Abstract
Reduced periodontal support, deriving from chronic inflammatory conditions, such as periodontitis, is one of the main causes of tooth loss. The use of dental implants for the replacement of missing teeth has attracted growing interest as a standard procedure in clinical practice. However, adequate bone volume and soft tissue augmentation at the site of the implant are important prerequisites for successful implant positioning as well as proper functional and aesthetic reconstruction of patients. Three-dimensional (3D) scaffolds have greatly contributed to solve most of the challenges that traditional solutions (i.e., autografts, allografts and xenografts) posed. Nevertheless, mimicking the complex architecture and functionality of the periodontal tissue represents still a great challenge. In this study, a porous poly(ε-caprolactone) (PCL) and Sr-doped nano hydroxyapatite (Sr-nHA) with a multi-layer structure was produced via a single-step additive manufacturing (AM) process, as a potential strategy for hard periodontal tissue regeneration. Physicochemical characterization was conducted in order to evaluate the overall scaffold architecture, topography, as well as porosity with respect to the original CAD model. Furthermore, compressive tests were performed to assess the mechanical properties of the resulting multi-layer structure. Finally, in vitro biological performance, in terms of biocompatibility and osteogenic potential, was evaluated by using human osteosarcoma cells. The manufacturing route used in this work revealed a highly versatile method to fabricate 3D multi-layer scaffolds with porosity levels as well as mechanical properties within the range of dentoalveolar bone tissue. Moreover, the single step process allowed the achievement of an excellent integrity among the different layers of the scaffold. In vitro tests suggested the promising role of the ceramic phase within the polymeric matrix towards bone mineralization processes. Overall, the results of this study demonstrate that the approach undertaken may serve as a platform for future advances in 3D multi-layer and patient-specific strategies that may better address complex periodontal tissue defects.
Highlights
Oral diseases represent a significant health and economic problem, affecting about 3.5 billion people worldwide [1]
Single unit multi-layer composite scaffolds were produced in this work through a solvent free and single step manufacturing process
In relation to the ceramic phase, previous studies on Sr-containing biomaterials in various forms indicated that even small amounts of Sr (0.1 wt%) can enhance the osteoconductive properties of calcium phosphate, have a positive effect on bone mineralization, elevate the mechanical property of bone tissue and have crucial effects by inducing collagen type I synthesis [50,51,52,53]
Summary
Oral diseases represent a significant health and economic problem, affecting about 3.5 billion people worldwide [1]. This burden is expected to increase as a direct consequence of the aging global population, of which more than 20% will be older than 65 by 2050 [2,3]. Polymers 2020, 12, 2233 conditions, tooth loss has been recognized as one of the most common [4]. This can be the result of trauma, oral cavities, cancer and periodontal diseases, which comprise of periodontitis and gingivitis. In case of severe periodontitis, reduced periodontal support can lead to tooth movement and eventually tooth loss [5]
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