Fibrin-based scaffolds for dental pulp regeneration: from biology to nanotherapeutics

Abstract

Tissue engineering-based endodontic therapies, designed to regenerate the dental pulp (DP) in the devitalised endodontic space, have been proposed to improve tooth longevity compared to conventional root-filling therapies. Their aim is to restore tooth vitality and major DP functions necessary to maintain tooth health such as immunosurveillance, sensitivity and healing/repair/regenerative capacities. Several formulations based on the use of fibrin, the main component of the blood clot matrix, recently gave valuable results in the regeneration of the human DP. This review describes recent fibrin-based scaffolds designed for that purpose. After having presented the various strategies for DP regeneration, the main fibrin-based scaffolds reported so far for clinical use in endodontics were reviewed. Particular emphasis was given to hydrogel devices that may be improved by incorporation of bioactive molecules that stimulate vascularisation and tissue neoformation or provide antibacterial properties. Data indicate that fibrin-based scaffolds constitute a highly favourable environment for mesenchymal stem cells, which is maintained upon functionalisation. Additional knowledge is needed to understand how fibrin and functionalising agents affect adhesion, survival, proliferation, migration and differentiation of cells incorporated in the scaffold or which will colonise it from neighbouring host tissues. This knowledge is needed to adapt the hydrogel formulation for various clinical conditions.

Progress of Research on the Application of Triple Antibiotic Paste and Hydrogel Scaffold Materials in Endodontic Revascularization: A Systematic Review

“…Scaffold materials: scaffolds play a bridging role in endodontic regeneration, acting as a delivery system to realize the sustained local release of stem cells and growth factors [ 13 ]. In recent years, hydrogels have gained popularity among scaffold materials [ 14 ], which have a 95% water content, a three-dimensional structure, some toughness, and rheological properties, and can regulate stem cell fate, modulate growth factor release, and load drugs [ 15 ].…”

Recent advances on injectable nanocomposite hydrogels towards bone tissue rehabilitation

“…18,[68][69][70] Additionally, they can be tuned to degrade at a desired rate to match the repair and regeneration of bone tissue. Among the variety of natural polymers that have been studied, the popular ones include biopolymers based on proteins such as collagen, 16,[71][72][73] gelatin, [74][75][76][77] fibroin, 78,79 and fibrin 80,81 ; polysaccharides such as chitosan, 36,48,55,[82][83][84][85][86][87][88][89] alginate, 25,73,83,[90][91][92][93][94] starch, 70,88,95,96 and cellulose 31,50,[97][98][99][100][101][102][103] ; as well as glycosaminoglycans such as hyaluronic acid…”

“…Additionally, they can be tuned to degrade at a desired rate to match the repair and regeneration of bone tissue. Among the variety of natural polymers that have been studied, the popular ones include biopolymers based on proteins such as collagen, 16,71–73 gelatin, 74–77 fibroin, 78,79 and fibrin 80,81 ; polysaccharides such as chitosan, 36,48,55,82–89 alginate, 25,73,83,90–94 starch, 70,88,95,96 and cellulose 31,50,97–103 ; as well as glycosaminoglycans such as hyaluronic acid 44,64,104–107 which are widely used as hydrogels for tissue engineering applications. Few important natural biopolymers are described below for their use as matrices for injectable composite scaffold formation.…”

Biomechanical characterization of a fibrinogen–blood hydrogel for human dental pulp regeneration

“…17,18 Purified fibrin has also been tested for RET purposes in vivo showing beneficial results such as neovessel formation. 19 However, the poor mechanical strength and rapid degradation rate of fibrin set limits on its clinical applications. 20 A strategy to enhance the mechanical and biological characteristics of the fibrin network could be the modification of the concentration of blood components, such as fibrinogen.…”