Stem cell transplantation in head and neck oncology: Integrating oncologic treatment and maxillofacial reconstruction

Table 1 Types and sources of stem cells used in head and neck reconstruction

Stem cell type	Source tissue	Main clinical application	Delivery method	Key regenerative mechanism
Bone marrow-derived mesenchymal stem cells (BM-MSCs)	Iliac crest, long bones	Mandibular bone regeneration, osteoradionecrosis, vascularized flap enhancement	Local injection, scaffold seeding, or infusion during reconstruction	Osteogenic differentiation; secretion of VEGF, PDGF, and IL-10 promoting angiogenesis and anti-inflammatory effects
Adipose-derived stem cells (ADSCs)	Subcutaneous adipose tissue	Soft tissue augmentation, post-radiation fibrosis repair, contour restoration	Fat graft enrichment, injection, or matrix incorporation	Paracrine secretion of growth factors enhancing angiogenesis and collagen remodeling
Dental pulp and periodontal ligament stem cells (DPSCs/PDLSCs)	Extracted teeth, periodontal ligament	Craniofacial bone and dental tissue regeneration	Scaffold-based implantation or hydrogel encapsulation	Osteogenic and neurogenic differentiation; ECM deposition
Salivary gland progenitor/stem cells	Submandibular or parotid gland tissue	Radiation-induced xerostomia, salivary gland dysfunction	Autologous isolation, ex vivo expansion, and reinfusion post-radiotherapy	Acinar and ductal cell regeneration; revascularization of glandular tissue
Induced pluripotent stem cells (iPSCs)	Reprogrammed somatic cells (skin fibroblasts, blood cells)	Customized bone and mucosal reconstruction; tissue engineering	Scaffold seeding, 3D bioprinting, or pre-differentiation into osteoblasts and chondrocytes	High differentiation capacity enabling patient-specific tissue formation
Allogeneic MSCs (umbilical cord, Wharton’s jelly, placenta)	Postnatal tissues	Alternative source when an autologous harvest is not feasible	Intralesional injection or scaffold integration	Immunomodulation and trophic signaling with low immunogenicity

BM-MSCs: Bone marrow-derived mesenchymal stem cells; VEGF: Vascular endothelial growth factor; PDGF: Platelet-derived growth factor; IL: Interleukin; ADSCs: Adipose-derived stem cells; DPSCs: Dental pulp stem cells; PDLSCs: Periodontal ligament stem cells; ECM: Extracellular matrix; iPSCs: Induced pluripotent stem cells; MSC: Mesenchymal stem cell; 3D: Three-dimensional.