Abstract
The regeneration and integration of multiple tissue types is critical for efforts to restore the function of musculoskeletal complex. In particular, the neogenesis of periodontal constructs for systematic tooth-supporting functions is a current challenge due to micron-scaled tissue compartmentalization, oblique/perpendicular orientations of fibrous connective tissues to the tooth root surface and the orchestration of multiple regenerated tissues. Although there have been various biological and biochemical achievements, periodontal tissue regeneration remains limited and unpredictable. The purpose of this paper is to discuss current advanced engineering approaches for periodontal complex formations; computer-designed, customized scaffolding architectures; cell sheet technology-based multi-phasic approaches; and patient-specific constructs using bioresorbable polymeric material and 3-D printing technology for clinical application. The review covers various advanced technologies for periodontal complex regeneration and state-of-the-art therapeutic avenues in periodontal tissue engineering.
Highlights
Periodontal tissue constructs perform significant functions in the support of tooth structures under occlusal/masticatory loading conditions [1] and in defense against the invasion of various oral microorganisms [2,3]
The periodontal complex consists of tooth-supportive structures that are germane in remodeling, preservation, or maintenance of tissues including the cementum, periodontal ligament (PDL; fibrous connective tissue), and alveolar bone [4]
Periodontal disease or traumatic injury can lead to destruction of the periodontal complex including hard tissue resorption, destruction of the PDL, or biomechanical malfunctions due to the loosening of PDL anchorages from mineralized tissue surfaces and subsequent tooth loss [3]
Summary
Periodontal tissue constructs perform significant functions in the support of tooth structures under occlusal/masticatory loading conditions [1] and in defense against the invasion of various oral microorganisms [2,3]. To optimize the physiological functionalities in dental and craniofacial complexes, periodontal complexes must show specific orientations of fibrous tissue bundles, collagenous fiber integration between mineralized surfaces, and spatiotemporal orchestration of compartmentalized tissue types [5,6,7]. Spatiotemporal compartmentalization is a critical requirement for micron-scaled multiple tissue regeneration and functional restoration [22]. Therapeutic strategies for the regeneration of hierarchical architectures involved in systematic integrations for the re-establishment of tooth-supportive functions are currently limited mainly by the sub-micron-scaled interfaces and systematic compartmentalization to mimic periodontal structures and functions. Periodontal regeneration strategies have been developed to facilitate spatiotemporal morphogenesis and the organization of fibrous connective tissue and mineralized structures in preclinical scenarios
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