Role of nanostructured biopolymers and bioceramics in enamel, dentin and periodontal tissue regeneration

Bioinspired Multiscale Mineralization: From Fundamentals to Potential Applications

The wondrous and imaginative designs of nature have always been an inexhaustible treasure trove for material scientists. Throughout the long evolutionary process, biominerals with hierarchical structures possess some specific advantages such as outstanding mechanical properties, biological functions, and sensing performances, the formation of which (biomineralization) is delicately regulated by organic component. Provoked by the subtle structures and profound principles of nature, bioinspired functional minerals can be designed with the participation of organic molecules. Because of the designable morphology and functions, multiscale mineralization has attracted more and more attention in the areas of medicine, chemistry, biology, and material science. This review provides a summary of current advancements in this extending topic. The mechanisms underlying mineralization is first concisely elucidated. Next, several types of minerals are categorized according to their structural characteristic, as well as the different potential applications of these materials. At last, a comprehensive overview of future developments for bioinspired multiscale mineralization is given. Concentrating on the mechanism of fabrication and broad application prospects of multiscale mineralization, the hope is to provide inspirations for the design of other functional materials.

Biomimetic Hydrogels as the Inductive Endochondral Ossification Template for Promoting Bone Regeneration

Repairing critical size bone defects (CSBD) is a major clinical challenge and requires effective intervention by biomaterial scaffolds. Inspired by the fact that the cartilaginous template-based endochondral ossification (ECO) process is crucial to bone healing and development, developing biomimetic biomaterials to promote ECO is recognized as a promising approach for repairing CSBD. With the unique highly hydrated 3D polymeric network, hydrogels can be designed to closely emulate the physiochemical properties of cartilage matrix to facilitate ECO. In this review, the various preparation methods of hydrogels possessing the specific physiochemical properties required for promoting ECO are introduced. The materiobiological impacts of the physicochemical properties of hydrogels, such as mechanical properties, topographical structures and chemical compositions on ECO, and the associated molecular mechanisms related to the BMP, Wnt, TGF-β, HIF-1α, FGF, and RhoA signaling pathways are further summarized. This review provides a detailed coverage on the materiobiological insights required for the design and preparation of hydrogel-based biomaterials to facilitate bone regeneration.

Asymmetric resorbable-based dental barrier membrane for periodontal guided tissue regeneration and guided bone regeneration: A review

Guided tissue regeneration (GTR) and guided bone regeneration (GBR) are two common dental regenerative treatments targeted at reconstructing damaged periodontal tissue and bone caused by periodontitis. During GTR/GBR treatment, a barrier membrane is placed in the interface between the soft tissue and the periodontal defect to inhibit soft tissue ingrowth and creating a space for the infiltration of slow-growing bone cells into the defect site. Recently, asymmetric resorbable-based barrier membrane has received a considerable attention as a new generation of GTR/GBR membrane. Despite numerous literatures about asymmetric-based membrane that had been published, there is lacks comprehensive review on asymmetric barrier membrane that particularly highlight the importance of membrane structure for periodontal regeneration. In this review, we systematically cover the latest development and advancement of various kinds of asymmetric barrier membranes used in periodontal GTR/GBR application. Herein, the ideal requirements for constructing a barrier membrane as well as the rationale behind the asymmetric design, are firstly presented. Various innovative methods used in fabricating asymmetric barrier membrane are being further discussed. Subsequently, the application and evaluation of various types of asymmetric barrier membrane used for GTR/GBR are compiled and extensively reviewed based on the recent literatures reported. Based on the existing gap in this field, the future research directions of asymmetric resorbable-based barrier membrane such as its combination potential with bone grafts, are also presented.

Advances in biomineralization-inspired materials for hard tissue repair

Biomineralization is the process by which organisms form mineralized tissues with hierarchical structures and excellent properties, including the bones and teeth in vertebrates. The underlying mechanisms and pathways of biomineralization provide inspiration for designing and constructing materials to repair hard tissues. In particular, the formation processes of minerals can be partly replicated by utilizing bioinspired artificial materials to mimic the functions of biomolecules or stabilize intermediate mineral phases involved in biomineralization. Here, we review recent advances in biomineralization-inspired materials developed for hard tissue repair. Biomineralization-inspired materials are categorized into different types based on their specific applications, which include bone repair, dentin remineralization, and enamel remineralization. Finally, the advantages and limitations of these materials are summarized, and several perspectives on future directions are discussed.

Recent trends in gelatin methacryloyl nanocomposite hydrogels for tissue engineering

Gelatin methacryloyl (GelMA), a photocrosslinkable gelatin-based hydrogel, has been immensely used for diverse applications in tissue engineering and drug delivery. Apart from its excellent functionality and versatile mechanical properties, it is also suitable for a wide range of fabrication methodologies to generate tissue constructs of desired shapes and sizes. Despite its exceptional characteristics, it is predominantly limited by its weak mechanical strength, as some tissue types naturally possess high mechanical stiffness. The use of high GelMA concentrations yields high mechanical strength, but not without the compromise in its porosity, degradability, and three-dimensional (3D) cell attachment. Recently, GelMA has been blended with various natural and synthetic biomaterials to reinforce its physical properties to match with the tissue to be engineered. Among these, nanomaterials have been extensively used to form a composite with GelMA, as they increase its biological and physicochemical properties without affecting the unique characteristics of GelMA and also introduce electrical and magnetic properties. This review article presents the recent advances in the formation of hybrid GelMA nanocomposites using a variety of nanomaterials (carbon, metal, polymer, and mineral-based). We give an overview of each nanomaterial's characteristics followed by a discussion of the enhancement in GelMA's physical properties after its incorporation. Finally, we also highlight the use of each GelMA nanocomposite for different applications, such as cardiac, bone, and neural regeneration.

Biopolymers Hybrid Particles Used in Dentistry

This literature review provides an overview of the fabrication and application of biopolymer hybrid particles in dentistry. A total of 95 articles have been included in this review. In the review paper, the common inorganic particles and biopolymers used in dentistry are discussed in general, and detailed examples of inorganic particles (i.e., hydroxyapatite, calcium phosphate, and bioactive glass) and biopolymers such as collagen, gelatin, and chitosan have been drawn from the scientific literature and practical work. Among the included studies, calcium phosphate including hydroxyapatite is the most widely applied for inorganic particles used in dentistry, but bioactive glass is more applicable and multifunctional than hydroxyapatite and is currently used in clinical practice. Today, biopolymer hybrid particles are receiving more attention as novel materials for several applications in dentistry, such as drug delivery systems, bone repair, and periodontal regeneration surgery. The literature published on the biopolymer gel-assisted synthesis of inorganic particles for dentistry is somewhat limited, and therefore, this article focuses on reviewing and discussing the biopolymer hybrid particles used in dentistry.

A Bibliometric Analysis of the Global Trend of Using Alginate, Gelatine, and Hydroxyapatite for Bone Tissue Regeneration Applications

Collecting information from previous investigations and expressing it in a scientometrics study can be a priceless guide to getting a complete overview of a specific research area. The aim of this study is to explore the interrelated connection between alginate, gelatine, and hydroxyapatite within the scope of bone tissue and scaffold. A review of traditional literature with data mining procedures using bibliometric analyses was considered to identify the evolution of the selected research area between 2009 and 2019. Bibliometric methods and knowledge visualization technologies were implemented to investigate diverse publications based on the following indicators: year of publication, document type, language, country, institution, author, journal, keyword, and number of citations. An analysis using a bibliometric study found that 7446 papers were located with the keywords "bone tissue" and "scaffold", and 1767 (alginate), 185 (gelatine), 5658 (hydroxyapatite) papers with those specific sub keywords. The number of publications that relate to "tissue engineering" and bone more than doubled between 2009 (1352) and 2019 (2839). China, the United States and India are the most productive countries, while Sichuan University and the Chinese Academy of Science from China are the most important institutions related to bone tissue scaffold. Materials Science and Engineering C is the most productive journal, followed by the Journal of Biomedical Materials Research Part A. This paper is a starting point, providing the first bibliometric analysis study of bone tissue and scaffold considering alginate, gelatine and hydroxyapatite. A bibliometric analysis would greatly assist in giving a scientific insight to support desired future research work, not only associated with bone tissue engineering applications. It is expected that the analysis of alginate, gelatine and hydroxyapatite in terms of 3D bioprinting, clinical outcomes, scaffold architecture, and the regenerative medicine approach will enhance the research into bone tissue engineering in the near future. Continued studies into these research fields are highly recommended.

Electrospun polyamide-6/chitosan nanofibers reinforced nano-hydroxyapatite/polyamide-6 composite bilayered membranes for guided bone regeneration

Periodontal defect poses a significant challenge in orthopedics. Guided Bone Regeneration (GBR) membrane is considered as one of the most successful methods applied to reconstruct alveolar bone and then to achieve periodontal defect repair/regeneration. In this paper, a novel polyamide-6/chitosan@nano-hydroxyapatite/polyamide-6 (PA6/CS@n-HA/PA6) bilayered tissue guided membranes by combining a solvent casting and an electrospinning technique was designed. The developed PA6/CS@n-HA/PA6 composites were characterized by a series of tests. The results show that n-HA/PA6 and electrospun PA6/CS layers are tightly bound by molecular interaction and chemical bonding, which enhances the bonding strength between two distinct layers. The porosity and adsorption average pore diameter of the PA6/CS@n-HA/PA6 membranes are 36.90 % and 22.61 nm, respectively. The tensile strength and elastic modulus of PA6/CS@n-HA/PA6 composites are 1.41 ± 0.18 MPa and 7.15 ± 1.09 MPa, respectively. In vitro cell culture studies demonstrate that PA6/CS@n-HA/PA6 bilayered scaffolds have biological safety, good bioactivity, biocompatibility and osteoconductivity.

Nanomaterials in Dentistry: State of the Art and Future Challenges

Nanomaterials are commonly considered as those materials in which the shape and molecular composition at a nanometer scale can be controlled. Subsequently, they present extraordinary properties that are being useful for the development of new and improved applications in many fields, including medicine. In dentistry, several research efforts are being conducted, especially during the last decade, for the improvement of the properties of materials used in dentistry. The objective of the present article is to offer the audience a complete and comprehensive review of the main applications that have been developed in dentistry, by the use of these materials, during the last two decades. It was shown how these materials are improving the treatments in mainly all the important areas of dentistry, such as endodontics, periodontics, implants, tissue engineering and restorative dentistry. The scope of the present review is, subsequently, to revise the main applications regarding nano-shaped materials in dentistry, including nanorods, nanofibers, nanotubes, nanospheres/nanoparticles, and zeolites and other orders porous materials. The results of the bibliographic analysis show that the most explored nanomaterials in dentistry are graphene and carbon nanotubes, and their derivatives. A detailed analysis and a comparative study of their applications show that, although they are quite similar, graphene-based materials seem to be more promising for most of the applications of interest in dentistry. The bibliographic study also demonstrated the potential of zeolite-based materials, although the low number of studies on their applications shows that they have not been totally explored, as well as other porous nanomaterials that have found important applications in medicine, such as metal organic frameworks, have not been explored. Subsequently, it is expected that the research effort will concentrate on graphene and zeolite-based materials in the coming years. Thus, the present review paper presents a detailed bibliographic study, with more than 200 references, in order to briefly describe the main achievements that have been described in dentistry using nanomaterials, compare and analyze them in a critical way, with the aim of predicting the future challenges.

Bioactivity Behavior Evaluation of PCL-Chitosan-Nanobaghdadite Coating on AZ91 Magnesium Alloy in Simulated Body Fluid

Polymer–ceramic composite coatings on magnesium-based alloys have attracted lots of attention in recent years, to control the speed of degradability and to enhance bioactivity and biocompatibility. In this study, to decrease the corrosion rate in a simulated body fluid (SBF) solution for long periods, to control degradability, and to enhance bioactivity, polycaprolactone–chitosan composite coatings with different percentages of baghdadite (0 wt.%, 3 wt.%, and 5 wt.%) were applied to an anodized AZ91 alloy. According to the results of the immersion test of the composite coating containing 3 wt.% baghdadite in a phosphate buffer solution (PBS), the corrosion rate decreased from 0.45 (for the AZ91 sample) to 0.11 mg/cm2·h after seven days of immersion. To evaluate the apatite formation capability of specimens, samples were immersed in an SBF solution. The results showed that the samples were bioactive as apatite layers formed on the surface of specimens. The composite coating containing 3 wt.% baghdadite showed the highest apatite-formation capability, with a controlled release of ions, and the lowest corrosion rate in the SBF.

Laponite-based Nanomaterials for Biomedical Applications: A Review

Laponite based nanomaterials (LBNMs) are highly diverse regarding their mechanical, chemical, and structural properties, coupled with shape, size, mass, biodegradability and biocompatibility. These ubiquitous properties of LBNMs make them appropriate materials for extensive applications. These have enormous potential for effective and targeted drug delivery comprised of numerous biodegradable materials which results in enhanced bioavailability. Moreover, the clay material has been explored in tissue engineering and bioimaging for the diagnosis and treatment of various diseases. The material has been profoundly explored for minimized toxicity of nanomedicines. The present review compiled relevant and informative data to focus on the interactions of laponite nanoparticles and application in drug delivery, tissue engineering, imaging, cell adhesion and proliferation, and in biosensors. Eventually, concise conclusions are drawn concerning biomedical applications and identification of new promising research directions.

A facile strategy to construct silk fibroin based GTR membranes with appropriate mechanical performance and enhanced osteogenic capacity

A facile method to modify electrospun silk fibroin nanofibrous membranes for enhanced mechanical properties and osteogenic function via polyphenol chemistry.

Chitosan-based double-faced barrier membrane coated with functional nanostructures and loaded with BMP-6

In the present study, a chitosan-based, multifunctional and double-faced barrier membrane was developed for the periodontitis therapy. The porous surface of the membrane was coated with bone-like hydroxyapatite (HA) produced by microwave-assisted biomimetic method and enriched with bone morphogenetic factor 6 (BMP-6) to enhance the bioactivity of chitosan. This surface of the membrane was designed to be in contact with the hard tissue that was damaged due to periodontitis. Otherwise the nonporous surface of membrane, which is in contact with the inflammatory soft tissue, was coated with electrospun polycaprolactone (PCL) fibers to prevent the migration of epithelial cells to the defect area. PrestoBlue, Scanning Electron Microscope (SEM) and real-time PCR results demonstrated that while porous surface of the membrane was enhancing the proliferation and differentiation of MC3T3-E1 preosteoblasts, nonporous surface of membrane did not allow migration of epithelial Madine Darby Bovine Kidney (MDBK) cells. The barrier membrane developed here is biodegradable and can be easily manipulated, has osteogenic activity and inactivity for epithelial cells. Thus, by implanting this membrane to the damaged periodontal tissue, bone regeneration will take place and integrity of periodontal tissues will be preserved.

Controllable Synthesis of Biomimetic Hydroxyapatite Nanorods with High Osteogenic Bioactivity

The development of biodegradable materials with high osteogenic bioactivity is important for achieving rapid bone regeneration. Although hydroxyapatite (HAp) has been applied as a biomaterial for bone engineering due to its good osteoconductivity, conventional synthetic HAp nanomaterials still lack sufficient osteogenesis, likely due to their high crystallinity and uncontrollable architecture. A design of HAp nanoparticles mimicking bone features may create good microenvironments that promote osteogenesis for rapid bone regeneration. In this study, HAp nanoparticles with a comparatively less crystalline structure and nanorod shapes mimicking biological HAp nanocrystals of natural bone were fabricated using a simple chemical precipitation approach with mild temperature control in the absence of any organic solvents. Transmission electron microscopy (TEM) indicated that HAp nanorods with aspect ratios from 2.0 to 4.4 were synthesized by adjusting the reaction time as well as the reaction temperature. Fourier transform infrared spectroscopy and X-ray diffraction experiments displayed that HAp nanorods prepared at 30 °C (HAp-30 with an aspect ratio of 2.9) had a low crystalline structure and B-type CO₃^2- substitution similar to those of natural HAp originating from bone tissue. The energy-dispersive spectroscopy (EDS) results showed that the Ca/P ratio of HAp-30 was 1.66 ± 0.13. An in vitro biological evaluation against rat bone marrow-derived mesenchymal stem cells indicated that the resulting HAp nanorods had excellent biocompatibility (with an ∼80-fold increase in IC50 compared to that of conventional HAp nanoparticles). Interestingly, the alkaline phosphatase (ALP), alizarin red S, and immunofluorescence staining results all showed that stem cells display an obvious osteogenesis dependence on the HAp nanostructure. Specifically, HAp nanorods with a moderate aspect ratio had the optimal osteogenic capacity (e.g., HAp-30 offered a 2.8-fold increase in ALP expression and a 4-fold increase in OCN expression relative to that provided by irregular HAp at day 14). It is expected that HAp nanorods with controllable architectures and size have potential as a kind of new bioactive bone filler for bone defect repair.

Applying Baghdadite/PCL/Chitosan Nanocomposite Coating on AZ91 Magnesium Alloy to Improve Corrosion Behavior, Bioactivity, and Biodegradability

Magnesium alloys have received a great amount of attention regarding being used in biomedical applications; however, they show high degradability, poor bioactivity, and biocompatibility. To improve these properties, surface modification and various types of coatings have been applied. In this study, an anodized AZ91 alloy was coated with a polymer matrix composite made of polycaprolactone/chitosan (PCL/Ch) with different percentages of baghdadite to improve its resistance to corrosion, bioactivity, and biocompatibility. The effects of different percentages of baghdadite (0 wt %, 1 wt %, 3 wt %, and 5 wt %) on the surface microstructure, corrosion resistance, roughness, and wettability were evaluated. The results indicated that the applied nano-polymer-ceramic coating including 3 wt % baghdadite was hydrophobic, which consequently increased the corrosion resistance and decreased the corrosion current density of the anodized AZ91 alloy. Coating with 3 wt % baghdadite increased the roughness of AZ91 from 0.329 ± 0.02 to 7.026 ± 0.31 μm. After applying the polymer-ceramic coating on the surface of anodized AZ91, the corrosion products changed into calcium–phosphate compounds instead of Mg(OH)2, which is more stable in a physiological environment.

Advance of Nano-Composite Electrospun Fibers in Periodontal Regeneration

Periodontitis is considered to be the main cause of tooth loss, which affects about 15% of the adult population around the world. Scaling and root-planning are the conventional treatments utilized to remove the contaminated tissue and bacteria, but eventually lead to the formation of a poor connection—long junctional epithelium. Therefore, regenerative therapies, such as guided tissue/bone regeneration (GTR/GBR) for periodontal regeneration have been attempted. GTR membranes, acting as scaffolds, create three-dimensional (3D) environment for the guiding of cell attachment, proliferation and differentiation, and play a significant role in periodontal regeneration. Nano-composite scaffolds based on electrospun nanofibers have gained great attention due to their ability to emulate natural extracellular matrix (ECM) that affects cell survival, attachment and reorganization. Promoted protein absorption, cellular reactions, activation of specific gene expression and intracellular signaling, and high surface area to volume ratio are also important properties of nanofibrous scaffolds. Moreover, several bioactive components, such as bioceramics and functional polymers can be easily blended into nanofibrous matrixes to regulate the physical-chemical-biological properties and regeneration abilities. Simultaneously, functional growth factors, proteins and drugs are also incorporated to regulate cellular reactions and even modify the local inflammatory microenvironment, which benefit periodontal regeneration and functional restoration. Herein, the progress of nano-composite electrospun fibers for periodontal regeneration is reviewed, including fabrication methods, compound types and processes, and surface modifications, etc. Significant proof-of-concept examples are utilized to illustrate the results of material characteristics, cellular interactions and periodontal regenerations. Finally, the existing limitations of nano-composite electrospun fibers and the development tendencies in future are also discussed.

Influence of chemically modified Luffa on the preparation of nanofiber and its biological evaluation for biomedical applications

In the present investigation, the natural cellulose was extracted from Luffa cylindrica vegetable sponge by chemical modification. Both chemically modified and unmodified Luffa was characterized by Fourier-transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy. The chemically modified cellulose was used for the preparation of a nanofibrous scaffold using the electrospinning method. In order to achieve the uniform and bead free fibers with desired fiber diameter the parameters such as applied voltage, tip to collector distance, solution concentration were optimized. Different ratio of hydroxyapatite (HAP): polylactic acid (PLA) such as 40:60, 50:50, 60:40, and 70:30 have been selected for the current evaluation and was compared with HAP-treated cellulose (TC)-PLA. With the increase in the concentration of HAP in the polymeric network, the diameter of the fiber was found to be thin with the high electric field. The functional group, phase formation and dielectric and mechanical properties of the developed nanofiber have been characterized by FTIR, XRD, mechanical property measurements, and SEM. From the results, we observed that the polymer composite developed with the ratio of 70:30 produces a bead free product with enhanced mechanical and bioactivity property by the formation of hydroxy carbonated apatite layer on the surface. All the nanofibrous scaffold fabricated with and without modification have shown good Cyto compatibility on MG-63 Osteoblast cell lines at 48 hr. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 610-620, 2019.

Recent Trends in the Fabrication of Starch Nanofibers: Electrospinning and Non-electrospinning Routes and Their Applications in Biotechnology

Electrospinning a versatile and the most preferred technique for the fabrication of nanofibers has revolutionized by opening unlimited avenues in biomedical fields. Presently, the simultaneous functionalization and/or post-modification of as-spun nanofibers with biomolecules has been explored, to serve the distinct goals in the aforementioned field. Starch is one of the most abundant biopolymers on the earth. Besides, being biocompatible and biodegradable in nature, it has unprecedented properties of gelatinization and retrogradation. Therefore, starch has been used in numerous ways for wide range of applications. Keeping these properties in consideration, the present article summarizes the recent expansion in the fabrication of the pristine/modified starch-based composite scaffolds by electrospinning along with their possible applications. Apart from electrospinning technique, this review will also provide the comprehensive information on various other techniques employed in the fabrication of the starch-based nanofibers. Furthermore, we conclude with the challenges to be overcome in the fabrication of nanofibers by the electrospinning technique and future prospects of starch-based fabricated scaffolds for exploration of its applications.

Nano-Biphasic Calcium Phosphate Ceramic for the Repair of Bone Defects

Calcium phosphate bioceramics has recently experienced increased interest in bone reconstruction. Mimicking of natural structure of bone, like the use of nanomaterials, is an attractive approach for generating scaffolds for bone regeneration. The aim of present study was to evaluate the effect of nanonization on the biphasic calcium phosphate (BCP) ceramic in the repair of bone cavities in the canine mandible. A commercial BCP was dry-milled in a high energy planetary ball mill with zirconia balls and container. Three holes (8 mm in diameter) were outlined to the depth of cortical bone of mandibular angle of 5 dogs bilaterally. The first hole (positive control group A, n = 10) was filled in with commercial BCP material. The second hole was loaded with the nanonized BCP (experimental group C, n = 10) and the third one was left untreated (negative control group B, n = 10). The defects were allowed to regenerate for 8 weeks. New bone formation was greater in groups A and C than in B. No difference was seen between group A and group C (P = 0.676). The residual bone material in group C (19.34 ± 8.03) was as much as one-half of that in group A (38.69 ± 7.90%) (P = 0.000). The negative control group B presented the highest amount of soft tissue within the bone defects. The least percentage of marrow space was found in the positive control group (13.23 ± 13.52). Our results depicted that the rate of resorption increased significantly after nanonization even though the nano-sized BCP failed to make a superior regeneration than the ordinary BCP.

The anti-inflammatory effect of locally delivered nano-doxycycline gel in therapy of chronic periodontitis

BACKGROUND AND OBJECTIVE

To date, various drugs as host modulating agents had been suggested as adjunctive treatment modality in the therapy of chronic periodontal disease. In this study, the anti-inflammatory effect of subgingivally delivered nanostructured doxycycline gel (nDOX) was evaluated and compared to conventional doxycycline gel (DOX) used as adjunct to scaling and root planning (SRP) in the treatment of moderate chronic periodontitis to reduce probing pocket depth.

MATERIAL AND METHODS

Nanostructured doxycycline gel (nDOX) was prepared using spray-drying technique with chitosan (CH) as a matrix polymer, followed by dispersion in polyvinyl alcohol (PVA). The deepest periodontal pocket in 45 patients suffering from moderate chronic periodontitis was selected. The patients were divided into three groups following scaling and root planning (SRP); group I: SRP + nDOX, group II: SRP + DOX and group III: SRP + placeboCH. Plaque Index (PI), Gingival Index (GI), pocket depth (PD) and clinical attachment level(CAL), as well as ginigival crevicular fluid levels of (GCF) IL-6 and TNF-α were assessed at baseline, 1 and 3 months following local drug application.

RESULTS

Group I showed significant reduction in probing depth and attachment gain compared with group II and III at one and three months period. The inflammatory mediators levels were significantly reduced in all treatment groups at one-month period. Except for group I, the reduced values were observed at three-month period.

CONCLUSION

The results suggest that treatment with nDOX gel as an adjunct to SRP had anti-inflammatory effect by improving both clinical parameters and inflammatory markers up to three months period.

Engineered scaffolds and cell-based therapy for periodontal regeneration

BACKGROUND

The main objective of regenerative periodontal therapy is to completely restore the periodontal tissues lost. This review summarizes the most recent evidence in support of scaffold- and cell-based tissue engineering, which are expected to play a relevant role in next-generation periodontal regenerative therapy.

METHODS

A literature search (PubMed database) was performed to analyze more recently updated articles regarding periodontal regeneration, scaffolds and cell-based technologies.

RESULTS

Evidence supports the importance of scaffold physical cues to promote periodontal regeneration, including scaffold multicompartmentalization and micropatterning. The in situ delivery of biological mediators and/or cell populations, both stem cells and already differentiated cells, has shown promising in vivo efficacy.

CONCLUSIONS

Porous scaffolds are pivotal for clot stabilization, wound compartmentalization, cell homing and cell nutrients delivery. Given the revolutionary introduction of rapid prototyping technique and cell-based therapies, the fabrication of custom-made scaffolds is not far from being achieved.

Advances and perspectives in tooth tissue engineering

Bio-engineered teeth that can grow and remodel in a manner similar to that of natural teeth have the potential to serve as permanent replacements to the currently used prosthetic teeth, such as dental implants. A major challenge in designing functional bio-engineered teeth is to mimic both the structural and anisotropic mechanical characteristics of the native tooth. Therefore, the field of dental and whole tooth regeneration has advanced towards the molecular and nanoscale design of bio-active, biomimetic systems, using biomaterials, drug delivery systems and stem cells. The focus of this review is to discuss recent advances in tooth tissue engineering, using biomimetic scaffolds that provide proper architectural cues, exhibit the capacity to support dental stem cell proliferation and differentiation and sequester and release bio-active agents, such as growth factors and nucleic acids, in a spatiotemporal controlled manner. Although many in vitro and in vivo studies on tooth regeneration appear promising, before tooth tissue engineering becomes a reality for humans, additional research is needed to perfect methods that use adult human dental stem cells, as opposed to embryonic dental stem cells, and to devise the means to generate bio-engineered teeth of predetermined size and shape. Copyright © 2016 John Wiley & Sons, Ltd.

Nanomaterial-based bone regeneration

Bone diseases/injuries have been driving an urgent quest for bone substitutes for bone regeneration. Nanoscaled materials with bone-mimicking characteristics may create suitable microenvironments to guide effective bone regeneration. In this review, the natural hierarchical architecture of bone and its regeneration mechanisms are elucidated. Recent progress in the development of nanomaterials which can promote bone regeneration through bone-healing mimicry (e.g., compositional, nanocrystal formation, structural, and growth factor-related mimicking) is summarized. The nanoeffects of nanomaterials on the regulation of bone-related biological functions are highlighted. How to prepare nanomaterials with combinative bone-biomimicry features according to the bone healing process is prospected in order to achieve rapid bone regeneration in situ.

From molecules to macrostructures: recent development of bioinspired hard tissue repair

This review summarizes the bioinspired strategies for hard tissue repair, ranging from molecule-induced mineralization, to microscale assembly to macroscaffold fabrication.

Dental and Nondental Stem Cell Based Regeneration of the Craniofacial Region: A Tissue Based Approach

Craniofacial reconstruction may be a necessary treatment for those who have been affected by trauma, disease, or pathological developmental conditions. The use of stem cell therapy and tissue engineering shows massive potential as a future treatment modality. Currently in the literature, there is a wide variety of published experimental studies utilising the different stem cell types available and the plethora of available scaffold materials. This review investigates different stem cell sources and their unique characteristics to suggest an ideal cell source for regeneration of individual craniofacial tissues. At present, understanding and clinical applications of stem cell therapy remain in their infancy with numerous challenges to overcome. In spite of this, the field displays immense capacity and will no doubt be utilised in future clinical treatments of craniofacial regeneration.

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.

Advancing biomaterials of human origin for tissue engineering

Biomaterials have played an increasingly prominent role in the success of biomedical devices and in the development of tissue engineering, which seeks to unlock the regenerative potential innate to human tissues/organs in a state of deterioration and to restore or reestablish normal bodily function. Advances in our understanding of regenerative biomaterials and their roles in new tissue formation can potentially open a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multi-component construction of native extracellular matrices (ECMs) for cell accommodation, the synthetic biomaterials produced today routinely incorporate biologically active components to define an artificial in vivo milieu with complex and dynamic interactions that foster and regulate stem cells, similar to the events occurring in a natural cellular microenvironment. The range and degree of biomaterial sophistication have also dramatically increased as more knowledge has accumulated through materials science, matrix biology and tissue engineering. However, achieving clinical translation and commercial success requires regenerative biomaterials to be not only efficacious and safe but also cost-effective and convenient for use and production. Utilizing biomaterials of human origin as building blocks for therapeutic purposes has provided a facilitated approach that closely mimics the critical aspects of natural tissue with regard to its physical and chemical properties for the orchestration of wound healing and tissue regeneration. In addition to directly using tissue transfers and transplants for repair, new applications of human-derived biomaterials are now focusing on the use of naturally occurring biomacromolecules, decellularized ECM scaffolds and autologous preparations rich in growth factors/non-expanded stem cells to either target acceleration/magnification of the body's own repair capacity or use nature's paradigms to create new tissues for restoration. In particular, there is increasing interest in separating ECMs into simplified functional domains and/or biopolymeric assemblies so that these components/constituents can be discretely exploited and manipulated for the production of bioscaffolds and new biomimetic biomaterials. Here, following an overview of tissue auto-/allo-transplantation, we discuss the recent trends and advances as well as the challenges and future directions in the evolution and application of human-derived biomaterials for reconstructive surgery and tissue engineering. In particular, we focus on an exploration of the structural, mechanical, biochemical and biological information present in native human tissue for bioengineering applications and to provide inspiration for the design of future biomaterials.

Advances in collagen, chitosan and silica biomaterials for oral tissue regeneration: from basics to clinical trials

Different materials have distinct surface and bulk characteristics; each of them potentially useful for the treatment of a particular wound or disease.

A Review on the Recent Research of Polycaprolactone (PCL)

The concept of biodegradable plastics is of considerable interest with respect to solid waste accumulation. Greater efforts have been made in developing degradable biological materials without any environmental pollution to replace the traditional plastics. Among numerous kinds of degradable polymers, polycaprolactone sometimes called PCL, an aliphatic polyester and biocompatible thermoplastic, is currently a most promising and popular material with the brightest development prospect and was considered as the ‘green’ eco friendly material. The application for this biodegradable plastic includes controlled drug releases, tissue engineering, bone scaffolds, packaging and, compost bags etc. This review will provide information on current PCL development, material properties of PCL and its composites, and also its wide spectrum applications.

Freeze gelated porous membranes for periodontal tissue regeneration

Guided tissue regeneration (GTR) membranes have been used for the management of destructive forms of periodontal disease as a means of aiding regeneration of lost supporting tissues, including the alveolar bone, cementum, gingiva and periodontal ligaments (PDL). Currently available GTR membranes are either non-biodegradable, requiring a second surgery for removal, or biodegradable. The mechanical and biofunctional limitations of currently available membranes result in a limited and unpredictable treatment outcome in terms of periodontal tissue regeneration. In this study, porous membranes of chitosan (CH) were fabricated with or without hydroxyapatite (HA) using the simple technique of freeze gelation (FG) via two different solvents systems, acetic acid (ACa) or ascorbic acid (ASa). The aim was to prepare porous membranes to be used for GTR to improve periodontal regeneration. FG membranes were characterized for ultra-structural morphology, physiochemical properties, water uptake, degradation, mechanical properties, and biocompatibility with mature and progenitor osteogenic cells. Fourier transform infrared (FTIR) spectroscopy confirmed the presence of hydroxyapatite and its interaction with chitosan. μCT analysis showed membranes had 85-77% porosity. Mechanical properties and degradation rate were affected by solvent type and the presence of hydroxyapatite. Culture of human osteosarcoma cells (MG63) and human embryonic stem cell-derived mesenchymal progenitors (hES-MPs) showed that all membranes supported cell proliferation and long term matrix deposition was supported by HA incorporated membranes. These CH and HA composite membranes show their potential use for GTR applications in periodontal lesions and in addition FG membranes could be further tuned to achieve characteristics desirable of a GTR membrane for periodontal regeneration.

Bilayered construct for simultaneous regeneration of alveolar bone and periodontal ligament

Periodontitis is an inflammatory disease that causes destruction of tooth-supporting tissues and if left untreated leads to tooth loss. Current treatments have shown limited potential for simultaneous regeneration of the tooth-supporting tissues. To recreate the complex architecture of the periodontium, we developed a bilayered construct consisting of poly(caprolactone) (PCL) multiscale electrospun membrane (to mimic and regenerate periodontal ligament, PDL) and a chitosan/2wt % CaSO4 scaffold (to mimic and regenerate alveolar bone). Scanning electron microscopy results showed the porous nature of the scaffold and formation of beadless electrospun multiscale fibers. The fiber diameter of microfiber and nanofibers was in the range of 10 ± 3 µm and 377 ± 3 nm, respectively. The bilayered construct showed better protein adsorption compared to the control. Osteoblastic differentiation of human dental follicle stem cells (hDFCs) on chitosan/2wt % CaSO4 scaffold showed maximum alkaline phosphatase at seventh day followed by a decline thereafter when compared to chitosan control scaffold. Fibroblastic differentiation of hDFCs was confirmed by the expression of PLAP-1 and COL-1 proteins which were more prominent on PCL multiscale membrane in comparison to control membranes. Overall these results show that the developed bilayered construct might serve as a good candidate for the simultaneous regeneration of the alveolar bone and PDL.

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Strontium-substituted hierarchical Ti surface can enhance the osseointegration by both increasing new bone formation and reducing bone resorption under osteoporotic conditions.

Preparation of laponite bioceramics for potential bone tissue engineering applications

We report a facile approach to preparing laponite (LAP) bioceramics via sintering LAP powder compacts for bone tissue engineering applications. The sintering behavior and mechanical properties of LAP compacts under different temperatures, heating rates, and soaking times were investigated. We show that LAP bioceramic with a smooth and porous surface can be formed at 800°C with a heating rate of 5°C/h for 6 h under air. The formed LAP bioceramic was systematically characterized via different methods. Our results reveal that the LAP bioceramic possesses an excellent surface hydrophilicity and serum absorption capacity, and good cytocompatibility and hemocompatibility as demonstrated by resazurin reduction assay of rat mesenchymal stem cells (rMSCs) and hemolytic assay of pig red blood cells, respectively. The potential bone tissue engineering applicability of LAP bioceramic was explored by studying the surface mineralization behavior via soaking in simulated body fluid (SBF), as well as the surface cellular response of rMSCs. Our results suggest that LAP bioceramic is able to induce hydroxyapatite deposition on its surface when soaked in SBF and rMSCs can proliferate well on the LAP bioceramic surface. Most strikingly, alkaline phosphatase activity together with alizarin red staining results reveal that the produced LAP bioceramic is able to induce osteoblast differentiation of rMSCs in growth medium without any inducing factors. Finally, in vivo animal implantation, acute systemic toxicity test and hematoxylin and eosin (H&E)-staining data demonstrate that the prepared LAP bioceramic displays an excellent biosafety and is able to heal the bone defect. Findings from this study suggest that the developed LAP bioceramic holds a great promise for treating bone defects in bone tissue engineering.

In vivo study of chitosan-natural nano hydroxyapatite scaffolds for bone tissue regeneration

Significant development has been achieved with bioceramics and biopolymer scaffolds in the construction of artificial bone. In the present study, we have developed and compared chitosan-micro hydroxyapatite (chitosan-mHA) and chitosan-nano hydroxyapatite (chitosan-nHA) scaffolds as bone graft substitutes. The biocompatibility and cell proliferation of the prepared scaffolds were checked with preosteoblast (MC3T3-E1) cells. Total Volume (TV), bone volume (BV), bone surface (BS), trabecular thickness (Tb.Th), trabecular number (Tb.N) and trabecular separation (Tb.Sp) were found to be higher in chitosan-nHA than chitosan-mHA scaffold. Hence, we suggest that chitosan-nHA scaffold could be a promising biomaterial for bone tissue engineering.

Tetracycline nanoparticles loaded calcium sulfate composite beads for periodontal management

BACKGROUND

The objective of this study was to fabricate, characterize and evaluate in vitro, an injectable calcium sulfate bone cement beads loaded with an antibiotic nanoformulation, capable of delivering antibiotic locally for the treatment of periodontal disease.

METHODS

Tetracycline nanoparticles (Tet NPs) were prepared using an ionic gelation method and characterized using DLS, SEM, and FTIR to determine size, morphology, stability and chemical interaction of the drug with the polymer. Further, calcium sulfate (CaSO4) control and CaSO4-Tet NP composite beads were prepared and characterized using SEM, FTIR and XRD. The drug release pattern, material properties and antibacterial activity were evaluated. In addition, protein adsorption, cytocompatibility and alkaline phosphatase activity of the CaSO4-Tet NP composite beads in comparison to the CaSO4 control were analyzed.

RESULTS

Tet NPs showed a size range of 130±20nm and the entrapment efficiency calculated was 89%. The composite beads showed sustained drug release pattern. Further the drug release data was fitted into various kinetic models wherein the Higuchi model showed higher correlation value (R(2)=0.9279) as compared to other kinetic models. The composite beads showed antibacterial activity against Staphylococcus aureus and Escherichia coli. The presence of Tet NPs in the composite bead didn't alter its cytocompatibility. In addition, the composite beads enhanced the ALP activity of hPDL cells.

CONCLUSIONS

The antibacterial and cytocompatible CaSO4-Tet NP composite beads could be beneficial in periodontal management to reduce the bacterial load at the infection site.

GENERAL SIGNIFICANCE

Tet NPs would deliver antibiotic locally at the infection site and the calcium sulfate cement, would itself facilitate tissue regeneration.

Uniaxially aligned electrospun all-cellulose nanocomposite nanofibers reinforced with cellulose nanocrystals: scaffold for tissue engineering

Uniaxially aligned cellulose nanofibers with well oriented cellulose nanocrystals (CNCs) embedded were fabricated via electrospinning using a rotating drum as the collector. Scanning electron microscope (SEM) images indicated that most cellulose nanofibers were uniaxially aligned. The incorporation of CNCs into the spinning dope resulted in more uniform morphology of the electrospun cellulose/CNCs nanocomposite nanofibers (ECCNN). Polarized light microscope (PLM) and transmission electron microscope (TEM) showed that CNCs dispersed well in ECCNN nonwovens and achieved considerable orientation along the long axis direction. This unique hierarchical microstructure of ECCNN nonwovens gave rise to remarkable enhancement of their physical properties. By incorporating 20% loading (in weight) of CNCs, the tensile strength and elastic modulus of ECCNN along the fiber alignment direction were increased by 101.7 and 171.6%, respectively. Their thermal stability was significantly improved as well. In addition, the ECCNN nonwovens were assessed as potential scaffold materials for tissue engineering. It was elucidated from MTT tests that the ECCNN were essentially nontoxic to human cells. Cell culture experiments demonstrated that cells could proliferate rapidly not only on the surface but also deep inside the ECCNN. More importantly, the aligned nanofibers of ECCNN exhibited a strong effect on directing cellular organization. This feature made the scaffold particularly useful for various artificial tissues or organs, such as blood vessel, tendon, nerve, and so on, in which cell orientation was crucial for their performance.

Fabrication and evaluation of electrospun PCL–gelatin micro-/nanofiber membranes for anti-infective GTR implants

Infection is the major reason for GTR/GBR membrane failure in clinical applications.