Hydrogel Tissue Expanders for Stomatology. Part II. Poly(styrene-maleic anhydride) Hydrogels

Hydrogel based soft tissue expanders for orodental reconstruction

Tension-free flap closure to prevent soft tissue dehiscence is a prerequisite for successful bone augmentation in orodental reconstructive surgery. Since soft tissue contour follows the underlying jaw bony architecture, resorption of alveolar (jaw) bone limits the availability of soft tissue for wound closure following major bone reconstruction, required to facilitate oral rehabilitation with endosseous dental implants following tooth loss. Although there are several clinical procedures to increase soft tissue volume, these techniques are complicated and technically demanding. Soft tissue expansion, an established technique in reconstructive surgery, is an ideal alternative to generate surplus soft tissue prior to bone augmentation and dental implant placement. Increase in tissue volume can be achieved by using soft tissue expanders (STEs). Contemporary STEs have evolved from silicone balloons to osmotically inflating hydrogel-based systems. Here, we provide an overview of STEs in clinical oral surgery, outline the current research in STEs, and an update on recent clinical trials as well as the associated complications. Also, the mechanism governing soft tissue expansion and the critical factors that control the expansion process are covered. Design considerations for STEs for intraoral applications are given particular attention. Finally, we present our perspectives on utilization of minimally invasive methods to administer STEs for orodental applications. STATEMENT OF SIGNIFICANCE: Soft tissue expansion is required for a range of reconstructive applications and more notably in regenerative dentistry for vertical bone augmentation. This review describes the commercially available soft tissue expanders along with the latest systems being currently developed. This review insightfully discusses the biological and physical mechanisms leading to soft tissue expansion and critically assesses the design criteria of soft tissue expanders. A particular focus is given on the development of a new generation of hydrogel-based soft tissue expanders; their chemistry and required physical properties for tissue expansion is described and the obstacles towards clinical translations are identified. Finally, the review elaborates on promising minimally invasive injectable hydrogel-based tissue expanders and highlights the beneficial features of these systems.

A Supramolecular Hydrogel Based on Copolymers of Acrylic Acid and Maleic Anhydride Derivatives with Terpyridine Motifs

A kind of terpyridine derivative (NH₂-Tpy) in which the amino was incorporated by a short alkyl chain was synthesized. Through grafting of terpyridine units into the hydrophilic copolymers of maleic anhydride and acrylic acid PAAMa via the reaction of the amino groups in NH₂-Tpy and the maleic anhydride units, a series of gelator polymers—P1, P2, and P3—containing different contents of terpyridine units was synthesized. Under coordination of Ni²⁺ and terpyridine ligands in linear polymers, the supramolecular hydrogels H1, H2, and H3 with different cross-linking degrees were prepared. The linear polymers P1–P3 had a strong absorption peak at about 290 nm in the UV-vis spectra which was attributed to π–π* transition, and there was a new peak at about 335 nm led by the metal-to-ligands charge transfer (MLCT) when coordinated with Ni²⁺ ions. According to the rheological behaviors, the storage modulus (G′) was larger than the loss modulus (G′′). These hydrogels showed typical gel-like characteristics when the terpyridine content of the hydrogels exceeded 10%, and the hydrogels showed liquid-like characteristics when the terpyridine content of the hydrogels was less than 7%. The results of the micromorphological investigation of the xerogels from SEM illustrated the metal–terpyridine coordination cross-linking could have an important influence on the microstructures of the resulting hydrogels. Furthermore, these hydrogels based on supramolecular cross-links exhibited reversible solution–gel transition at different environmental temperatures. At the same time, the equilibrium swelling of the supramolecular hydrogels was 8.0–12.3 g/g, which increased with the decrease in the content of the terpyridine units in the resulting hydrogels.

Novel Self-Healing Metallocopolymers with Pendent 4-Phenyl-2,2':6',2″-terpyridine Ligand: Kinetic Studies and Mechanical Properties

We report here our successful attempt to obtain self-healing supramolecular hydrogels with new metal-containing monomers (MCMs) with pendent 4-phenyl-2,2′:6′,2″-terpyridine metal complexes as reversible moieties by free radical copolymerization of MCMs with vinyl monomers, such as acrylic acid and acrylamide. The resulting metal-polymer hydrogels demonstrate a developed system of hydrogen, coordination and electron-complementary π–π stacking interactions, which play a critical role in achieving self-healing. Kinetic data show that the addition of a third metal-containing comonomer to the system decreases the initial polymerization rate, which is due to the specific effect of the metal group located in close proximity of the active center on the growth of radicals.