The article presents the topicality, theoretical aspects and features of the use of stem cells from the maxillofacial area in the treatment of dental diseases. The analysis of literature generalizes the advantages of this method: a less traumatic accessible method and no obstacles of ethical and legislative nature in the allocation of material, high concentration and ability of mesenchymal stem cells to self-renewal and differentiation, respectively, the effectiveness and prospect of use in restorative therapy facial area. We also considered the characteristics of fat pad determining the appropriateness of using them as an innovative, valuable, affordable source of fat stem cells for tissue engineering purposes. At the same time, the spread of dental pathologies and diseases causes the need for further study, theoretical substantiation, experimental testing of this method and widespread use of stem cells from the maxillofacial area in solving topical clinical problems, in particular: restoration of damaged dentin, growing teeth using bioengineering technologies. The article describes the characteristics of adipose tissue, which largely determine the feasibility of its use as a source of stem cells; selection features and basic properties of stem cells; case of stem cells from the maxillofacial area (about eight unique populations of «dental» stem cells). As a result of literature analysis, the sequence of surgical technique for removal of fat bodies is presented; modern algorithm for obtaining stem cells from of fat pad; a number of experiments on the use of adipose stem cells (clinical study of the closure of the maxillofacial area defect, the study of using mesenchymal stem cells of adipose tissue in the treatment of periodontitis, the clinical case of the local periodontitis treatment using stem cells from the pulp). The purpose of the study was to analyze the scientific-theoretical and clinical aspects of using stem cells derived from the maxillofacial area as an innovative approach in dentistry. Methods of theoretical analysis of the literature sources presented in scientific publications included in scientometric databases PubMed, Index Copernicus, Ulrich's Periodicals, Google Scholar, Web of Science, Scopus, Medline, etc. were used; generalization of the knowledge obtained during the training at the Department of Surgical Dentistry and Oral and Maxillofacial Surgery of the Bogomolets National Medical University.

Keywords: stem cells, mesenchymal stem cells from maxillofacial area, dentistry, maxillofacial surgery

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1. Maximow A. Der Lymphozyt als gemeinsame Stammzelle der verschiedenen Blutelemente in der embryonalen Entwicklung und im postfetalen Leben der Säugetiere. Originally in: Folia Haematologica. 8.1909: 125-34. Republished in: Cell Ther Transplant. 2009; 1: e.000040.01. https://doi.org/10.3205/ctt-2008-en-000040.01 [German]
2. Wei X, Yang X, Han ZP, Qu FF, Shao L, Shi YF. Mesenchymal stem cells: a new trend for cell therapy. Acta Pharmacologica Sinica. 2013; 34: 747-54. https://www.ncbi.nlm.nih.gov/pubmed/23736003. https://www.ncbi.nlm.nih.gov/pmc/articles/4002895. https://doi.org/10.1038/aps.2013.50
3. Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006; 126: 663-76. https://www.ncbi.nlm.nih.gov/pubmed/16904174. https://doi.org/10.1016/j.cell.2006.07.024
4. Takahashi K, Tanabe K, Ohnuki M, Narita M, Ichisaka T, Tomoda K, et al. Induction of pluripotent stem cells from adult human fibroblasts by defined factors. Cell. 2007; 131(5): 861-72. https://www.ncbi.nlm.nih.gov/pubmed/18035408. https://doi.org/10.1016/j.cell.2007.11.019
5. Petrenko ОY, Ivanov EN, Petrenko YО. Stvolovi klityny z zhyrovoyi tkanyny [Adipose Stem Cells]. Biotekhnologiya. 2008; 1(4): 39-48. [Ukrainian]
6. Zhang HM, Yan YP, Qi KM, Wang JQ, Liu ZF. Anatomical structure of the buccal fat pad and its clinical adaptations. Plastic and reconstructive surgery. 2002; 109(7): 2509-18. https://www.ncbi.nlm.nih.gov/pubmed/12045584. https://doi.org/10.1097/00006534-200206000-00052
7. Mitsu M, Sonal A, Harsh Sh, Siddharth V, Jigar D, Lalit S. Buccal Fat Pad-Derived Stem Cells for Repair of Maxillofacial Bony Defects. J Maxillofac Oral Surg. 2019 Mar; 18(1): 112-23. https://www.ncbi.nlm.nih.gov/pubmed/30728702. https://www.ncbi.nlm.nih.gov/pmc/articles/6328824. https://doi.org/10.1007/s12663-018-1106-3
8. Farré-Guasch E, Martí-Pagè C, Hernádez-Alfaro F, KleinNulend J, Casals N. Buccal fat pad, an oral access source of human adipose stem cells with potential for osteochondral tissue engineering: an in vitro study. Tissue Eng Part C Methods. 2010 Oct; 16(5): 1083-94. https://www.ncbi.nlm.nih.gov/pubmed/20078198. https://doi.org/10.1089/ten.tec.2009.0487
9. Min-Keun K, Wonil H, Seong-Gon K. The use of the buccal fat pad flap for oral reconstruction. Maxillofac Plast Reconstr Surg. 2017 Dec; 39(1): 5. https://www.ncbi.nlm.nih.gov/pubmed/28286743. https://www.ncbi.nlm.nih.gov/pmc/articles/5325802. https://doi.org/10.1186/s40902-017-0105-5
10. Subramaniam S, Gomez M, Maza G, Prevedello DM, Carrau RL. Does 3D volumetric analysis predict the reach of endoscopically harvested buccal fat pad flap. Laryngoscope. 2019 Dec. https://www.ncbi.nlm.nih.gov/pubmed/31876287. https://doi.org/10.1002/lary.28487
11. Chalisserry EP, Nam SY, Park SH, Anil S. Therapeutic potential of dental stem cells. J Tissue Eng. 2017 May 23; 8: 2041731417702531. https://www.ncbi.nlm.nih.gov/pubmed/28616151. https://www.ncbi.nlm.nih.gov/pmc/articles/5461911. https://doi.org/10.1177/2041731417702531
12. Montero JF, de Souza HC, Martins MS, Oliveira MN, Benfatti CA, de Souza Magini R. Versatility and Importance of Bichat's Fat Pad in Dentistry: Case Reports of Its Use in Occlusal Trauma. J Contemp Dent Pract. 2018 Jul 1; 19(7): 888-94. https://www.ncbi.nlm.nih.gov/pubmed/30066696. https://doi.org/10.5005/jp-journals-10024-2352
13. Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, et al. Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell. 2002; 13(12): 4279-95. https://www.ncbi.nlm.nih.gov/pubmed/12475952. https://www.ncbi.nlm.nih.gov/pmc/articles/138633. https://doi.org/10.1091/mbc.e02-02-0105
14. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001; 7(2): 211-8. https://www.ncbi.nlm.nih.gov/pubmed/11304456. https://doi.org/10.1089/107632701300062859
15. Кhojasteh A, Sadeghi N. Application of buccal fat pad-derived stem cells in combination with autogenous iliac bone graft in the treatment of maxillomandibular atrophy: A preliminary human study. International Journal of Oral and Maxillofacial Surgery. 2016; 45(7): 864-71. https://www.ncbi.nlm.nih.gov/pubmed/26846793. https://doi.org/10.1016/j.ijom.2016.01.003
16. Khojasteh A, Kheiri L, Behnia H, Tehranchi A, Nazeman P, Nadjmi N, et al. Lateral Ramus Cortical Bone Plate in Alveolar Cleft Osteoplasty with Concomitant Use of Buccal Fat Pad Derived Cells and Autogenous Bone: Phase I Clinical Trial. Biomed Res Int. 2017; 2017: 6560234. https://www.ncbi.nlm.nih.gov/pubmed/29379800. https://www.ncbi.nlm.nih.gov/pmc/articles/5742895. https://doi.org/10.1155/2017/6560234
17. Rusanov VP, Ermukhanova GT, Myrzakulova UR, Bymenov KS, Turdyev N, Khalmurzaev A. Kafedra stomatologyy detskogo vozrasta, khyrurgycheskoy stomatologyy KazNMU im SD Asfendyyarova. Obosnovanye prymenenyya transplantata na osnove autologychnykh multypotentnykh mezenkhymalnykh stromalnykh kletok zhyrovoy tkany v khyrurgycheskom lechenyy eksperymentalnogo paradontyta. Vestnyk KazNMU. 2016; 1: 1301-310.
18. Hernández-Monjaraz B, Santiago-Osorio E, Ledesma-Martínez E. Retrieval of a periodontally compromised tooth by allogeneic grafting of mesenchymal stem cells from dental pulp. Journal of International Medical. 2018 June; 18: 2983-93. https://www.ncbi.nlm.nih.gov/pubmed/29911458. https://www.ncbi.nlm.nih.gov/pmc/articles/6124270. https://doi.org/10.1177/0300060518773244