Tissue-Engineered Grafts for Orofacial Cleft Repair: A Scoping Review From Bench to Bedside

ObjectiveTo map and synthesize translational evidence on tissue-engineered grafts for orofacial cleft repair, emphasizing scaffold technologies, cellular therapies, growth-factor strategies, comparative outcomes, and barriers to clinical adoption.DesignScoping review using a structured, systematic-style search strategy and PRISMA-style study selection.SettingSystematic searches of PubMed, Embase, and Scopus from inception through March 23, 2026.Patients/ParticipantsPeer-reviewed human clinical studies, systematic reviews/meta-analyses, and high-impact preclinical studies relevant to alveolar cleft or cleft palate reconstruction.InterventionsTissue-engineered approaches including calcium phosphate and collagen-based scaffolds, hydrogels, 3D-printed constructs, mesenchymal stromal/stem cell-based therapies, bone marrow-derived cell concentrates, and growth-factor delivery systems such as recombinant human bone morphogenetic protein-2 (rhBMP-2).Main Outcome Measure(s)Study characteristics, translational relevance, radiographic bone fill or height, volumetric/densitometric outcomes, donor-site morbidity, complication profiles, dental eruption, craniofacial growth, and long-term graft stability.ResultsOf 719 records identified, 48 peer-reviewed studies met inclusion criteria. Autologous iliac crest cancellous bone remains the benchmark for secondary alveolar bone grafting. The strongest clinical evidence supports rhBMP-2 as a carrier-dependent, iliac-crest-sparing alternative or adjunct in selected patients, particularly with structurally supportive constructs such as demineralized bone matrix. Cell-based and scaffold-based therapies show feasibility but remain limited by heterogeneity in materials, processing, outcome measures, and follow-up duration.ConclusionsTissue-engineered grafts are progressing toward clinically evaluable cleft reconstruction therapies but have not replaced autologous bone grafting. Future studies require standardized imaging, dental, growth, safety, and patient-centered endpoints to define durable, scalable, and equitable clinical use.