Extrusion-based printing dominates biofabrication for craniomaxillofacial reconstruction in scoping review

Reconstruction of the craniomaxillofacial (CMF) region poses combined structural and biological challenges that are difficult to address using conventional approaches. Although biofabrication has gained attention in this context, its progression across fabrication strategies and stages of translational validation has not been examined in a consolidated manner. A scoping review was conducted in accordance with PRISMA-ScR recommendations. Relevant studies published between 2010 and 2025 were identified and examined using a four-dimensional analytical framework (spatial, biological, temporal, and biomechanical complexity) to evaluate fabrication strategy, construct complexity, bio-additive integration, and translational maturity. Analysis of 107 studies indicated that research activity clustered around a limited set of approaches, most frequently extrusion-based printing (70.1%) in combination with composite material systems (59.8%). Although 21.5% of studies investigated complex multi-tissue constructs, most of these were evaluated exclusively in vitro or in small animal models. Bio-additive incorporation predominantly focused on osteogenic enhancement, with relatively limited attention to angiogenic support. Across studies, outcome reporting favored structural characteristics over assessments of functional recovery. These findings highlight a gap between increasing construct complexity in CMF biofabrication and validation in functionally and clinically relevant models. Progress toward translation is likely to depend on closer integration of fabrication strategies, biological design considerations, and function-oriented evaluation frameworks.