According to the American Academy of Cranio-Maxillo-Facial Surgeons (AACMFS: American Academy of Cranio-Maxillo-Facial Surgeons, visit: https:/ /aacmfs.org/), reconstructive surgery implies surgery that seeks to rebuild, restore, or return to normality the hard and soft tissues of the cranio-maxillo-facial region that have become abnormal, dysfunctional or deformed due to an event. This event may be caused by trauma, tumor resection, or the result of a disease process. Cranio- maxillo-facial reconstructive surgery (including oral and dental) returns almost to normal those tissues and structures/body parts that were previously within the normal range, before the event. This contrasts with aesthetic and cosmetic surgery, for example, which seeks to improve an already normal facial or body appearance (also performed by some cranio-maxillo-facial surgeons). Therefore, reconstructive surgery is an integral part of cranio-maxillo-facial surgery and encompasses a wide range of interventional surgical procedures. Here, to rehabilitate patients with bone defects of critical size, for example, surgical reconstructions are required. However, surgical techniques are not enough. Successful bone reconstruction in the oral and maxillofacial region, using modern bone tissue engineering techniques, is applicable but requires innovative future research focusing on cells, grafts, growth factors, signaling pathways, and defect improvement. , as well as the vascularization of the graft. This brief communication attempts to provide some critical insights, highlighting recent advances, challenges and opportunities for research, development and innovation in this ever-growing and impactful area (quality of life) with a focus on system engineering. craniofacial bone tissue.