Oral and Maxillofacial Surgery Bone Grafting; Past, Present and Future

Abstract
Bone grafting has been an inherent part of our specialty since its inception. From the past, nonvascularized block grafts gave way to cancellous marrow grafts and now to today’s free vascular osteocutaneous grafts and
in-situ tissue engineered grafts. Numerous innovations and discoveries have paved the way. An incomplete list would include rigid fixation, microvascular techniques with vein couplers, platelet rich plasma,
recombinant human bone morphogenetic protein, and bone marrow stem cell aspirates among others. The result has been more predictable bone regeneration and a better quality of bone with reduced morbidity and in many cases reduced cost.

As oral and maxillofacial surgery proceeds into the future, the vision includes growth factor loaded scaffolds, exosomes, adipose derived stem cells, cartilage together with bone regeneration, more recombinant growth factors, among others. Although oral and maxillofacial surgery will share the bone regeneration advances with our orthopedic colleagues, we will continue to lead the way forward as we have done in the past.

Learning Objectives
1). For the attendees to learn the various indications for in-situ tissue engineering of bone in the maxillofacial area.
2). For the attendees to understand the combinations of cells-signal-matrix using allogeneic bone of the correct particle size, rhBMP-2/ACS, and the stem cells/progenitor cells in bone marrow.
3). For the attendees to know of the best dosages of stem/progenitor cells from bone marrow and how to obtain them as well as the best dosages of rhBMP-2/ACS for bone regeneration with reduction in post operative edema.