Small-Scale Fabrication of Biomimetic Structures for Periodontal Regeneration

Abstract

The periodontium is the supporting tissues for the tooth organ and is vulnerable to destruction, arising from overpopulating pathogenic bacteria and spirochaetes. The presence of microbes together with host responses can destroy large parts of the periodontium sometimes leading tooth loss. Permanent tissue replacements are made possible with tissue engineering techniques. However, existing periodontal biomaterials cannot promote proper tissue architectures, necessary tissue volumes within the periodontal pocket and a “water-tight” barrier, to become clinically acceptable. New kinds of small-scale engineered biomaterials, with increasing biological complexity are needed to guide proper biomimetic regeneration of periodontal tissues. So the ability to make compound structures with small modules, filled with tissue components, is a promising design strategy for simulating the anatomical complexity of the periodotium attachment complexes along the tooth root and the abutment with the tooth collar. Anatomical structures such as, intima, adventitia, and special compartments such as the epithelial cell rests of Malassez or a stellate reticulum niche need to be engineered from the start of regeneration to produce proper periodontium replacement. It is our contention that the positioning of tissue components at the origin is also necessary to promote self-organizing cell–cell connections, cell–matrix connections. This leads to accelerated, synchronized and well-formed tissue architectures and anatomies. This strategy is a highly effective preparation for tackling periodontitis, periodontium tissue resorption, and to ultimately prevent tooth loss. Furthermore, such biomimetic tissue replacements will tackle problems associated with dental implant support and perimimplantitis.

Main Applications and Recent Research Progresses of Additive Manufacturing in Dentistry

“…FDA has cleared some 3D-printed devices for clinical use including orthopedics devices, surgical guides, and dental bridges [ 111 , 112 ]. In dentistry, the main applications and research directions of 3D printing include the following: three-dimensional stereoscopic image software combined with prototype models for anatomy teaching guidance [ 113 , 114 ], preoperative planning and drills [ 115 ], prognosis analysis and judgment [ 116 ], personalized treatment equipment, assistive devices and implants including personalized orthodontic brackets and accessories [ 117 , 118 ], restorations [ 119 ], trays [ 96 ], implants and surgical guides [ 120 , 121 ], and bioactive materials combined with living cells and growth factors to print tissues and organs with bioactive functions [ 122 , 123 ] ( Figure 4 ). Nevertheless, the bioprinting is still at the stage of printing biological scaffolds and needed further exploitation to mimic complex structure and function of natural tissues in the human body [ 124 ].…”

“…The engineering of periodontal ligament (PDL), cementum, and the alveolar bone is based on a modular approach. Bioprinting using microfluidic AM technology could manufacture more highly intricate morphologies, internal structures, and architectures that accurately replicate the exact anatomical organization and biological function of periodontal tissues [ 122 ]. A solution containing keratinocytes and fibroblasts as ink components was successfully used to print out the epithelial cell rests of Malassez which are necessary for the initial stage of periodontal tissue formation [ 122 ].…”

“…Bioprinting using microfluidic AM technology could manufacture more highly intricate morphologies, internal structures, and architectures that accurately replicate the exact anatomical organization and biological function of periodontal tissues [ 122 ]. A solution containing keratinocytes and fibroblasts as ink components was successfully used to print out the epithelial cell rests of Malassez which are necessary for the initial stage of periodontal tissue formation [ 122 ]. Periodontal ligament stem cells (PDLSCs) show great potentials in periodontal tissue regeneration under the appropriate extracellular matrix (ECM) [ 193 ].…”

Effects of Circuit Weight-Interval Training on Physical Fitness, Cardiac Autonomic Control, and Quality of Life in Sedentary Workers

“…On the other hand, RMSSD is the most robust and widely used HRV index and has been reported to be a valid estimate of cardiac vagal modulation [ 68 ]. Despite this, RMSSD recordings have revealed large day-to-day variation as a result of different conditions of evaluation [ 69 , 70 ]. Considering the potential effects of evaluating HRV in different positions, it should be noted that the supine position provided more reliable HRV parameters in comparison to other conditions to evaluate HRV in response to training interventions [ 71 , 72 ].…”

Preparation of micro/nanopatterned gelatins crosslinked with genipin for biocompatible dental implants

“…It is also used as an absorbable hemostatic sponge to provide an occlusive matrix [ 23 – 24 ] and as a bone healing material in tissue engineering [ 25 – 26 ] in the field of dentistry. Recent studies have attempted to regenerate collagen fibers, lost as a result of periodontal disease, using topographical scaffolds [ 27 – 29 ].…”