. Marx &
  • L. A. Wisner-Lynch
UK: Quintessence price £73.00; pp 312 ISBN 9780867154641 | ISBN: 978-0-8671-5464-1

This is a comprehensive textbook written by an eminent group of clinicians, scientists and researchers in the field. It consists of 20 chapters which are sub-divided into four sections to help the readers sail smoothly through this comprehensive book.

The first four chapters address the principles of tissue-engineering: each chapter contains clear diagrams and illustrations which explain the cellular interaction and gene turning on for tissue healing and bone regeneration. The authors also provide several tables to help the readers understand the broad spectrum of cytokines, their mode of action and the complex regulatory mechanism of osteogenesis.

The scientific basis of tissue engineering is discussed in detail: the role of the scaffolds, cells and regulators is explained. The cycle of the osteogenesis cascade is discussed; the authors provide several figures of electronic microscopic images to illustrate bone mineralisation.

The advances in gene therapy for periodontal bioengineering are discussed, and the applications of tissue engineering principles in clinical practice are highlighted. This concept is demonstrated with more than 40 illustrations in Chapter 4, which demonstrate the application of basic science clinically.

The book then starts to focus on the treatment of advanced periodontal defects using bioactive therapies. There is a nice illustration of a periodontal defect and the application of recent regenerative techniques which include ceramics, xenographs and recombinant growth factors for surgical repair. The readers would be enlightened by the recent advances in this field and made aware of the improved bone and periodontal regeneration using recent advances of tissue bioengineering.

The textbook also illustrates the soft tissue engineering applications in dentistry, which would be of particular interest to GDPs and clinicians who are dealing with localised bony defects of the oral cavity. There is no doubt that the chapter on the development of implant placement is crucial for those who are practising oral and maxillofacial surgery. Once more, the illustrations are more than satisfactory and there are some interesting presentations which illustrate the possible clinical difficulties and the required procedures to achieve the best possible results.

A full chapter has been dedicated to the application of platelet-rich plasma in oral and maxillofacial surgery and periodontology. This chapter provides a manual of safe practice and a good guide to practitioners to achieve the best possible results. The textbook focuses on the osseous regeneration with recombinant BMP2, which is a fairly recent application of this cytokine in the maxillofacial region. There is a clear demonstration of using BMP2 for ridge augmentation and sinus build-up with histological evidence to demonstrate the regenerative process. The necessity for multi-centre randomised clinical trials to demonstrate the effectiveness and safety of the recombinant BMP2 in sinus floor augmentation is emphasised. The ability to use the recombinant product that eliminates the need for harvesting of autogenous bone and the morbidity associated with the harvesting procedure, is highlighted.

The concept of distraction osteogenesis is also included in the textbook, which provides the reader with the broad scope of all the recent advances in manipulating bone healing.

Three chapters of this book are dedicated to craniofacial osseous reconstruction with recent tissue engineering strategies. This would be of particular interest to craniofacial surgeons who undertake major facial reconstructions secondary to cancer resection or loss of bone due to trauma. In addition, the manipulation of tissue healing in cleft lip and palate has also been considered to complement the chapters on craniofacial reconstruction. I found the section on the tissue engineering strategy in the treatment of temporomandibular joint dysfunction syndrome fascinating. It covers the basic anatomy and physiology of the joint, and the molecular mechanism associated with the inflammation of this structure. The use of cartilage as a tissue scaffolding is also discussed. The authors conclude that new tissue engineering approaches to promote cartilage and disc repair of the temporomandibular joint are promising as future strategies. The authors highlight the importance of further understanding of the cellular and mechanical mechanisms of tissue repair. The use of relevant animal models may overcome some of the important research difficulties.

The last two chapters of this book are really beyond the scope of oral and maxillofacial surgery; one of them is on ankle fusion procedures and the other is on tendon healing.

In summary, I found this textbook enlightening, comprehensive and easy to read. There are hundreds of references included after each chapter which provide useful material for researchers in the field as well as for readers who would like to expand their knowledge on the subject. I would highly recommend this book to be acquired by all the research centres in the field, major teaching institutes and general hospitals which undertake sophisticated reconstructive procedures in the head and neck region.