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Li H, Zhang D, Bao P, Li Y, Liu C, Meng T, Wang C, Wu H, Pan K. Recent Advances in Functional Hydrogels for Treating Dental Hard Tissue and Endodontic Diseases. ACS NANO 2024. [PMID: 38874120 DOI: 10.1021/acsnano.4c02754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Oral health is the basis of human health, and almost everyone has been affected by oral diseases. Among them, endodontic disease is one of the most common oral diseases. Limited by the characteristics of oral biomaterials, clinical methods for endodontic disease treatment still face large challenges in terms of reliability and stability. The hydrogel is a kind of good biomaterial with an adjustable 3D network structure, excellent mechanical properties, and biocompatibility and is widely used in the basic and clinical research of endodontic disease. This Review discusses the recent advances in functional hydrogels for dental hard tissue and endodontic disease treatment. The emphasis is on the working principles and therapeutic effects of treating different diseases with functional hydrogels. Finally, the challenges and opportunities of hydrogels in oral clinical applications are discussed and proposed. Some viewpoints about the possible development direction of functional hydrogels for oral health in the future are also put forward. Through systematic analysis and conclusion of the recent advances in functional hydrogels for dental hard tissue and endodontic disease treatment, this Review may provide significant guidance and inspiration for oral disease and health in the future.
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Affiliation(s)
- Huixu Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266003, P. R. China
- School of Stomatology, Qingdao University, Qingdao 266003, P. R. China
- Department of Endodontics in the first clinical division, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, P. R. China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, P. R. China
| | - Ding Zhang
- School of Materials Science and Engineering, National Institute for Advanced Materials, Nankai University, Tianjin 300350, P. R. China
| | - Pingping Bao
- Department of Endodontics in the first clinical division, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, P. R. China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, P. R. China
| | - Ying Li
- Department of Endodontics in the first clinical division, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, P. R. China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, P. R. China
| | - Chaoge Liu
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, P. R. China
- Department of Oramaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, P. R. China
| | - Tingting Meng
- Department of Endodontics in the first clinical division, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, P. R. China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, P. R. China
| | - Chao Wang
- College of Pharmacy, Xinjiang Medical University, Urumqi 830017, P. R. China
| | - Heting Wu
- College of Pharmacy, Xinjiang Medical University, Urumqi 830017, P. R. China
| | - Keqing Pan
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266003, P. R. China
- School of Stomatology, Qingdao University, Qingdao 266003, P. R. China
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Elnawam H, Abdallah A, Nouh S, Khalil NM, Elbackly R. Influence of extracellular matrix scaffolds on histological outcomes of regenerative endodontics in experimental animal models: a systematic review. BMC Oral Health 2024; 24:511. [PMID: 38689279 PMCID: PMC11061952 DOI: 10.1186/s12903-024-04266-x] [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: 01/05/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Decellularized extracellular matrix (dECM) from several tissue sources has been proposed as a promising alternative to conventional scaffolds used in regenerative endodontic procedures (REPs). This systematic review aimed to evaluate the histological outcomes of studies utilizing dECM-derived scaffolds for REPs and to analyse the contributing factors that might influence the nature of regenerated tissues. METHODS The PRISMA 2020 guidelines were used. A search of articles published until April 2024 was conducted in Google Scholar, Scopus, PubMed and Web of Science databases. Additional records were manually searched in major endodontic journals. Original articles including histological results of dECM in REPs and in-vivo studies were included while reviews, in-vitro studies and clinical trials were excluded. The quality assessment of the included studies was analysed using the ARRIVE guidelines. Risk of Bias assessment was done using the (SYRCLE) risk of bias tool. RESULTS Out of the 387 studies obtained, 17 studies were included for analysis. In most studies, when used as scaffolds with or without exogenous cells, dECM showed the potential to enhance angiogenesis, dentinogenesis and to regenerate pulp-like and dentin-like tissues. However, the included studies showed heterogeneity of decellularization methods, animal models, scaffold source, form and delivery, as well as high risk of bias and average quality of evidence. DISCUSSION Decellularized ECM-derived scaffolds could offer a potential off-the-shelf scaffold for dentin-pulp regeneration in REPs. However, due to the methodological heterogeneity and the average quality of the studies included in this review, the overall effectiveness of decellularized ECM-derived scaffolds is still unclear. More standardized preclinical research is needed as well as well-constructed clinical trials to prove the efficacy of these scaffolds for clinical translation. OTHER The protocol was registered in PROSPERO database #CRD42023433026. This review was funded by the Science, Technology and Innovation Funding Authority (STDF) under grant number (44426).
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Affiliation(s)
- Hisham Elnawam
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Champollion Street, Azarita, Alexandria, Egypt.
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Amr Abdallah
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Champollion Street, Azarita, Alexandria, Egypt
| | - Samir Nouh
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
- Surgery Department, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt
| | - Nesma Mohamed Khalil
- Oral Biology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania Elbackly
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Champollion Street, Azarita, Alexandria, Egypt
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Kiarashi M, Bayat H, Shahrtash SA, Etajuri EA, Khah MM, Al-Shaheri NA, Nasiri K, Esfahaniani M, Yasamineh S. Mesenchymal Stem Cell-based Scaffolds in Regenerative Medicine of Dental Diseases. Stem Cell Rev Rep 2024; 20:688-721. [PMID: 38308730 DOI: 10.1007/s12015-024-10687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Biomedical engineering breakthroughs and increased patient expectations and requests for more comprehensive care are propelling the field of regenerative dentistry forward at a fast pace. Stem cells (SCs), bioactive compounds, and scaffolds are the mainstays of tissue engineering, the backbone of regenerative dentistry. Repairing damaged teeth and gums is a significant scientific problem at present. Novel therapeutic approaches for tooth and periodontal healing have been inspired by tissue engineering based on mesenchymal stem cells (MSCs). Furthermore, as a component of the MSC secretome, extracellular vesicles (EVs) have been shown to contribute to periodontal tissue repair and regeneration. The scaffold, made of an artificial extracellular matrix (ECM), acts as a supporting structure for new cell development and tissue formation. To effectively promote cell development, a scaffold must be non-toxic, biodegradable, biologically compatible, low in immunogenicity, and safe. Due to its promising biological characteristics for cell regeneration, dental tissue engineering has recently received much attention for its use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix. Moreover, as a bioactive material for carrying MSC-EVs, the combined application of scaffolds and MSC-EVs has a better regenerative effect on dental diseases. In this paper, we discuss how MSCs and MSC-derived EV treatment may be used to regenerate damaged teeth, and we highlight the role of various scaffolds in this process.
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Affiliation(s)
- Mohammad Kiarashi
- College of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | | | - Enas Abdalla Etajuri
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Meysam Mohammadi Khah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kamyar Nasiri
- Department of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran.
| | - Mahla Esfahaniani
- Faculty of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Saman Yasamineh
- Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
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Chen A, Deng S, Lai J, Li J, Chen W, Varma SN, Zhang J, Lei C, Liu C, Huang L. Hydrogels for Oral Tissue Engineering: Challenges and Opportunities. Molecules 2023; 28:3946. [PMID: 37175356 PMCID: PMC10179962 DOI: 10.3390/molecules28093946] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/20/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Oral health is crucial to daily life, yet many people worldwide suffer from oral diseases. With the development of oral tissue engineering, there is a growing demand for dental biomaterials. Addressing oral diseases often requires a two-fold approach: fighting bacterial infections and promoting tissue growth. Hydrogels are promising tissue engineering biomaterials that show great potential for oral tissue regeneration and drug delivery. In this review, we present a classification of hydrogels commonly used in dental research, including natural and synthetic hydrogels. Furthermore, recent applications of these hydrogels in endodontic restorations, periodontal tissues, mandibular and oral soft tissue restorations, and related clinical studies are also discussed, including various antimicrobial and tissue growth promotion strategies used in the dental applications of hydrogels. While hydrogels have been increasingly studied in oral tissue engineering, there are still some challenges that need to be addressed for satisfactory clinical outcomes. This paper summarizes the current issues in the abovementioned application areas and discusses possible future developments.
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Affiliation(s)
- Anfu Chen
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Royal National Orthopaedic Hospital, London HA4 4LP, UK
| | - Shuhua Deng
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Jindi Lai
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Jing Li
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Weijia Chen
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Swastina Nath Varma
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Royal National Orthopaedic Hospital, London HA4 4LP, UK
| | - Jingjing Zhang
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Caihong Lei
- Guangdong Provincial Key Laboratory of Functional Soft Condensed Matter, School of Materials and Energy, Guangdong University of Technology, Guangzhou 510006, China; (A.C.)
| | - Chaozong Liu
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Royal National Orthopaedic Hospital, London HA4 4LP, UK
| | - Lijia Huang
- Guangdong Provincial Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510275, China
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Histological Evaluation of Restylane Lyft Used as a Scaffold for Dental Pulp Regeneration in Non-Infected Immature Teeth in Dogs. MATERIALS 2022; 15:ma15124095. [PMID: 35744154 PMCID: PMC9228365 DOI: 10.3390/ma15124095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022]
Abstract
Commercially available hyaluronic acid dermal fillers used as a scaffold in regenerative endodontic procedures (REPs) have demonstrated attractive potentials. This study aimed to histologically evaluate the outcome of REPs using Restylane Lyft (HA) as a scaffold. REPs were performed on pulpless, immature roots in dogs (n = 69). The roots were divided into four groups: blood clot (BC), Restylane Lyft (BC + HA), negative control, and positive control. At 13 weeks postoperatively, hard tissue formation, vascularization, the presence of vascularized soft connective tissue and collagen fibers, the degree of inflammation within pulp spaces and/or periapical tissues, and apical closure were evaluated histologically. The vascularization and formation of loosely arranged collagen fibers within the regenerated soft connective tissues were observed significantly more in the BC+HA group (85% and 40%, respectively; p < 0.05) compared to the BC group (54.6% and 9.1%, respectively; p < 0.05). The degree of inflammation was significantly higher in the HA group than in the BC group; moderate to severe inflammatory cell infiltration was seen in 45% and 13.6% of the cases, respectively. The results of the present study suggest that Restylane Lyft combined with a blood clot used as a scaffold may improve the outcomes of REPs in non-infected, pulpless, immature teeth in dogs.
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Fan Z, Cheng P, Zhang P, Gao Y, Zhao Y, Liu M, Gu J, Wang Z, Han J. A novel multifunctional Salecan/κ-carrageenan composite hydrogel with anti-freezing properties: Advanced rheology, thermal analysis and model fitting. Int J Biol Macromol 2022; 208:1-10. [PMID: 35299074 DOI: 10.1016/j.ijbiomac.2022.03.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 12/11/2022]
Abstract
The multifunctional hydrogels (HGs) have attracted intensive concern in biomedicine, food, and flexible devices. Nevertheless, chemically crosslinked synthetic HGs are commonly under specific restrictions because of their possible biotoxicity. This study focuses on the employment of physical approaches to prepare novel Salecan/κ-carrageenan composites HGs (CHGs) without changing their basic structures. Comprehensive rheological and thermal studies have been performed to investigate their distinctive properties. The data obtained from the tests and model fitting confirmed that the highest activation energy of CHGs was 172,142.2 J/mol, and the maximum equilibrium creep compliance was 0.0085 1/Pa. The sample recovery rate could reach 92.6%, while the anti-freezing temperature can be as low as -20 °C. It is the first report focusing on novel CHGs made from Salecan and κ-carrageenan with ideal anti-freezing ability, enhanced thermostability, good injectability, self-recovery, and other rheological properties that will provide effective support for various future applications.
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Affiliation(s)
- Zhiping Fan
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
| | - Ping Cheng
- Liaocheng High-Tech Biotechnology Co., Ltd, Liaocheng 252059, China
| | - Pan Zhang
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China
| | - Yan Gao
- Liaocheng High-Tech Biotechnology Co., Ltd, Liaocheng 252059, China
| | - Yanna Zhao
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China
| | - Min Liu
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China
| | - Jiahui Gu
- Anton Paar (Shanghai) Trading Co., Ltd, Shanghai 201103, China
| | - Zhengping Wang
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China
| | - Jun Han
- Institute of BioPharmaceutical Research, Liaocheng University, Liaocheng 252059, China
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