Multiphasic Scaffolds for Periodontal Tissue Engineering

Abstract

For a successful clinical outcome, periodontal regeneration requires the coordinated response of multiple soft and hard tissues (periodontal ligament, gingiva, cementum, and bone) during the wound-healing process. Tissue-engineered constructs for regeneration of the periodontium must be of a complex 3-dimensional shape and adequate size and demonstrate biomechanical stability over time. A critical requirement is the ability to promote the formation of functional periodontal attachment between regenerated alveolar bone, and newly formed cementum on the root surface. This review outlines the current advances in multiphasic scaffold fabrication and how these scaffolds can be combined with cell- and growth factor-based approaches to form tissue-engineered constructs capable of recapitulating the complex temporal and spatial wound-healing events that will lead to predictable periodontal regeneration. This can be achieved through a variety of approaches, with promising strategies characterized by the use of scaffolds that can deliver and stabilize cells capable of cementogenesis onto the root surface, provide biomechanical cues that encourage perpendicular alignment of periodontal fibers to the root surface, and provide osteogenic cues and appropriate space to facilitate bone regeneration. Progress on the development of multiphasic constructs for periodontal tissue engineering is in the early stages of development, and these constructs need to be tested in large animal models and, ultimately, human clinical trials.

Integrated three‐dimensional fiber/hydrogel biphasic scaffolds for periodontal bone tissue engineering

“…Strategic biomimicry could be imparted through the use of multiphasic scaffolds designed for functional integration of the different periodontal soft and hard tissue components with one another or with the host environment. 9 With this aim, various strategic scaffold multiphasic architectures have been developed: bone scaffolds combined with an occlusive membrane, 10,11 layered biphasic scaffolds for bone and ligament compartments 12 -16 and layered triphasic scaffolds for cementum, periodontal ligament and bone compartment. 17 Regenerative approaches toward in situ periodontal tissue regeneration are frequently based on endogenous resources such as cells and growth factors.…”

3D-printed Bioresorbable Scaffold for Periodontal Repair

“…Tissue-engineered constructs have potential to induce bone-ligament complex regeneration to treat disease-or trauma-induced damage to periodontia (Ivanovski et al 2014). Herein, we provide the first reported human case of treatment of a large periodontal osseous defect with a 3D-printed bioresorbable patient-specific polymer scaffold and signaling growth factor.…”

What is the clinical applicability of regenerative therapies in dentistry?

“…The main objective of periodontal regenerative therapy is the restructuring of the original architecture and function of the periodontal complex, involving the formation of new cementum at the root of the tooth, as well as the new periodontal insertion between the newly formed bone and cementum [28][29] . This therapy, therefore, uses specific techniques aimed at restoring tooth support segments that have been lost as a result of periodontitis or gingival trauma 30 .…”