Potential Clinical Application of Organs-on-a-Chip in Periodontal Diseases: A Systematic Review of In Vitro Studies

Abstract

The periodontium is a unique organ from the standpoint of building an organ-on-a-chip (OoC) since it is a system that is continually threatened by microorganisms, their noxious compounds, and antigenic components. At the same time, periodontal health depends on a balanced connection between the host and the bacteria in the oral cavity, which is a complex micro-ecological environment. The objective of this systematic review of in vitro studies is to revise the potential clinical application of OoC in periodontal diseases. PRISMA was used to guide this analysis. The review framework made use of several databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS as well as the gray literature. This systematic review comprised seven studies. The clinical efficacy of OoC in periodontal diseases was observed in models of the gingival crevice for the research of periodontitis, periodontal medication analysis, the interaction of multiple microbial species, pH measurements in in situ-grown biofilm, testing antimicrobial reagents, evaluation of mucosal interactions with microorganisms, and a device for quantitative exploration of microorganisms. OoC has the potential to advance our understanding of periodontal diseases by providing a more accurate representation of the oral microenvironment and enabling the development of new treatments.

The Potential Clinical Applications of a Microfluidic Lab-on-a-Chip for the Identification and Antibiotic Susceptibility Testing of Enterococcus faecalis-Associated Endodontic Infections: A Systematic Review

“…Developing and operating microfluidic devices can be technically challenging, requiring specialized knowledge and equipment. This complexity can limit their accessibility and widespread use, particularly in resource-limited settings [15,16]. The lack of standardized protocols and assays for microfluidic devices can make it challenging to compare results across different platforms and studies [16].…”

“…The lack of standardized protocols and assays for microfluidic devices can make it challenging to compare results across different platforms and studies [16]. Skilled personnel are required for operating and maintaining microfluidic devices, which can be a limiting factor in some clinical settings [15,16]. Despite these limitations, ongoing research and technological advancements continue to address many of these challenges, making microfluidics LOC platforms increasingly valuable tools in the field of microbiology and antimicrobial susceptibility testing.…”

“…Similarly, traditional antibiotic susceptibility testing (AST) methods yield reliable results but are time-consuming and labour-intensive [13]. Consequently, therapeutic intervention with empirical antimicrobial therapy comes before understanding of AST, and clinicians tend to administer antimicrobials with the broadest spectrum of activity and the greatest feasible dosage [14,15]. Therefore, there is a definite need for novel techniques that enable rapid, low-cost, and simply adopted AST without sacrificing accuracy [15].…”

“…The recent advancements in lab-on-a-chip (LOC) technology have the potential to address these challenges, improve fundamental bacteriological investigation, and contribute to the advancement of therapeutic methodologies. LOC technology enables the miniaturization and automation of complex laboratory processes, allowing for the rapid and efficient analysis of biological, chemical, or environmental samples [15,16]. Microfluidic systems are a subset of LOC devices, but an LOC system may also include other components beyond microfluidics, such as sensors, detectors, or actuators, to create a complete analytical or diagnostic platform [17].…”

“…LOC and microfluidic systems can provide rapid results, often within minutes, whereas biochemical assessments and molecular analysis can take hours or even days [16,17]. Moreover, LOC and microfluidic systems can detect low concentrations of bacteria, making them more sensitive than some biochemical tests [15]. This is crucial for identifying E. faecalis, which may be present in low numbers in some clinical samples.…”