This article will present an image-based approach to design and manufacture of scaffolds for the tissue engineering of bone and cartilage constructs. Our vision of tissue-engineered bone and/or cartilage constructs utilizes 3-D designed and manufactured biodegradable scaffolds that are site specific for the area of maxillofacial reconstruction. The fabricated site-specific scaffold can be constructed such that it will impart biologic cues to implanted cells placed within its interstices. These biologic cues should influence scaffold implanted mesenchymal stem cells (MSC) or bone marrow stromal cells (BMSC) to form the necessary tissue for site specific facial reconstruction. This new approach to tissue engineering of the maxillofacial region would be advantageous because of its site-specific anatomical configuration as well as its potential ability to adapt to the functional forces placed on it during function. The reconstruction of the condylar-ramus area of the temporomandibular joint (TMJ) will be used as an illustration of this approach.