Nanostructured Guidance for Peripheral Nerve Injuries: A Review with a Perspective in the Oral and Maxillofacial Area

Abstract

Injury to peripheral nerves can occur as a result of various surgical procedures, including oral and maxillofacial surgery. In the case of nerve transaction, the gold standard treatment is the end-to-end reconnection of the two nerve stumps. When it cannot be performed, the actual strategies consist of the positioning of a nerve graft between the two stumps. Guided nerve regeneration using nano-structured scaffolds is a promising strategy to promote axon regeneration. Biodegradable electrospun conduits composed of aligned nanofibers is a new class of devices used to improve neurite extension and axon outgrowth. Self assembled peptide nanofibrous scaffolds (SAPNSs) demonstrated promising results in animal models for central nervous system injuries, and, more recently, for peripheral nerve injury. Aims of this work are (1) to review electrospun and self-assembled nanofibrous scaffolds use in vitro and in vivo for peripheral nerve regeneration; and (2) its application in peripheral nerve injuries treatment. The review focused on nanofibrous scaffolds with a diameter of less than approximately 250 nm. The conjugation in a nano scale of a natural bioactive factor with a resorbable synthetic or natural material may represent the best compromise providing both biological and mechanical cues for guided nerve regeneration. Injured peripheral nerves, such as trigeminal and facial, may benefit from these treatments.

Anisotropic Materials for Skeletal‐Muscle‐Tissue Engineering

“…A wide variety of polymers, both natural and synthetic, can be electrospun to form nanofibers. [80, 82, 83] Table 2 lists some polymers that are typically used with electrospinning systems along with their associated properties. Electrospun nanofibers offer several advantages over nanofibers produced by other fabrication methods, such as control over fiber diameter and alignment, and the possibility of fabricating composite nanofibers.…”

Influence of oriented nanofibrous PCL scaffolds on quantitative gene expression during neural differentiation of mouse embryonic stem cells

“…A number of polymeric nanofibers exist that are promising candidates for nerve repair, including poly (caprolactone) (PCL), PLLA, poly (lactic‐ co ‐glycolic acid), collagen, and chitosan …”

“…In the study of Wang et al in 2011, the aligned silk fibroin blended PLLA‐ co ‐ɛ‐caprolactone nanofibrous scaffolds was achieved by electrospinning, which were then reeled into aligned nerve guidance conduits to promote nerve regeneration . In another review article, composites of PCL and gelatin or collagen were used for nerve regeneration …”

“…A number of polymeric nanofibers exist that are promising candidates for nerve repair, including poly (caprolactone) (PCL), PLLA, poly (lactic-co-glycolic acid), collagen, and chitosan. 6 In the study of Wang et al in 2011, the aligned silk fibroin blended PLLA-co-E-caprolactone nanofibrous scaffolds was achieved by electrospinning, which were then reeled into aligned nerve guidance conduits to promote nerve regeneration. 7 In another review article, composites of PCL and gelatin or collagen were used for nerve regeneration.…”

Current and future applications of nanotechnology in plastic and reconstructive surgery

“…Plastic surgeons perform the majority of the peripheral nerve surgeries involving the hands, face, and trunk. [21,22] Traumatic nerve injuries resulting in loss of nerve tissue over 5 mm frequently require nerve grafting, often from an autologous source. Donor sites for this procedure, however, are limited.…”