Abstract
Cranio-maxillofacial structure is a region of particular interest in the field of regenerative medicine due to both its anatomical complexity and the numerous abnormalities affecting this area. However, this anatomical complexity is what makes possible the coexistence of different microbial ecosystems in the oral cavity and the maxillofacial region, contributing to the increased risk of bacterial infections. In this regard, different materials have been used for their application in this field. These materials can be obtained from natural and renewable feedstocks, or by synthetic routes with desired mechanical properties, biocompatibility and antimicrobial activity. Hence, in this review, we have focused on bio-based polymers which, by their own nature, by chemical modifications of their structure, or by their combination with other elements, provide a useful antibacterial activity as well as the suitable conditions for cranio-maxillofacial tissue regeneration. This approach has not been reviewed previously, and we have specifically arranged the content of this article according to the resulting material and its corresponding application; we review guided bone regeneration membranes, bone cements and devices and scaffolds for both soft and hard maxillofacial tissue regeneration, including hybrid scaffolds, dental implants, hydrogels and composites.
Highlights
Tissue engineering approaches aim to provide damaged tissues with the most suitable conditions in order to regenerate and fully heal as soon as possible
This has led to the study of composites based on bioactive glasses (BGs) and other natural polymers such as gelatin and collagen biomimetic electrospun fish collagen, which possess antibacterial activity against S. aureus and which could be used as a functional skin wound dressing [101]
De Mori et al, designed a complex polymethyl methacrylate (PMMA)-based cement which was loaded with silver nanowires to achieve antibacterial properties; chitosan to achieve porosity, reduce the maximum setting temperature, and maintain appropriate mechanical properties; and methacryloyl chitosan to promote cross-linking with MMA, reducing the quantity of the monomer that is available for use [114]
Summary
Tissue engineering approaches aim to provide damaged tissues with the most suitable conditions in order to regenerate and fully heal as soon as possible. We have focused on the cranio-maxillofacial structure, a region of particular interest due to the numerous dental procedures, oral cavity diseases and treatments, and cranial abnormalities including craniosynostosis, neoplasms, cleft-lip palate and other kinds of hypoplasias, among others [1,2,3]. In this sense, there are multiple zones within the maxillofacial structure that may act as reservoirs of potentially pathogenic bacterial organisms, which tend to cause infections when the tissues are damaged (e.g., oral cavity). [8,9]
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