Tissue Engineering in Periodontics – A Review

2005

Regenerative treatment of periodontal defects with an agent, or procedure, requires that each functional stage of reconstruction be grounded in a biologically directed process. With this paradigm, we contended the way of periodontal regeneration through the application of current knowledge in the fields of molecular and cell biology, developmental biology and tissue engineering principles as applicable to tissue engineering. Through a combination of transplanted biomaterials containing appropriately selected and primed cells, together with an appropriate mix of regulatory factors to allow growth and specialization of the cells and matrix, we envision a new vista for periodontal regeneration becoming possible.

Periodontology 2000, 2000

Advanced Healthcare Materials, 2018

the mechanical forces experienced during mastication. Periodontitis is a chronic inflammatory disease initiated by an oral bacterial biofilm, which results in periodontal hard and soft tissues destruction and can lead to tooth loss. It affects 30-40% of the population [1] and the large impact and burden of this disease on individuals and the community is well recognized not only in terms of compromised quality of life, but also overall health and systemic well-being. [2] 1.1. The Unique Challenges Faced in Achieving Periodontal Regeneration The ultimate objective of periodontal treatment is regeneration of the lost tissues of the periodontium, which involves the functional reattachment of the periodontal ligament onto newly formed cementum and alveolar bone. This requires a highly coordinated spatiotemporal healing response, including cementogenesis concomitant with periodontal ligament fiber reattachment to the previously contaminated root surface, as well as bone formation within the periodontal defect (Figure 1). In addition to the challenges posed by the complex architecture of the periodontium, healing is further complicated by the avascular nature of the tooth surface, which means that all periodontal wound healing occurs by secondary intention. Furthermore, The periodontium, consisting of gingiva, periodontal ligament, cementum, and alveolar bone, is a hierarchically organized tissue whose primary role is to provide physical and mechanical support to the teeth. Severe cases of periodontitis, an inflammatory condition initiated by an oral bacterial biofilm, can lead to significant destruction of soft and hard tissues of the periodontium and result in compromised dental function and aesthetics. Although current treatment approaches can limit the progression of the disease by controlling the inflammatory aspect, complete periodontal regeneration cannot be predictably achieved. Various tissue engineering approaches are investigated for their ability to control the critical temporospatial wound healing events that are essential for achieving periodontal regeneration. This paper reviews recent progress in the field of periodontal tissue engineering with an emphasis on advanced 3D multiphasic tissue engineering constructs (TECs) and provides a critical analysis of their regenerative potential and limitations. The review also elaborates on the future of periodontal tissue engineering, including scaffold customization for individual periodontal defects, TEC's functionalization strategies for imparting enhanced bioactivity, periodontal ligament fiber guidance, and the utilization of chair-side regenerative solutions that can facilitate clinical translation.

2015

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 2010

Periodontitis affects around 15 per cent of human adult populations. While periodontal treatment aimed at removing the bacterial cause of the disease is generally very successful, the ability predictably to regenerate the damaged tissues remains a major unmet objective for new treatment strategies. Existing treatments include the use of space-maintaining barrier membranes (guided tissue regeneration), use of graft materials, and application of bioactive molecules to induce regeneration, but their overall effects are relatively modest and restricted in application. The periodontal ligament is rich in mesenchymal stem cells, and the understanding of the signalling molecules that may regulate their differentation has increased enormously in recent years. Applying these principles for the development of new tissue engineering strategies for periodontal regeneration will require further work to determine the efficacy of current experimental preclinical treatments, including pharmacologic...

This review encompasses different pre-clinical bioengineering approaches for periodontal tissues, maxillary jaw bone, and the entire tooth. Moreover, it sheds light on their potential clinical therapeutic applications in the field of regenerative medicine. Herein, the electrospinning method for the synthesis of polycaprolactone (PCL) membranes, that are capable of mimicking the extracellular matrix (ECM), has been described. Furthermore, their functionalization with cyclosporine A (CsA), bone morphogenetic protein-2 (BMP-2), or anti-inflammatory drugs' nanoreservoirs has been demonstrated to induce a localized and targeted action of these molecules after implantation in the maxillary jaw bone. Firstly, periodontal wound healing has been studied in an induced periodontal lesion in mice using an ibuprofen-functionalized PCL membrane. Thereafter, the kinetics of maxillary bone regeneration in a pre-clinical mouse model of surgical bone lesion treated with BMP-2 or BMP-2/Ibuprofen functionalized PCL membranes have been analyzed by histology, immunology, and micro-computed tomography (micro-CT). Furthermore, the achievement of innervation in bioengineered teeth has also been demonstrated after the co-implantation of cultured dental cell reassociations with a trigeminal ganglia (TG) and the cyclosporine A (CsA)-loaded poly(lactic-co-glycolic acid) (PLGA) scaffold in the jaw bone. The prospective clinical applications of these different tissue engineering approaches could be instrumental in the treatment of various periodontal diseases, congenital dental or cranio-facial bone anomalies, and post-surgical complications.

https://www.ijrrjournal.com/IJRR_Vol.6_Issue.2_Feb2019/Abstract_IJRR0026.html, 2019

Three-dimensional (3D)-printing nowadays is commonly applied in tissue engineering. This brief review provides importance of 3D printing techniques & approaches in regenerating ligament-bone complexes by regulating spatiotemporal cell organizations. Some techniques currently being used to produce scaffolds are 3D Printing, Fused Deposition Modelling (FDM), Stereolithography and Selective Laser Sintering (SLS). These tissue engineering strategies will help in enhancing the knowledge regarding regeneration of tooth supporting structures.

Periodontology 2000, 2011

2016

Periodontal regeneration has become one of the primary objectives of periodontal therapy. The resulting scientific endeavours have elucidated modes of periodontal wound healing, the growth of periodontal cells and their association with the surrounding matrix, and growth-promoting factors. The periodontal regeneration industry is producing better and more expensive devices, but the criteria for evaluating their success have not progressed to the same extent. Although clinical measurements of attachment level and probing depths, along with radiography, are good methods of evaluating tooth survival and prognosis, they do not indicate true biological regeneration. The goals of periodontal therapy include not only the arrest of periodontal disease progression, but also the regeneration of structures lost to disease, where appropriate. Conventional surgical approaches (e.g., flap debridement) continue to offer time-tested and reliable methods to access root surfaces, reduce periodontal p...