Abstract
Periodontitis is defined as a chronic inflammatory condition, characterized by destruction of the periodontium, composed of hard (i.e. alveolar bone and cementum) and soft tissues (i.e. gingiva and periodontal ligament) surrounding and supporting the teeth. In severe cases, reduced periodontal support can lead to tooth loss, which requires tissue augmentation or procedures that initiate a repair, yet ideally a regenerative response. However, mimicking the three-dimensional complexity and functional integration of the different tissue components via scaffold- and/or matrix-based guided tissue engineering represents a great challenge. Additive biomanufacturing, a manufacturing method in which objects are designed and fabricated in a layer-by-layer manner, has allowed a paradigm shift in the current manufacturing of medical devices and implants. This shift from design-to-manufacture to manufacture-to-design, seen from a translational research point of view, provides the biomedical engineering and periodontology communities a technology with the potential to achieve tissue regeneration instead of repair. In this review, the focus is put on additively biomanufactured scaffolds for periodontal applications. Besides a general overview of the concept of additive biomanufacturing within this field, different developed scaffold designs are described. To conclude, future directions regarding advanced biomaterials and additive biomanufacturing technologies for applications in regenerative periodontology are highlighted.
Highlights
Periodontitis is a highly prevalent disease caused by a bacterial biofilm.[40]
It is defined as a chronic inflammation resulting in irreversible destruction of the periodontium, which consists of the hard and soft tissues surrounding and supporting the teeth
All of the above-mentioned approaches are still associated with significant clinical drawbacks; the availability of autologous grafts is limited, gene therapy may trigger host immune reactions or tumorigenesis, growth factors are often unstable, and biomaterials are linked with a high failure rate
Summary
Periodontitis is a highly prevalent disease caused by a bacterial biofilm.[40]. It is defined as a chronic inflammation resulting in irreversible destruction of the periodontium, which consists of the hard (i.e. alveolar bone and cementum) and soft (i.e. gingiva and periodontal ligament) tissues surrounding and supporting the teeth. In the context of periodontal regeneration, additive biomanufacturing, which referrers to the translation of additive manufacturing technologies into the field of tissue engineering and regenerative medicine (TE&RM), has significant advantages.[8] This approach, in which threedimensional (3D) structures are fabricated in a layer-bylayer manner based on a computer-aided design (CAD), facilitates the development of multiphasic scaffolds. These multiphasic scaffolds consist of a hierarchical architecture to guide simultaneous tissue formation, which could further mimic the properties and architectural configuration of periodontal tissues.[24,35]. To bring the review to an end, future directions in the context of advanced biomaterials and additive biomanufacturing technologies for regenerative periodontology are described
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