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Rahimnejad M, Makkar H, Dal-Fabbro R, Malda J, Sriram G, Bottino MC. Biofabrication Strategies for Oral Soft Tissue Regeneration. Adv Healthc Mater 2024; 13:e2304537. [PMID: 38529835 PMCID: PMC11254569 DOI: 10.1002/adhm.202304537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/01/2024] [Indexed: 03/27/2024]
Abstract
Gingival recession, a prevalent condition affecting the gum tissues, is characterized by the exposure of tooth root surfaces due to the displacement of the gingival margin. This review explores conventional treatments, highlighting their limitations and the quest for innovative alternatives. Importantly, it emphasizes the critical considerations in gingival tissue engineering leveraging on cells, biomaterials, and signaling factors. Successful tissue-engineered gingival constructs hinge on strategic choices such as cell sources, scaffold design, mechanical properties, and growth factor delivery. Unveiling advancements in recent biofabrication technologies like 3D bioprinting, electrospinning, and microfluidic organ-on-chip systems, this review elucidates their precise control over cell arrangement, biomaterials, and signaling cues. These technologies empower the recapitulation of microphysiological features, enabling the development of gingival constructs that closely emulate the anatomical, physiological, and functional characteristics of native gingival tissues. The review explores diverse engineering strategies aiming at the biofabrication of realistic tissue-engineered gingival grafts. Further, the parallels between the skin and gingival tissues are highlighted, exploring the potential transfer of biofabrication approaches from skin tissue regeneration to gingival tissue engineering. To conclude, the exploration of innovative biofabrication technologies for gingival tissues and inspiration drawn from skin tissue engineering look forward to a transformative era in regenerative dentistry with improved clinical outcomes.
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Affiliation(s)
- Maedeh Rahimnejad
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hardik Makkar
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Renan Dal-Fabbro
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Jos Malda
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gopu Sriram
- Faculty of Dentistry, National University of Singapore, Singapore
- NUS Centre for Additive Manufacturing (AM.NUS), National University of Singapore, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Marco C. Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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Le N, Lu J, Tang P, Chung KH, Subhash H, Kilpatrick-Liverman L, Wang RK. Intraoral optical coherence tomography and angiography combined with autofluorescence for dental assessment. BIOMEDICAL OPTICS EXPRESS 2022; 13:3629-3646. [PMID: 35781964 PMCID: PMC9208603 DOI: 10.1364/boe.460575] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 05/11/2023]
Abstract
There remains a clinical need for an accurate and non-invasive imaging tool for intraoral evaluation of dental conditions. Optical coherence tomography (OCT) is a potential candidate to meet this need, but the design of current OCT systems limits their utility in the intraoral examinations. The inclusion of light-induced autofluorescence (LIAF) can expedite the image collection process and provides a large field of view for viewing the condition of oral tissues. This study describes a novel LIAF-OCT system equipped with a handheld probe designed for intraoral examination of microstructural (via OCT) and microvascular information (via OCT angiography, OCTA). The handheld probe is optimized for use in clinical studies, maintaining the ability to detect and image changes in the condition of oral tissue (e.g., hard tissue damage, presence of dental restorations, plaque, and tooth stains). The real-time LIAF provides guidance for OCT imaging to achieve a field of view of approximately 6.9 mm × 7.8 mm, and a penetration depth of 1.5 mm to 3 mm depending on the scattering property of the target oral tissue. We demonstrate that the proposed system is successful in capturing reliable depth-resolved images from occlusal and palatal surfaces and offers added design features that can enhance its usability in clinical settings.
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Affiliation(s)
- Nhan Le
- Department of Bioengineering,
University of Washington, Seattle, WA
98195, USA
- These authors contributed equally to this
work
| | - Jie Lu
- Department of Bioengineering,
University of Washington, Seattle, WA
98195, USA
- These authors contributed equally to this
work
| | - Peijun Tang
- Department of Bioengineering,
University of Washington, Seattle, WA
98195, USA
| | - Kwok-Hung Chung
- Department of Restorative Dentistry,
University of Washington, Seattle, WA
98195, USA
| | | | | | - Ruikang K. Wang
- Department of Bioengineering,
University of Washington, Seattle, WA
98195, USA
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3
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Laser coagulation and hemostasis of large diameter blood vessels: effect of shear stress and flow velocity. Sci Rep 2022; 12:8375. [PMID: 35589781 PMCID: PMC9120470 DOI: 10.1038/s41598-022-12128-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/29/2022] [Indexed: 11/08/2022] Open
Abstract
Photocoagulation of blood vessels offers unambiguous advantages to current radiofrequency approaches considering the high specificity of blood absorption at available laser wavelengths (e.g., 532 nm and 1.064 µm). Successful treatment of pediatric vascular lesions, such as port-wine stains requiring microvascular hemostasis, has been documented. Although laser treatments have been successful in smaller diameter blood vessels, photocoagulation of larger sized vessels is less effective. The hypothesis for this study is that a primary limitation in laser coagulation of large diameter blood vessels (500-1000 µm) originates from shear stress gradients associated with higher flow velocities along with temperature-dependent viscosity changes. Laser (1.07 µm) coagulation of blood vessels was tested in the chicken chorio-allantoic membrane (CAM). A finite element model is developed that includes hypothetical limitations in laser coagulation during irradiation. A protocol to specify laser dosimetry is derived from OCT imaging and angiography observations as well as finite element model results. Laser dosimetry is applied in the CAM model to test the experimental hypothesis that blood shear stress and flow velocity are important parameters for laser coagulation and hemostasis of large diameter blood vessels (500-1000 µm). Our experimental results suggest that shear stress and flow velocity are fundamental in the coagulation of large diameter blood vessels (500-1000 µm). Laser dosimetry is proposed and demonstrated for successful coagulation and hemostasis of large diameter CAM blood vessels.
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Webb BCW, Glogauer M, Santerre JP. The Structure and Function of Next-Generation Gingival Graft Substitutes-A Perspective on Multilayer Electrospun Constructs with Consideration of Vascularization. Int J Mol Sci 2022; 23:5256. [PMID: 35563649 PMCID: PMC9099797 DOI: 10.3390/ijms23095256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022] Open
Abstract
There is a shortage of suitable tissue-engineered solutions for gingival recession, a soft tissue defect of the oral cavity. Autologous tissue grafts lead to an increase in morbidity due to complications at the donor site. Although material substitutes are available on the market, their development is early, and work to produce more functional material substitutes is underway. The latter materials along with newly conceived tissue-engineered substitutes must maintain volumetric form over time and have advantageous mechanical and biological characteristics facilitating the regeneration of functional gingival tissue. This review conveys a comprehensive and timely perspective to provide insight towards future work in the field, by linking the structure (specifically multilayered systems) and function of electrospun material-based approaches for gingival tissue engineering and regeneration. Electrospun material composites are reviewed alongside existing commercial material substitutes', looking at current advantages and disadvantages. The importance of implementing physiologically relevant degradation profiles and mechanical properties into the design of material substitutes is presented and discussed. Further, given that the broader tissue engineering field has moved towards the use of pre-seeded scaffolds, a review of promising cell options, for generating tissue-engineered autologous gingival grafts from electrospun scaffolds is presented and their potential utility and limitations are discussed.
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Affiliation(s)
- Brian C. W. Webb
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, 164 Collage St Room 407, Toronto, ON M5S 3G9, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
| | - J. Paul Santerre
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, 164 Collage St Room 407, Toronto, ON M5S 3G9, Canada
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Stoetzer M, Alevizakos V, Rahlf B, Gellrich NC, Kampmann A, von See C. The Impact of Different Augmentative Methods on the Expression of Inflammatory Factors. J ORAL IMPLANTOL 2019; 45:356-361. [PMID: 31536443 DOI: 10.1563/aaid-joi-d-19-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many animal studies show that an intact periosteum plays an important role in osseous regeneration. The potential effect of an in vivo periosteal barrier membrane on the expression of specific proteins has not been examined sufficiently. The aim of the present study is to investigate the influence of the flap preparation method and collagen membrane on the emission of inflammatory factors. This study examines 20 patients with dental implants who had previously undergone an augmentation. A soft tissue sample was taken during augmentation and 3 months later from the same location. Samples were always taken from the margins of a previously prepared mucoperiosteal flap. The flap was raised with a conventional periosteal elevator in the control group and with a piezoelectric device in the test group. In both groups, we covered half of the augmented bone with a native collagen membrane (NCM; Geistlich Bio-Gide). This allowed us to examine the same incision area with and without a membrane. An immunohistochemical analysis was performed for collagen IV, fibronectin, and inflammatory factors such as cluster of differentiation 31 (CD31), cyclooxygenase-2 (COX-2), and interleukin 6 (IL-6). There was a clear difference in the expression of specific proteins after the piezoelectric device and the periosteal elevator were used. The expression of fibronectin, IL-6, and COX-2 was higher after preparation with the periosteal elevator than after piezoelectric periosteum dissection. The expression of collagen IV was higher after the piezoelectric procedure. No difference was observed for CD31. The membrane had no effect on the expression of collagen IV, fibronectin, IL-6, and COX-2. The type of periosteal preparation influences the expression of specific proteins. With regard to the factors examined here, NCM did not appear to influence the wound healing cascade.
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Affiliation(s)
| | - Vasilios Alevizakos
- Danube Private University, Center for Digital Technologies in Dentistry and CAD/CAM, Krems an der Donau, Austria
| | | | | | | | - Constantin von See
- Danube Private University, Center for Digital Technologies in Dentistry and CAD/CAM, Krems an der Donau, Austria
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6
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Movila A, Kajiya M, Wisitrasameewong W, Stashenko P, Vardar-Sengul S, Hernandez M, Thomas Temple H, Kawai T. Intravital endoscopic technology for real-time monitoring of inflammation caused in experimental periodontitis. J Immunol Methods 2018; 457:26-29. [PMID: 29567043 DOI: 10.1016/j.jim.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/02/2018] [Accepted: 03/12/2018] [Indexed: 12/27/2022]
Abstract
We report a novel method for in situ imaging of microvascular permeability in inflamed gingival tissue, using state-of-the-art Cellvizio™ intravital endoscopic technology and a mouse model of ligature-induced periodontitis. The silk ligature was first placed at the upper left second molar. Seven days later, the ligature was removed, and the animals were intravenously injected with Evans blue. Evans blue dye, which selectively binds to blood albumin, was used to monitor the level of inflammation by monitoring vascular permeability in control non-diseased and ligature-induced experimental periodontitis tissue. More specifically, leakage of Evans blue-bound albumin from the micro-capillary to connective tissue indicates the state of inflammation occurring in the specific site. Evans blue leakage from blood vessels was imaged in situ by directly attaching the endoscope (mini Z tip) of the Cellvizio™ system to the gingival tissue without any surgical incision. Evans blue emission intensity was significantly elevated in gingiva of periodontitis lesions, but not control non-ligature placed gingiva, indicating that this technology can be used as a potential minimally invasive diagnostic tool to monitor the level of inflammation at the periodontal disease site.
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Affiliation(s)
- Alexandru Movila
- The Forsyth Institute, Department of Immunology, Cambridge, MA, USA; Harvard University School of Dental Medicine, Department of Oral Medicine, Infection, and Immunity, Boston, MA, USA; Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL, USA.
| | - Mikihito Kajiya
- The Forsyth Institute, Department of Immunology, Cambridge, MA, USA
| | | | - Philip Stashenko
- Harvard University School of Dental Medicine, Department of Oral Medicine, Infection, and Immunity, Boston, MA, USA
| | - Saynur Vardar-Sengul
- Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL, USA
| | - Maria Hernandez
- Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL, USA
| | - H Thomas Temple
- Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Toshihisa Kawai
- Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, FL, USA
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7
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Townsend D, D'Aiuto F, Deanfield J. Preliminary study of video imaging of blood vessels in tissues lining the gingival sulcus in periodontally healthy individuals. J Periodontal Res 2013; 49:670-9. [DOI: 10.1111/jre.12150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2013] [Indexed: 12/23/2022]
Affiliation(s)
- D. Townsend
- Vascular Physiology Unit; University College London Institute of Cardiovascular Science; London UK
| | - F. D'Aiuto
- Periodontology Unit, Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - J. Deanfield
- Vascular Physiology Unit; University College London Institute of Cardiovascular Science; London UK
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