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In an increasingly aging population, where aesthetics plays an important role in society, the loss of bone and teeth due to disease or trauma places a large burden on healthcare systems worldwide. It is estimated that more than 2.2 million grafting procedures are performed annually to repair bone defects in orthopedics, neurosurgery and dentistry (Giannoudis et al, 2005). Following surgical intervention the use of bone grafts / substitute materials or distraction osteogenesis (DO) for the expansion of the maxialla are current approaches to facilitate bone regeneration. What is regeneration and how is it defined? Regeneration can be defined as ”the reproduction or reconstruction of a lost or injured part of the body in such a way that the architecture and function of the lost or injured tissues are completely restored” (Bosshardt et al, 2009), and as such it is necessary to consider the cells that are involved to produce the destroyed tissues, how can these cells be stimulated and is a space filler required to support the cells and to hold signaling molecules? Bone formation is a complex and dynamic process involving the interactions between cells and the surrounding milieu. Repair occurs before regeneration but where healing occurs first without restoration of function. The current chapter considers clinical approaches, cases and requirements for bone regeneration and brings it together with a biological perspective of the cellular and biomolecular interactions necessary to stimulate new bone formation. Given the increasing need for grafting procedures and the limitations to current grafting techniques the future applications of tissue engineering approaches are finally discussed.

Clinical Concepts in Oral and Maxillofacial Surgery and Novel Findings to the Field of Bone Regeneration