Regenerative Medicine for Periodontal and Peri-implant Diseases

Abstract

The balance between bone resorption and bone formation is vital for maintenance and regeneration of alveolar bone and supporting structures around teeth and dental implants. Tissue regeneration in the oral cavity is regulated by multiple cell types, signaling mechanisms, and matrix interactions. A goal for periodontal tissue engineering/regenerative medicine is to restore oral soft and hard tissues through cell, scaffold, and/or signaling approaches to functional and aesthetic oral tissues. Bony defects in the oral cavity can vary significantly, ranging from smaller intrabony lesions resulting from periodontal or peri-implant diseases to large osseous defects that extend through the jaws as a result of trauma, tumor resection, or congenital defects. The disparity in size and location of these alveolar defects is compounded further by patient-specific and environmental factors that contribute to the challenges in periodontal regeneration, peri-implant tissue regeneration, and alveolar ridge reconstruction. Efforts have been made over the last few decades to produce reliable and predictable methods to stimulate bone regeneration in alveolar bone defects. Tissue engineering/regenerative medicine provide new avenues to enhance tissue regeneration by introducing bioactive models or constructing patient-specific substitutes. This review presents an overview of therapies (e.g., protein, gene, and cell based) and biomaterials (e.g., resorbable, nonresorbable, and 3-dimensionally printed) used for alveolar bone engineering around teeth and implants and for implant site development, with emphasis on most recent findings and future directions.

Effect of Micro/Nano-Patterned Surfaces on Cell Adhesion of Ca9-22 cells

“…Biological blockades based on soft tissue around the dental implant area play an important role in the success of dental implant treatment. Adhesion to soft tissue toward the implant body and abutment appears to be important for preventing intrusion of the epithelia and bacteria, as well as inflammation around the implant area [3,4]. Specifically, control of the adhesion, expansion, migration, and differentiation in epithelial and fibroblast cells [5][6][7] is necessary, as biological blockades with soft tissue adhesion patterns are oriented along the implant long axis and perpendicularly.…”

Effects of short-term inflammatory and/or hypoxic pretreatments on periodontal ligament stem cells: in vitro and in vivo studies

“…More than 3 decades have passed since the introduction of bone grafting materials, bioactive agents and the guided tissue regeneration (GTR) technique to save teeth and regenerate lost/damaged periodontal hybrid tissues, including alveolar bone, cementum and the periodontal ligament (PDL) (McClain and Schallhorn 2000;Chen et al 2009;Kim et al 2014). Unfortunately, functional regeneration of the diseased periodontal structure has not been successful thus far (Larsson et al 2016). Although this ambitious goal has been achieved for certain ideal clinical scenarios, it is often considered an unpredictable task (McClain and Schallhorn 2000;Pihlstrom et al 2005).…”

Advanced Scaffolds for Dental Pulp and Periodontal Regeneration

“…21,23 While progress has been made, these requirements are only being approached in recent published work. Advances related to membranes’ biomodification to endow needed functionalities (e.g., antimicrobial, anti-inflammatory, cell differentiation capacities) and technologies (e.g., additive manufacturing) to engineer patient-specific membranes and constructs to amplify both hard and soft tissue periodontal regeneration are presented below.…”

“…The work reported in the literature has not only included antimicrobials and inorganic particles (e.g., calcium phosphates), but also biomolecules (e.g., growth factors), in the fabrication of membranes with therapeutic functions. 21,23 More recently, the combination of known materials and biomolecules with advanced technologies 24–31 , particularly 3D printing, have permitted translation of the first patient-specific scaffold modified with platelet-derived growth factor (rhPDGF-BB) for treating large periodontal defects. 26 …”