Macromolecule-based stem cell and cell-free strategies for oral and maxillofacial tissue repair

The oral and maxillofacial regions perform mastication, swallowing, speech, and expression; therefore, oral and maxillofacial tissue defects can seriously affect patient physical and mental health. Biomaterials can be used to repair maxillofacial defects. However, traditional biomaterials lack biocompatibility and cannot accurately match the shape of damaged tissues, leading to tissue immune rejection and chronic inflammation, thereby limiting their repair ability. Biomaterials can improve mesenchymal stem cell (MSC) survival by simulating the extracellular matrix (ECM). MSCs have excellent self-regenerative abilities and can differentiate into almost all cell types, making them valuable for tissue engineering. This review summarizes biomaterial-based, stem cell, and cell-free therapies and discusses their properties, advantages, disadvantages, and application mechanisms, with a particular focus on their use in oral and maxillofacial tissue defect repair and regeneration and the limitations of the current materials and strategies. This review provides insights into using biomaterials for oral and maxillofacial tissue defect repair and regeneration.