Towards 3D Multi-Layer Scaffolds for Periodontal Tissue Engineering Applications: Addressing Manufacturing and Architectural Challenges

Abstract

Reduced periodontal support, deriving from chronic inflammatory conditions, such as periodontitis, is one of the main causes of tooth loss. The use of dental implants for the replacement of missing teeth has attracted growing interest as a standard procedure in clinical practice. However, adequate bone volume and soft tissue augmentation at the site of the implant are important prerequisites for successful implant positioning as well as proper functional and aesthetic reconstruction of patients. Three-dimensional (3D) scaffolds have greatly contributed to solve most of the challenges that traditional solutions (i.e., autografts, allografts and xenografts) posed. Nevertheless, mimicking the complex architecture and functionality of the periodontal tissue represents still a great challenge. In this study, a porous poly(ε-caprolactone) (PCL) and Sr-doped nano hydroxyapatite (Sr-nHA) with a multi-layer structure was produced via a single-step additive manufacturing (AM) process, as a potential strategy for hard periodontal tissue regeneration. Physicochemical characterization was conducted in order to evaluate the overall scaffold architecture, topography, as well as porosity with respect to the original CAD model. Furthermore, compressive tests were performed to assess the mechanical properties of the resulting multi-layer structure. Finally, in vitro biological performance, in terms of biocompatibility and osteogenic potential, was evaluated by using human osteosarcoma cells. The manufacturing route used in this work revealed a highly versatile method to fabricate 3D multi-layer scaffolds with porosity levels as well as mechanical properties within the range of dentoalveolar bone tissue. Moreover, the single step process allowed the achievement of an excellent integrity among the different layers of the scaffold. In vitro tests suggested the promising role of the ceramic phase within the polymeric matrix towards bone mineralization processes. Overall, the results of this study demonstrate that the approach undertaken may serve as a platform for future advances in 3D multi-layer and patient-specific strategies that may better address complex periodontal tissue defects.

Biofabrication of Gingival Fibroblast Cell-Laden Collagen/Strontium-Doped Calcium Silicate 3D-Printed Bi-Layered Scaffold for Osteoporotic Periodontal Regeneration

“…In the past decade, the evolution of 3D printing and additive manufacturing, especially multi-extrusion 3D printing, have been explored in tissue engineering and have showed potential as a valuable strategy for the development of multi-layer scaffolds [ 24 ]. A recent study by Porta et al fabricated a porous multi-layer polycaprolactone with a Sr-hydroxyapatite scaffold via a single step extrusion process and proved that a multi-layer scaffold had improved biological, mechanical and osteogenic capabilities as compared to neat one-layer scaffolds [ 25 ]. In vitro studies had showed that the presence of ceramics within the polymeric matrix enhanced secretion of bone mineralization-related proteins.…”

Layered scaffolds in periodontal regeneration

“… Suitable for patient specific scaffolds. 95 Bottom layer: 20% Sr-nHA (bone component) Upper layer: 10% Sr-nHA (cementum) Starch/PCL (30:70 wt%; SPCL) Periodontal tissue (specially for alveolar bone) Bilayered Solvent casting Wet spinning SPCL solvent casting membrane: suitable obstacle for migration of gingival epithelium into the periodontal defect. SPCL fiber has enough biological, physical and chemical properties also suitable for periodontal tissue engineering.…”

Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects

“…Practical utilization requires faster manufacturing processes that maintain adequate print resolution, surface quality, and mechanical integrity, especially to hold relevance for applications in urgent care. Use of modern multi-extrusion printing systems is swiftly rising in tissue engineering for bone and periodontal structures due to its one-step printing approach, improved speeds, and ability to use versatile material formulations (Porta et al, 2020). Second, variations in part quality can occur due to errors introduced during the digital manipulation of virtual models or during the physical construction process.…”