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Oral soft tissue defects are a frequently encountered problem in dental praxis. Tooth loss, tooth root or implant recessions, infections or trauma require soft tissue reconstruction. The autologous graft remains the gold standard for gingiva and oral mucosa augmentation. However, prolonged pain, limited amount of harvested tissue, and increased ris...
Contexts in source publication
Context 1
... [6]. The marginal gingiva comprises a thin, non-keratinized epithelium (towards the tooth) and keratinized epithelium (towards the oral cavity), and lamina propria containing loosely connected collagen fibres [7]. Attached gingiva consists of the thick, keratinized epithelium and lamina propria with well-organized and dense collagen fibres (Fig. 2). Attached gingiva is indispensable for the maintenance of teeth, periodontal tissues, alveolar bone as well as dental implants. It forms a protective barrier against harmful environmental agents such as pathogens, chemicals, and constant ...
Context 2
... main cell type in the gingival epithelium are keratinocytes. Through a process of differentiation through several layers from lamina propria towards the surface (stratum corneum, granulosum, spinosum, and basale), keratinocytes form a defending stratified squamous epithelium (Fig. 2). Other cell types, namely Langerhans and Merkel cells, as well as melanocytes, are also found in the gingival epithelium. The gingival connective tissue consists of a papillary layer, with finger-like projections of connective tissue intermingled with the overlying epithelium -rete pegs, and the reticular layer, located further ...
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Citations
... Angiogenesis, the consequent formation of new blood vessels, may be a complex process requiring cooperation between numerous cell types, extracellular lattice components, and development variables. Viable vascularization is vital for appropriate tissue recovery, guaranteeing utilitarian and perfusable vascular systems required for the long-term survival and usefulness of built tissues post-transplantation [45][46][47]. Whereas different vascularization methodologies have been investigated, the significance of microvessel organization inside three-dimensional (3D) frameworks has frequently been ignored. More recent advancements in high-resolution microscopy and image preparation have revealed the profoundly organized nature of microvessels, adjusting themselves with tissue engineering to optimize atomic trade and utilitarian execution [48]. ...
... These molecules mediate cellular processes such as proliferation, apoptosis, and migration, as well as the production or degradation of the extracellular matrix (ECM). Consequently, these cellular and acellular components undergo reconstruction or degradation, contributing to the remodeling of the vessel architecture [46,47]. ...
Salivary gland biofabrication represents a promising avenue in regenerative medicine, aiming to address the challenges of salivary gland dysfunction caused by various factors such as autoimmune diseases and radiotherapy. This review examines the current state of bioprinting technology, biomaterials, and tissue engineering strategies in the context of creating functional, implantable salivary gland constructs. Key considerations include achieving vascularization for proper nutrient supply, maintaining cell viability and functionality during printing, and promoting tissue maturation and integration with surrounding tissues. Despite the existing challenges, recent advancements offer significant potential for the development of personalized therapeutic options to treat salivary gland disorders. Continued research and innovation in this field hold the potential to revolutionize the management of salivary gland conditions, improving patient outcomes and quality of life. This systematic review covers publications from 2018 to April 2024 and was conducted on four databases: Google Scholar, PubMed, EBSCOhost, and Web of Science. The key features necessary for the successful creation, implantation and functioning of bioprinted salivary glands are addressed.
... Using 3-D bioprinting and ECM-based bioinks to mimic the structure of native tissues provides a new direction for tissue regeneration and reconstruction [128]. Owing to the complex and compact structure of the oral cavity, these tools offer unique opportunities for fabricating and emulating the microstructures and microenvironments of oral soft tissues, thereby enabling personalized therapies [129]. In the initial stage of bioprinting, the regeneration of keratinized soft tissue with supporting bone can be considered for composite tissue defects in the oral cavity. ...
... In the initial stage of bioprinting, the regeneration of keratinized soft tissue with supporting bone can be considered for composite tissue defects in the oral cavity. However, despite the literature on the bioprinting of TEOMs, most studies remain in vitro and face obstacles hindering the clinical translation of 3-D_bioprinted TEOM implantation [129][130][131][132]. Collaborations across multidisciplinary fields are necessary to overcome these challenges. ...
Many conditions, including cancer, trauma, and congenital anomalies, can damage the oral mucosa. Multiple cultures of oral mucosal cells have been used for biocompatibility tests and oral biology studies. In recent decades, the clinical translation of tissue-engineered products has progressed significantly in developing tangible therapies and inspiring advancements in medical science. However, the reconstruction of an intraoral mucosa defect remains a significant challenge. Despite the drawbacks of donor-site morbidity and limited tissue supply, the use of autologous oral mucosa remains the gold standard for oral mucosa reconstruction and repair. Tissue engineering offers a promising solution for repairing and reconstructing oral mucosa tissues. Cell- and scaffold-based tissue engineering approaches have been employed to treat various soft tissue defects, suggesting the potential clinical use of tissue-engineered oral mucosa (TEOMs). In this review, we first cover the recent trends in the reconstruction and regeneration of extra-/intra-oral wounds using TEOMs. Next, we describe the current status and challenges of TEOMs. Finally, future strategic approaches and potential technologies to support the advancement of TEOMs for clinical use are discussed.
... (1) 3D printing: Enabling individualized, custom-fit materials that optimize the delivery of a material to a specific site (63)(64)(65)(66). (2) Scaffolds: New developments, including laminar cortical plates that provide better structure to ensure the needed mechanical proprieties, flexibility, delivery/carrier of factors, and primary closure of defects (11, 61). ...
Regenerative medicine has gained much attention and has been a hot topic in all medical fields since its inception, and dentistry is no exception. However, innovations and developments in basic research are sometimes disconnected from daily clinical practice. This existing gap between basic research and clinical practice can only be addressed with improved communication between clinicians, academicians, industry, and researchers to facilitate the advance of evidence-based therapies and procedures and to direct research to areas of clinical need. In this perspective, six participants with strong clinical and research interests debated five previously conceived questions. These questions covered current methods and procedures for soft and hard tissue regeneration in the oral cavity with predictable outcomes, limitations of their respective protocols, and needs for future development of regenerative materials and technologies.
... For example, the development of 3D printing technologies in tissue engineering has been increasing over the last decade [95,96]. This technology is able to produce an individualized scaffold to mimic tissue behavior with precise geometry matching the defects [97]. Peng et al. successfully constructed a 3D printing scaffold consisting of acellular dermal matrix/gelatin-sodium alginate (ADM/A/G) with living gingival fibroblasts which was able to promote cell proliferation and increase the expression of specific tissue biomarkers in vitro [98]. ...
Background:
Hydrogel is considered a promising scaffold biomaterial for gingival regeneration. In vitro experiments were carried out to test new potential biomaterials for future clinical practice. The systematic review of such in vitro studies could synthesize evidence of the characteristics of the developing biomaterials. This systematic review aimed to identify and synthesize in vitro studies that assessed the hydrogel scaffold for gingival regeneration.
Methods:
Data on experimental studies on the physical and biological properties of hydrogel were synthesized. A systematic review of the PubMed, Embase, ScienceDirect, and Scopus databases was conducted according to the Preferred Reporting System for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement guidelines. In total, 12 original articles on the physical and biological properties of hydrogels for gingival regeneration, published in the last 10 years, were identified.
Results:
One study only performed physical property analyses, two studies only performed biological property analyses, and nine studies performed both physical and biological property analyses. The incorporation of various natural polymers such as collagen, chitosan, and hyaluronic acids improved the biomaterial characteristics. The use of synthetic polymers faced some drawbacks in their physical and biological properties. Peptides, such as growth factors and arginine-glycine-aspartic acid (RGD), can be used to enhance cell adhesion and migration. Based on the available primary studies, all studies successfully present the potential of hydrogel characteristics in vitro and highlight the essential biomaterial properties for future periodontal regenerative treatment.
... In addition, buccal films are suitable for protecting wound surfaces, reducing pain, and increasing the effectiveness of treatment [26,27]. Although Nesic et al. reviewed three-dimensional (3D) printing techniques for tissue regeneration and oral vascular rehabilitation [28], limited studies have been performed on oral drug delivery to treat oral lesions through 3D printing [29]. Regarding limited data and studies about treating oral mucosal lesions with mucoadhesive scaffolds and the lack of standardization of these techniques, this study aims to fabricate a mucoadhesive scaffold by 3D bioprinting for drug delivery systems to treat oral mucosal lesions. ...
Background
Chronic oral lesions could be a part of some diseases, including mucocutaneous diseases, immunobullous diseases, gastrointestinal diseases, and graft versus host diseases. Systemic steroids are an effective treatment, but they cause unfavorable and even severe systemic side effects. Discontinuation of systemic corticosteroids or other immunosuppressive drugs leads to relapse, confirming the importance of long-term corticosteroid use. The present study aims to fabricate a mucoadhesive scaffold using three-dimensional (3D) bioprinting for sustained drug delivery in oral mucosal lesions to address the clinical need for alternative treatment, especially for those who do not respond to routine therapy.
Methods
3D bioprinting method was used for the fabrication of the scaffolds. Scaffolds were fabricated in three layers; adhesive/drug-containing, backing, and middle layers. For evaluation of the release profile of the drug, artificial saliva was used as the release medium. Mucoadhesive scaffolds were analyzed using a scanning electron microscope (SEM) and SEM surface reconstruction. The pH of mucoadhesive scaffolds and swelling efficacy were measured using a pH meter and Enslin dipositive, respectively. A microprocessor force gauge was used for the measurement of tensile strength. For the evaluation of the cytotoxicity, oral keratinocyte cells' survival rate was evaluated by the MTT method. Folding endurance tests were performed using a stable microsystem texture analyzer and analytic probe mini tensile grips.
Results
All scaffolds had the same drug release trend; An initial rapid explosive release during the first 12 h, followed by a gradual release. The scaffolds showed sustained drug release and continued until the fourth day. The pH of the surface of the scaffolds was 5.3–6.3, and the rate of swelling after 5 h was 28 ± 3.2%. The tensile strength of the scaffolds containing the drug was 7.8 ± 0.12 MPa. The scaffolds were non-irritant to the mucosa, and the folding endurance of the scaffolds was over three hundred times.
Conclusion
The scaffold fabricated using the 3D bioprinting method could be suitable for treating oral mucosal lesions.
... A combination of smart bioinks, ideally derived from decellularised tissues for the preservation of the tissue-specific matrix components together with the signalling molecules (epidermal growth factor -EGF, fibroblast growth factor-2 -FGF2, tumour growth factor beta -TGFβ, platelet-derived growth factor -PDGF, vascular endothelial growth factor -VEGF) can be precisely patterned via extrusion, laser-assisted, and inkjet 3D or stereolithography bioprinting to mimic the complex tissue architecture. Reproduced with permission (Nesic et al., 2020);Copyright 2020, Elsevier Ltd. by that virtue the skeleton are responsible for conferring integrity of internal structure, providing a stem cell reserve and sites for muscle attachment. It also functions as the prime regulator of serum calcium levels in order to mediate muscle contraction and hence aid in locomotion and perfusion of organs. ...
... Four-dimensional (4D) printing technology has been developed to counter this problem. In 2013, the idea of 4D printing was first provided by Prof. Tibbits and Prof. Jerry, in which advanced materials morph their shape with respect to time in a simulated environment [23][24][25]. 4D printing technology is the advanced version of 3D printing and is considered a state-of-the-art manufacturing technique [26]. 4D printing can fabricate any complex part using different materials while maintaining excellent quality, precision, accuracy, and performance capabilities compared to 3D printing techniques [27]. ...
4D bioprinting is the next-generation additive manufacturing-based fabrication platform employed to construct intricate, adaptive, and dynamic soft and hard tissue structures as well as biomedical devices by using stimuli-responsive materials, especially shape memory polymers (SMPs) and hydrogels, which possess desirable biomechanical characteristics. In the last few years, numerous efforts have been made by 4D printing community to develop novel stimuli-responsive polymeric materials by considering their biomedical perspective. This review presents an up-to-date overview of 4D bioprinting technology incorporating bioprinting materials, functionalities of biomaterials as well as the focused approach towards different tissue engineering and regenerative medicine (TERM) applications, including bone, cardiac, neural, cartilage, drug delivery systems, and other high-value biomedical devices. It also addresses current limitations and challenges in 4D bioprinting technology to provide a basis for foreseeable advancements for TERM applications that will prove helpful for their successful utilization in clinical settings.
... It is further forwarded through a mix-up step of mathematical analysis and directions for preparing the under-process product for realistic and actual working situations. [37][38][39][40] External stimuli such as humidity, temperature, forces, moisture, and photo-sensitive, and these practical cases are often affected by external stimuli. These 4D printed dentistry products would be able to carry their basic functioning under the influential conditions of the stimulus as mentioned above and perform satisfactorily. ...
Every industry need helps to modify its working style quickly with the improvement of existing technology. New developing technologies improve production speed, reduce industrial process costs, etc. Technical specialists carry out continuous research and development to increase efficiency. A significant advance in 4D printing over 3D Printing is its capacity to alter shape over time because external elements such as pressure, air, heat, water, etc., use controlled impact. 4D Printing has one “D" instead of 3D Printing, and the fourth aspect is time. Therefore, its capacity to alter shape over time is a significant advancement of 4D printing over 3D printing technologies. It is evident that 4D printing will be of tremendous value to manufacturers regarding features and advances in dentistry. Its applications cover medical modelling, surgical guides manufacture, prosthodontics, dentistry, orthodontics, implantology, and dentistry instruments. This paper is brief about 4D printing and its printing of smart materials through 4D printing. Process workflow and Bio-Oriented 4D printable smart materials for dentistry are presented diagrammatically. Further, the paper identifies and discusses the significant potential of 4D printing for dentistry. 4D printing is an innovative technology that uses the inputs from smart materials, and the 3D printed item becomes another structure via the impact of external energy sources such as temperature, light, or other environmental stimuli. The objective is to integrate technology and design to create self-assembly and programmable material technologies that better design, production, and performance.
... Différents matériaux existent et peuvent être des polymères (Nesic, Durual, et al. 2020) : -d'origine naturelle : agarose, alginate, collagène, gélatine, chitosan, fibrine -d'origine synthétique : PLA (polylactic acid), PGA (poly glycolic acid), PLGA (poly-lactic-coglycolic-acid) et PCL (polycaprolactone). ...
... Sont décrits dans le Tableau 7 quelques exemples récents. (Nesic, Durual, et al. 2020) 2.4. Problématique majeure de l'ingénierie tissulaire : la vascularisation des greffons ...
... L'impression 3D est une technique de biofabrication intéressante pour la régénération des tissus mous gingivaux pour de nombreuses raisons. D'abord, elle permet la fabrication d'une forme prédéterminée de greffon qui est ajustée au défaut avec une meilleure précision (Nesic, Durual, et al. 2020). Ensuite, cette technique semble particulièrement avantageuse pour le positionnement correct des fibres de collagène dans des orientations différentes au niveau de la lamina propria, pour une fonction mécanique optimale. ...
Introduction : Bien que la muqueuse orale présente un potentiel de régénération efficace, certaines pertes de substances nécessitent une augmentation chirurgicale de la quantité et/ou de la qualité du tissu. La greffe autologue est la thérapeutique de référence mais possède trois inconvénients majeurs : une morbidité et une quantité de tissu limitée au niveau du site donneur ainsi qu’une connexion vasculaire lente du greffon au niveau du site receveur. L’ingénierie tissulaire (IT) peut pallier en partie ces problématiques en produisant des substituts tissulaires se rapprochant le plus possible des tissus natifs en termes de macro et micro architectures. La bio-impression 3D est une technique d’IT particulièrement prometteuse car elle permet de positionner les éléments cellulaires de façon précise tout en conservant leur viabilité. L’objectif de ce travail de recherche était donc d’obtenir un tissu mou conjonctif contenant des canaux verticaux et une pré-vascularisation horizontale à l’aide de la bio-impression 3D par extrusion (EBB) dans lequel la viabilité des cellules serait préservée in vitro pendant au moins un mois avec une étude pour la mise en place d’une application in vivo.Méthodes : Suivant la triade de l’IT cellules/scaffold/molécules, le modèle a été construit de la façon suivante : (a) les cellules étaient des fibroblastes gingivaux humains (hGF) issus de cultures primaires d’explants et des cellules endothéliales issues de la veine ombilicale (HUVEC) ; (b) le matériau (ou scaffold) a été sélectionné parmi de nombreux hydrogels afin de se rapprocher le plus des propriétés mécaniques du tissu tout en autorisant l’impression et la viabilité des cellules ; (c) aucune molécule bioactive n’a été ajoutée en dehors de celles déjà présentes dans les milieux de culture et de celles sécrétées par les cellules. Deux bio-imprimantes à extrusion ont été utilisées : MultiPrint (IUT de Bordeaux) dans un premier temps pour la prise en main puis 3D Discovery (RegenHU) pour les expériences in vitro. Les substituts bio-imprimés ont été maintenus en culture pendant 28 jours sans bioréacteur. Différents tests ont été effectués pour les caractériser : viabilité et activité cellulaire, caractérisation des cellules (cytométrie en flux et immunocytofluorescence) et quantification des pré-vaisseaux obtenus.Résultats : Après avoir démontré que les hGF pouvaient être bio-imprimés par extrusion dans un hydrogel et maintenus vivants en culture dans les substituts, une revue systématique de la littérature a été ciblée sur les stratégies utilisées en IT orale pour fabriquer des vaisseaux sanguins in vitro. Les techniques les plus utilisées étaient les co-cultures de cellules stromales et endothéliales en suivant des paramètres spécifiques . La mise au point des cocultures hGF/HUVEC a permis de découvrir des propriétés de certains fibroblastes qui, au contact des cellules endothéliales, se comportaient comme des cellules péri-vasculaires. Ceci a rendu possible l’ organisation et la stabilisation du réseau d’HUVEC in vitro pendant 30 jours. Enfin, ces co-cultures ont été bio-imprimées dans des formes contenant des canaux verticaux et l’organisation des vaisseaux dans les constructions a été suivie dans le temps in vitro avec une proposition de protocole in vivo chez le rongeur.Conclusion : Des substituts conjonctifs contenant des canaux verticaux et un pré-réseau vasculaire qui se maintient dans le temps sans bioréacteur peuvent être obtenus par EBB. Les propriétés péri-vasculaires d’une certaine partie des hGF jouent un rôle primordial. Il est dans un premier temps nécessaire de finir la preuve de l’intérêt de ces pré-vaisseaux avec des expérimentations in vivo pour prouver la connexion accélérée et efficace de la construction pré-vascularisée. Il sera ensuite possible de complexifier le modèle en ajoutant d’autres types cellulaires, en modifiant la forme 3D et en travaillant sur le gros animal pour se rapprocher des applications cliniques.
... As is known, researchers these days are exploring both scaffold-based and scaffold-free approaches for hard dental tissue regenerative applications. 25,72,75 The ease of isolation of dental stem cells (DSCs) has facilitated their incorporation amongst various scaffolds to enhance their tissue regeneration efficacies. 42 Nowadays, multi-cellular scaffold-free transplants are also being explored for the treatment of interfacial defects at the periodontal pockets. ...
Designing 3D constructs with appropriate materials and structural frameworks for complex dental restorative/regenerative procedures has always remained a multi-criteria optimization challenge. In this regard, 3D printing has long been known to be a potent tool for various tissue regenerative applications, however, the preparation of biocompatible, biodegradable, and stable inks is yet to be explored and revolutionized for overall performance improvisation. The review reports the currently employed manufacturing processes for the development of engineered self-supporting, easily processable, and cost-effective 3D constructs with target-specific tuneable mechanics, bioactivity, and degradability aspects in the oral cavity for their potential use in numerous dental applications ranging from soft pulp tissues to hard alveolar bone tissues. A hybrid synergistic approach, comprising of development of multi-layered, structurally stable, composite building blocks with desired physicomechanical performance and bioactivity presents an optimal solution to circumvent the major limitations and develop new-age advanced dental restorations and implants. Further, the review summarizes some manufacturing perspectives which may inspire the readers to design appropriate structures for clinical trials so as to pave the way for their routine applications in dentistry in the near future.
