Multiphasic Membranes/Scaffolds for Periodontal Guided Tissue Regeneration

Abstract

Periodontal disease can lead to severe degeneration of periodontium tissue and the global prevalence is continuously increasing with the growth and aging of population. Guided tissue regeneration (GTR) therapy with an occlusive membrane represents a golden standard in the dental clinic. Given the complex anatomy of the natural periodontium comprising alveolar bone, periodontal ligament (PDL) and cementum, GTR membrane/scaffolds with advanced multiphasic design are put forward to potentially repair the entire periodontium and restore its normal function. In principle, the multiphasic GTR membranes/scaffolds aim to coordinate the responses of both hard and soft tissues during the defect‐healing process, augment multi‐tissue regeneration, and optimize the formation of new periodontal attachment. In the past few decades, a diversity of GTR membranes/scaffolds with biphasic, triphasic, or gradient structures have been developed and demonstrated a substantial success in periodontal regeneration. This review covers the recent advancements in design of multiphasic GTR membranes/scaffolds from the aspects of materials, functional agents, and fabrication procedures, as well as their therapeutic efficacy assessed in vitro and in vivo. Finally, the limitations in current GTR therapy are discussed and future directions on the material design are also included accordingly.

Recent Advances in Functionalized Electrospun Membranes for Periodontal Regeneration

“…For periodontal disease, two surgical approaches are used: GTR and GBR. They consist of surgical techniques used in dentistry and periodontics to promote the regeneration of periodontal tissues, including bone and soft tissues, that have been lost due to periodontal disease or other factors [ 81 ]. These techniques are employed to restore and maintain the health and functionality of the supporting structures of teeth.…”

“…and chemical composition (e.g., mineral components, bioactive factors, etc.) can co-ordinate hard and soft tissue responses during the defect healing process to ensure multi-tissue regeneration [ 81 ], ( Figure 6 ). Sequential spinning or multi-layering may be employed to fabricate multilayered membranes, or alternatively, ES can be combined with other technologies like tri-dimensional printing scaffolds [ 156 ], freeze-drying or phase separation processes [ 91 ].…”

Development of Bi- and Tri-Layer Nanofibrous Membranes Based on the Sulfated Polysaccharide Carrageenan for Periodontal Tissue Regeneration

“…Considering the complex anatomy of the periodontium, comprising PDL and alveolar bone, multiphasic/multilayer GTR membranes have been developed in recent years, aiming to regulate the responses of both soft and hard tissues during the healing process [11,50,51]. Consisting of different natural or/and synthetic biodegradable and biocompatible polymers in each phase/layer displaying specific functionalities, they can synergistically enhance cellular activity, promote tissue regeneration, and potentially reconstruct the entire periodontium, restoring its healthy state [52][53][54].…”

Hydrogels promote periodontal regeneration

“…The concept of GTR was introduced by Nyman et al in 1982 (Gottlow et al, 1990), emphasizing the use of membranes to prevent gingival epithelium from expanding toward the tooth root, thereby encouraging osteoblasts and periodontal ligament stem cells (PDLSCs) to form new attachments (Gottlow et al, 1990). The selection and application of barrier membranes are crucial for the effectiveness of GTR technology, which offers both absorbable and non-absorbable varieties (Alqahtani, 2023;Zhu et al, 2023). Nonabsorbable membranes, such as titanium and polytetrafluoroethylene, are known for their excellent mechanical and biocompatibility properties, suitable for independent usage in clinical settings (Mizraji et al, 2023).…”