Periodontal Tissues, Maxillary Jaw Bone, and Tooth Regeneration Approaches: From Animal Models Analyses to Clinical Applications

Abstract

This review encompasses different pre-clinical bioengineering approaches for periodontal tissues, maxillary jaw bone, and the entire tooth. Moreover, it sheds light on their potential clinical therapeutic applications in the field of regenerative medicine. Herein, the electrospinning method for the synthesis of polycaprolactone (PCL) membranes, that are capable of mimicking the extracellular matrix (ECM), has been described. Furthermore, their functionalization with cyclosporine A (CsA), bone morphogenetic protein-2 (BMP-2), or anti-inflammatory drugs’ nanoreservoirs has been demonstrated to induce a localized and targeted action of these molecules after implantation in the maxillary jaw bone. Firstly, periodontal wound healing has been studied in an induced periodontal lesion in mice using an ibuprofen-functionalized PCL membrane. Thereafter, the kinetics of maxillary bone regeneration in a pre-clinical mouse model of surgical bone lesion treated with BMP-2 or BMP-2/Ibuprofen functionalized PCL membranes have been analyzed by histology, immunology, and micro-computed tomography (micro-CT). Furthermore, the achievement of innervation in bioengineered teeth has also been demonstrated after the co-implantation of cultured dental cell reassociations with a trigeminal ganglia (TG) and the cyclosporine A (CsA)-loaded poly(lactic-co-glycolic acid) (PLGA) scaffold in the jaw bone. The prospective clinical applications of these different tissue engineering approaches could be instrumental in the treatment of various periodontal diseases, congenital dental or cranio-facial bone anomalies, and post-surgical complications.

Recent Progress in Carbon Nanotube Polymer Composites in Tissue Engineering and Regeneration

“…Along with its excellent biocompatibility, durability, drug solubility, and ease of manufacture, polycaprolactone (PCL), a highly crystal-like polymer, is commonly used as a tissue-engineering carrier for bone tissue [ 63 , 64 , 65 , 66 ]. Nevertheless, it exhibits a high hydrophobicity, weak cell affinity, poor bioavailability, and inadequate load-bearing physical characteristics.…”

LIPUS inhibited the expression of inflammatory factors and promoted the osteogenic differentiation capacity of hPDLCs by inhibiting the NF‐κB signaling pathway

“…Except for inflammation, studies noted that through the NF‐κB signaling pathway, LPS attenuated the osteogenic differentiation of PDLSCs . In the periodontal field, enhancing the NF‐κB signaling pathway could attenuate PDLC osteoblast differentiation, whereas repressing the NF‐κB signaling pathway in the inflammatory environment could rescue the osteogenesis ability of PDLCs . Therefore, regulating the NF‐κB signaling pathway might play a key role in controlling periodontal inflammation as well as osteogenesis.…”

“…In recent decades, a wide variety of techniques and biomaterials have been used to regenerate periodontal tissue, including guided tissue regeneration, guided bone regeneration, human bone grafts of human, and growth factors . In addition, various pharmacological agents, such as amoxicillin, azithromycin, and metronidazole, have been tested with the aim of regenerating the periodontium and maxillary bone in vitro and in vivo, as well as in clinical settings . However, complete regeneration is hardly achieved.…”

“…16 In addition, various pharmacological agents, such as amoxicillin, azithromycin, and metronidazole, have been tested with the aim of regenerating the periodontium and maxillary bone in vitro and in vivo, as well as in clinical settings. 15 However, complete regeneration is hardly achieved. Low-intensity pulsed ultrasound (LIPUS) has gradually become an innovative and noninvasive method applied in stem cell regeneration and has recently been applied for dental purposes.…”

Nanomaterials in Craniofacial Tissue Regeneration: A Review

“…Synthetic membranes combine strong mechanical properties to prevent collapse within the bony defect and biological properties to deliver biomolecules and cells to promote tissue regeneration. Polycaprolactone (PCL) membranes synthesized using the electrospinning technique can be loaded with anti-inflammatory drugs (such as ibuprofen) and growth factors (such as bone morphogenetic protein-2 (BMP-2)) to enhance periodontal regeneration [25]. Biomimetic fish collagen/ bioactive glass/ chitosan composite nanofiber membranes (Col/BG/CS) have good hydrophilicity, higher porosity and surface area promoting cell-cell and cell-matrix interaction, adequate tensile strength, and limited antibacterial properties [26].…”