Triple-layered PLGA/nanoapatite/lauric acid graded composite membrane for periodontal guided bone regeneration

Engineering soft-hard tissue interfaces in dental and craniofacial system by spatially controlled bioactivities

The interface between soft and hard tissues is constituted by a gradient change of cell types and matrix compositions that are optimally designed for proper load transmission and injury protection. In the musculoskeletal system, the soft-hard tissue interfaces at tendon-bone, ligament-bone, and meniscus-bone have been extensively researched as regenerative targets. Similarly, extensive research efforts have been made to guide the regeneration of multi-tissue complexes in periodontium. However, the other soft-hard tissue interfaces in the dental and craniofacial system have been somewhat neglected. This review discusses the clinical significance of developing regenerative strategies for soft-hard tissue interfaces in the dental and craniofacial system. It also discusses the research progress in the field focused on bioengineering approaches using 3D scaffolds equipped with spatially controlled bioactivities. The remaining challenges, future perspectives, and considerations for the clinical translation of bioactive scaffolds are also discussed.

Calcium Orthophosphate (CaPO4) Containing Composites for Biomedical Applications: Formulations, Properties, and Applications

The goal of this review is to present a wide range of hybrid formulations and composites containing calcium orthophosphates (abbreviated as CaPO4) that are suitable for use in biomedical applications and currently on the market. The bioactive, biocompatible, and osteoconductive properties of various CaPO4-based formulations make them valuable in the rapidly developing field of biomedical research, both in vitro and in vivo. Due to the brittleness of CaPO4, it is essential to combine the desired osteologic properties of ceramic CaPO4 with those of other compounds to create novel, multifunctional bone graft biomaterials. Consequently, this analysis offers a thorough overview of the hybrid formulations and CaPO4-based composites that are currently known. To do this, a comprehensive search of the literature on the subject was carried out in all significant databases to extract pertinent papers. There have been many formulations found with different material compositions, production methods, structural and bioactive features, and in vitro and in vivo properties. When these formulations contain additional biofunctional ingredients, such as drugs, proteins, enzymes, or antibacterial agents, they offer improved biomedical applications. Moreover, a lot of these formulations allow cell loading and promote the development of smart formulations based on CaPO4. This evaluation also discusses basic problems and scientific difficulties that call for more investigation and advancements. It also indicates perspectives for the future.

Engineering periodontal tissue interfaces using multiphasic scaffolds and membranes for guided bone and tissue regeneration

Periodontal diseases are one of the greatest healthcare burdens worldwide. The periodontal tissue compartment is an anatomical tissue interface formed from the periodontal ligament, gingiva, cementum, and bone. This multifaceted composition makes tissue engineering strategies challenging to develop due to the interface of hard and soft tissues requiring multiphase scaffolds to recreate the native tissue architecture. Multilayer constructs can better mimic tissue interfaces due to the individually tuneable layers. They have different characteristics in each layer, with modulation of mechanical properties, material type, porosity, pore size, morphology, degradation properties, and drug-releasing profile all possible. The greatest challenge of multilayer constructs is to mechanically integrate consecutive layers to avoid delamination, especially when using multiple manufacturing processes. Here, we review the development of multilayer scaffolds that aim to recapitulate native periodontal tissue interfaces in terms of physical, chemical, and biological characteristics. Important properties of multiphasic biodegradable scaffolds are highlighted and summarised, with design requirements, biomaterials, and fabrication methods, as well as post-treatment and drug/growth factor incorporation discussed.

Guided Tissue and Bone Regeneration Membranes: A Review of Biomaterials and Techniques for Periodontal Treatments

This comprehensive review provides an in-depth analysis of the use of biomaterials in the processes of guided tissue and bone regeneration, and their indispensable role in dental therapeutic interventions. These interventions serve the critical function of restoring both structural integrity and functionality to the dentition that has been lost or damaged. The basis for this review is laid through the exploration of various relevant scientific databases such as Scopus, PubMed, Web of science and MEDLINE. From a meticulous selection, relevant literature was chosen. This review commences by examining the different types of membranes used in guided bone regeneration procedures and the spectrum of biomaterials employed in these operations. It then explores the manufacturing technologies for the scaffold, delving into their significant impact on tissue and bone regenerations. At the core of this review is the method of guided bone regeneration, which is a crucial technique for counteracting bone loss induced by tooth extraction or periodontal disease. The discussion advances by underscoring the latest innovations and strategies in the field of tissue regeneration. One key observation is the critical role that membranes play in guided reconstruction; they serve as a barrier, preventing the entry of non-ossifying cells, thereby promoting the successful growth and regeneration of bone and tissue. By reviewing the existing literature on biomaterials, membranes, and scaffold manufacturing technologies, this paper illustrates the vast potential for innovation and growth within the field of dental therapeutic interventions, particularly in guided tissue and bone regeneration.

3D Bioprinting of a Bioactive Composite Scaffold for Cell Delivery in Periodontal Tissue Regeneration

Hydrogels have been widely applied to the fabrication of tissue engineering scaffolds via three-dimensional (3D) bioprinting because of their extracellular matrix-like properties, capacity for living cell encapsulation, and shapeable customization depending on the defect shape. However, the current hydrogel scaffolds show limited regeneration activity, especially in the application of periodontal tissue regeneration. In this study, we attempted to develop a novel multi-component hydrogel that possesses good biological activity, can wrap living cells for 3D bioprinting and can regenerate periodontal soft and hard tissue. The multi-component hydrogel consisted of gelatin methacryloyl (GelMA), sodium alginate (SA) and bioactive glass microsphere (BGM), which was first processed into hydrogel scaffolds by cell-free 3D printing to evaluate its printability and in vitro biological performances. The cell-free 3D-printed scaffolds showed uniform porous structures and good swelling capability. The BGM-loaded scaffold exhibited good biocompatibility, enhanced osteogenic differentiation, apatite formation abilities and desired mechanical strength. The composite hydrogel was further applied as a bio-ink to load with mouse bone marrow mesenchymal stem cells (mBMSCs) and growth factors (BMP2 and PDGF) for the fabrication of a scaffold for periodontal tissue regeneration. The cell wrapped in the hydrogel still maintained good cellular vitality after 3D bioprinting and showed enhanced osteogenic differentiation and soft tissue repair capabilities in BMP2- and PDGF-loaded scaffolds. It was noted that after transplantation of the cell- and growth factor-laden scaffolds in Beagle dog periodontal defects, significant regeneration of gingival tissue, periodontal ligament, and alveolar bone was detected. Importantly, a reconstructed periodontal structure was established in the treatment group eight weeks post-transplantation of the scaffolds containing the cell and growth factors. In conclusion, we developed a bioactive composite bio-ink for the fabrication of scaffolds applicable for the reconstruction and regeneration of periodontal tissue defects.

Phytochemical delivery through nanocarriers: a review

In recent times, phytochemicals encapsulated or conjugated with nanocarriers for delivery to the specific sites have gained considerable research interest. Phytochemicals are mostly plant secondary metabolites which reported to be beneficial for human health and in disease theraphy. However, these compound are large size and polar nature of these compounds, make it difficult to cross the blood-brain barrier (BBB), endothelial lining of blood vessels, gastrointestinal tract and mucosa. Moreover, they are enzymatically degraded in the gastrointestinal tract. Therefore, encapsulation or conjugation of these compounds with nanocrriers could be an alternate way to enhance their bioefficacy by influencing their gastrointestinal stability, rate of absorption and dispersion. This review presents an overview of nanocarriers alternatives which improves therapeutic value and avoid toxicity, by releasing bioactive compounds specifically at target tissues with enhanced stability and bioavailability. Future investigations may emphasize on deciphering the structural changes in nanocarriers during digestion and absorption, the difference between in-vitro and in-vivo digestion simulations, and impact of nanocarriers on the metabolism of phytochemicals.

Functionally graded biomaterials for use as model systems and replacement tissues

The heterogeneity of native tissues requires complex materials to provide suitable substitutes for model systems and replacement tissues. Functionally graded materials have the potential to address this challenge by mimicking the gradients in heterogeneous tissues such as porosity, mineralization, and fiber alignment to influence strength, ductility, and cell signaling. Advancements in microfluidics, electrospinning, and 3D printing enable the creation of increasingly complex gradient materials that further our understanding of physiological gradients. The combination of these methods enables rapid prototyping of constructs with high spatial resolution. However, successful translation of these gradients requires both spatial and temporal presentation of cues to model the complexity of native tissues that few materials have demonstrated. This review highlights recent strategies to engineer functionally graded materials for the modeling and repair of heterogeneous tissues, together with a description of how cells interact with various gradients.

Medium-Chain Fatty Acids Released from Polymeric Electrospun Patches Inhibit Candida albicans Growth and Reduce the Biofilm Viability

Oral candidiasis is a very common oral condition among susceptible individuals, with the main causative organism being the fungus Candida albicans. Current drug delivery systems to the oral mucosa are often ineffective because of short drug/tissue contact times as well as increased prevalence of drug-resistant Candida strains. We evaluated the potency of saturated fatty acids as antifungal agents and investigated their delivery by novel electrospun mucoadhesive oral patches using agar disk diffusion and biofilm assays. Octanoic (C8) and nonanoic (C9) acids were the most effective at inhibiting C. albicans growth on disk diffusion assays, both in solution or when released from polycaprolactone (PCL) or polyvinylpyrrolidone/RS100 (PVP/RS100) electrospun patches. In contrast, dodecanoic acid (C12) displayed the most potent antifungal activity against pre-existing C. albicans biofilms in solution or when released by PCL or PVP/RS100 patches. Both free and patch-released saturated fatty acids displayed a significant toxicity to wild-type and azole-resistant strains of C. albicans. These data not only provide evidence that certain saturated fatty acids have the potential to be used as antifungal agents but also demonstrate that this therapy could be delivered directly to Candida-infected sites using electrospun mucoadhesive patches, demonstrating a potential new therapeutic approach to treat oral thrush.

Production and Characterization of Porous Polymeric Membranes of PLA/PCL Blends with the Addition of Hydroxyapatite

Polymer membranes have been widely used in guided tissue regeneration (GTR) and guided bone regeneration (GBR). The literature recognizes that poly (lactic acid) (PLA)/poly (ε-caprolactone) (PCL) blends have better physicochemical properties and that a porous polymer surface facilitates cell adhesion and proliferation. In addition, hydroxyapatite (HAp) incorporated into the polymer matrix promotes osteoinduction properties and osteoconduction to the polymer-ceramic biocomposite. Therefore, polymer membranes of PLA/PCL blend with the addition of HAp could be an alternative to be used in GBR. HAp was obtained by precipitation using the mixture of solutions of tetrahydrate calcium nitrate and monobasic ammonium phosphate salts. The porous membranes of the PLA/PCL (80/20) blend with the addition of HAp were obtained by solvent casting with a controlled humidity method, with the dispersion of HAp in chloroform and subsequent solubilization with the components of the blend. The solution was poured into molds for solvent evaporation under a controlled humidity atmosphere. The membranes showed the formation of pores on their surface, together with dispersed HAp particles. The results showed an increase in the surface porosity and improved bioactivity properties with the addition of HAp. Moreover, in biological studies with cell culture, it was possible to observe that the membranes with HAp have no cytotoxic effect on MC3T3 cells. These results indicate a promising use of the new biomaterial for GBR.

Development of keratin-based membranes for potential use in skin repair

The layers in skin determine its protective and hemostasis functions. This layered microstructure cannot be naturally regenerated after severe burns; we aim to reconstruct it using guided tissue regeneration (GTR). In GTR, a membrane is used to regulate tissue growth by stopping fast-proliferating cells and allowing slower cells to migrate and reconstruct specialized microstructures. Here, we proposed the use of keratin membranes crosslinked via dityrosine bonding. Variables from the crosslinking process were grouped within an energy density (ED) parameter to manufacture and evaluate the membranes. Sol fraction, spectrographs, and thermograms were used to quantify the non-linear relation between ED and the resulting crosslinking degree (CD). Mechanical and swelling properties increased until an ED threshold was reached; at higher ED, the CD and properties of the membranes remained invariable indicating that all possible dityrosine bonds were formed. Transport assays showed that the membranes allow molecular diffusion; low ED membranes retain solutes within their structure while the high ED samples allow higher transport rates indicating that uncrosslinked proteins can be responsible of reducing transport. This was confirmed with lower transport of adipogenic growth factors to stem cells when using low ED membranes; high ED samples resulted in increased production of intracellular lipids. Overall, we can engineer keratin membranes with specific CD, a valuable tool to tune microstructural and transport properties.

Fabrication, in vitro and in vivo studies of bilayer composite membrane for periodontal guided tissue regeneration

Development of a guided occlusive biodegradable membrane with controlled morphology in order to restrict the ingrowth of epithelial cells is still a challenge in dental tissue engineering. A bilayer membrane with a non-porous upper layer (polyurethane) and porous lower layer (polycaprolactone and bioactive glass composite) with thermoelastic properties to sustain surgery treatment was developed by lyophilization. Morphology, porosity, and layers attachment were controlled by using the multi-solvent system. In vitro and in vivo biocompatibility, cell attachment, and cell proliferation were analyzed by immunohistochemistry and histology. The cell proliferation rate and cell attachment results showed good biocompatibility of both surfaces, though cell metabolic activity was better on the polycaprolactone-bioactive glass surface. Furthermore, the cells were viable, adhered, and proliferated well on the lower porous bioactive surface, while non-porous polyurethane surface demonstrated low cell attachment, which was deliberately designed and a pre-requisite for guided tissue regeneration/guided bone regeneration membranes. In addition, in vivo studies performed in a rat model for six weeks revealed good compatibility of membranes. Histological analysis (staining with hematoxylin and eosin) indicated no signs of inflammation or accumulation of host immune cells. These results suggested that the fabricated biocompatible bilayer membrane has the potential for use in periodontal tissue regeneration.

* Engineering Membranes for Bone Regeneration

This review is focused on the use of membranes for the specific application of bone regeneration. The first section focuses on the relevance of membranes in this context and what are the specifications that they should possess to improve the regeneration of bone. Afterward, several techniques to engineer bone membranes by using "bulk"-like methods are discussed, where different parameters to induce bone formation are disclosed in a way to have desirable structural and functional properties. Subsequently, the production of nanostructured membranes using a bottom-up approach is discussed by highlighting the main advances in the field of bone regeneration. Primordial importance is given to the promotion of osteoconductive and osteoinductive capability during the membrane design. Whenever possible, the films prepared using different techniques are compared in terms of handability, bone guiding ability, osteoinductivity, adequate mechanical properties, or biodegradability. A last chapter contemplates membranes only composed by cells, disclosing their potential to regenerate bone.

Poly(Lactic-co-Glycolic Acid): Applications and Future Prospects for Periodontal Tissue Regeneration

Periodontal tissue regeneration is the ultimate goal of the treatment for periodontitis-affected teeth. The success of regenerative modalities relies heavily on the utilization of appropriate biomaterials with specific properties. Poly (lactic-co-glycolic acid) (PLGA), a synthetic aliphatic polyester, has been actively investigated for periodontal therapy due to its favorable mechanical properties, tunable degradation rates, and high biocompatibility. Despite the attractive characteristics, certain constraints associated with PLGA, in terms of its hydrophobicity and limited bioactivity, have led to the introduction of modification strategies that aimed to improve the biological performance of the polymer. Here, we summarize the features of the polymer and update views on progress of its applications as barrier membranes, bone grafts, and drug delivery carriers, which indicate that PLGA can be a good candidate material in the field of periodontal regenerative medicine.

Antibacterial efficacy of triple-layered poly(lactic-co-glycolic acid)/nanoapatite/lauric acid guided bone regeneration membrane on periodontal bacteria

A guided bone regeneration (GBR) membrane has been extensively used in the repair and regeneration of damaged periodontal tissues. One of the main challenges of GBR restoration is bacterial colonization on the membrane, constitutes to premature membrane degradation. Therefore, the purpose of this study was to investigate the antibacterial efficacy of triple-layered GBR membrane composed of poly(lactic-co-glycolic acid) (PLGA), nanoapatite (NAp) and lauric acid (LA) with two types of Gram-negative periodontal bacteria, Fusobacterium nucleatum and Porphyromonas gingivalis through a disc diffusion and bacterial count tests. The membranes exhibited a pattern of growth inhibition and killing effect against both bacteria. The increase in LA concentration tended to increase the bactericidal activities which indicated by higher diameter of inhibition zone and higher antibacterial percentage. It is shown that the incorporation of LA into the GBR membrane has retarded the growth and proliferation of Gram-negative periodontal bacteria for the treatment of periodontal disease.

Bi-layered constructs of poly(glycerol-sebacate)-β-tricalcium phosphate for bone-soft tissue interface applications

This study aims to establish a facile protocol for the preparation of a bi-layered poly(glycerol-sebacate) (PGS)/β-tricalcium phosphate (β-TCP) construct and to investigate its potential for bone-soft tissue engineering applications. The layered structure was prepared by distributing the ceramic particles within a prepolymer synthesized in a microwave reactor followed by a cross-linking of the final construct in vacuum (<10mbar). The vacuum stage led to the separation of cross-linked elastomer (top) and ceramic (bottom) phases. Results showed that addition of β-TCP particles to the elastomer matrix after the polymerization led to an increase in compression strength (up to 14±2.3MPa). Tensile strength (σ), Young's modulus (E), and elongation at break (%) values were calculated as 0.29±0.03MPa and 0.21±0.03; 0.38±0.02 and 1.95±0.4; and 240±50% and 24±2% for PGS and PGS/β-TCP bi-layered constructs, respectively. Morphology was characterized by using Scanning Electron Microscopy (SEM) and micro-computed tomography (μ-CT). Tomography data revealed an open porosity of 35% for the construct, mostly contributed from the ceramic phase since the elastomer side has no pore. Homogeneous β-TCP distribution within the elastomeric structure was observed. Cell culture studies confirmed biocompatibility with poor elastomer-side and good bone-side cell attachment. In a further study to investigate the osteogenic properties, the construct were loaded with BMP-2 and/or TGF-β1. The PGS/β-TCP bi-layered constructs with improved mechanical and biological properties have the potential to be used in bone-soft tissue interface applications where soft tissue penetration is a problem.

Biodegradable Polymer Membranes Applied in Guided Bone/Tissue Regeneration: A Review

Polymer membranes have been widely used in guided tissue regeneration (GTR) and guided bone regeneration (GBR). In this review, various commercially available membranes are described. Much attention is paid to the recent development of biodegradable polymers applied in GTR and GBR, and the important issues of biodegradable polymeric membranes, including their classification, latest experimental research and clinical applications, as well as their main challenges are addressed. Herein, natural polymers, synthetic polymers and their blends are all introduced. Pure polymer membranes are biodegradable and biocompatible, but they lack special properties such as antibacterial properties, osteoconductivity, and thus polymer membranes loaded with functional materials such as antibacterial agents and growth factors show many more advantages and have also been introduced in this review. Despite there still being complaints about polymer membranes, such as their low mechanical properties, uncontrollable degradation speed and some other drawbacks, these problems will undoubtedly be conquered and biodegradable polymers will have more applications in GTR and GBR.

Calcium Orthophosphate-Containing Biocomposites and Hybrid Biomaterials for Biomedical Applications

The state-of-the-art on calcium orthophosphate (CaPO4)-containing biocomposites and hybrid biomaterials suitable for biomedical applications is presented. Since these types of biomaterials offer many significant and exciting possibilities for hard tissue regeneration, this subject belongs to a rapidly expanding area of biomedical research. Through the successful combinations of the desired properties of matrix materials with those of fillers (in such systems, CaPO4 might play either role), innovative bone graft biomaterials can be designed. Various types of CaPO4-based biocomposites and hybrid biomaterials those are either already in use or being investigated for biomedical applications are extensively discussed. Many different formulations in terms of the material constituents, fabrication technologies, structural and bioactive properties, as well as both in vitro and in vivo characteristics have been already proposed. Among the others, the nano-structurally controlled biocomposites, those containing nanodimensional compounds, biomimetically fabricated formulations with collagen, chitin and/or gelatin, as well as various functionally graded structures seem to be the most promising candidates for clinical applications. The specific advantages of using CaPO4-based biocomposites and hybrid biomaterials in the selected applications are highlighted. As the way from a laboratory to a hospital is a long one and the prospective biomedical candidates have to meet many different necessities, the critical issues and scientific challenges that require further research and development are also examined.

Star-shaped PCL/PLLA blended fiber membrane via electrospinning

Electrospun fiber mesh has been a candidate for guided bone regeneration membrane. However, its poor mechanics property has been limited in clinical application. In this study, various star-shaped poly(ε-caprolactones) (PCLs) are successfully synthesized by ring-opening polymerization and mixed with poly(l-lactide) (PLLA) to be made into blended membranes through electrospinning. Their corresponding properties are evaluated including morphology, thermodynamics, mechanics, and cytotoxicity. The blended fibers show smooth surface and well-distributed structure, which have slight differences in morphology with the change of arm number of star-shaped PCL. Crystallization of the fibrous membrane is influenced by star-shaped PCLs. Glass temperature drops from 64.23 °C for pure PLLA membrane to 53.62-49 °C for the blended membranes. The membranous tensile strength is depended strongly on star-shaped PCLs. The tensile strength goes up with arm number increasing; on the contrary, at the same arm number, the mechanics strength decreases with molecular weight increasing. And the fibrous membrane containing 20 wt.% star-shaped PCL shows better mechanics property compared to the other membranes. The star-shaped PCL/PLLA fiber membrane is not cytotoxicity.