Postgraduate Student University College London (UCL) London, United Kingdom
Abstract: Cranioplasty options for critical-sized cranial defects in pediatric patients are limited and often associated with disadvantages, especially to accommodate developing brain structures. Tissue engineering using mesenchymal stem cells (MSCs) on biomimetic, biodegradable scaffolds offers promising solutions. This scoping review evaluates and compares the osteoconductive potential, effectiveness, and clinical practicality of three types of human-derived MSCs—adipose-derived stem cells (ADSCs), amniotic fluid-derived stem cells (AFSCs), and stem cells from exfoliated deciduous teeth (SHEDs)—for cranial bone regeneration in non-human subjects. Following PRISMA for Scoping Reviews guidelines, a database review across MEDLINE, Scopus, Embase, Web of Science, and Cochrane library was conducted. In-vivo preclinical trials investigating human-derived-MSCs seeded onto scaffolds to regenerate calvarial defects were included. Among 340 articles reviewed, 24 studies were selected. The MSCs were seeded onto 5 major categorised scaffold groups: poly lactic-co-glycolic acid composites, calcium-phosphate based composites, silk fibroin, collagen-based hydrogels, and polycaprolactone-based composites. Successful osteogenic potential was demonstrated for all involved stem cells, resulting in calvarial bone regeneration and subsequent scaffold degradation with new bone formation in preclinical subjects, though at varying bone regeneration rates. ADSCs, AFSCs, and SHEDs emerge as promising stem cell sources for treating calvarial defects in pediatric patients. Their demonstrated osteogenic potential on biodegradable scaffolds implies feasibility for skull bone regeneration, underscored by factors such as minimal immunogenic risks, diminished harvest site morbidity, and the ample availability of stem cells within the pediatric age group of newborns to 12 years old. The high proliferation and differentiation rates of in-vivo expanded stem cells further support their therapeutic potential. Scaffold material composition compatibility and its influence on osteogenic growth rates hold promise for enhancing treatment efficacy.
