Biomedical Engineering Reference
In-Depth Information
plays an important role in the normal function of craniofacial and systemic system.
However, a logical various conventional therapies (open flap debridement (OFD), guided tis-
sue regeneration (GTR), and bone replacement grafts, provided either alone or in a combina-
tion) for periodontal
tissue regeneration have shown limited and variable clinical outcomes
(
Figure 20.2
)
[42]
.
To accelerate clinical translation, there is an ongoing need to develop therapeutics based
on endogenous regenerative technology (ERT), which can stimulate latent self-repair mechan-
isms in patients and harness the host's innate capacity for regeneration. ERT in periodontics
applies the patient's own regenerative “tool,” i.e. patient-derived growth factors and fibrin
scaffolds, sometimes in association with commercialized products (e.g., Emdogain and Bio-
OSS), to create a materials niche in an injured site where the progenitor/stem cells from
neighboring tissues can be recruited for in situ periodontal regeneration. The selection and
design of materials influence therapeutic potential and the number and invasiveness of the
associated clinical procedures
[42]
. This has shifted the focus from the attempt to recreate
tissue replacement/constructs ex vivo to the development of biofunctionalized biomaterials
that incorporate and release regulatory signal in a precise and near-physiological fashion to
achieve in situ regeneration. Therefore, certain artificially designed scaffold features such as
porosity, pore size, and interpore connectivity are necessary for optimal tissue engineering
applications (accelerated/expedited tissue regeneration) no matter which biomaterial scaffold
is proposed
[43]
.
In this regard, a biomimetic scaffold mimicking certain features such as nanoscale topogra-
phy and biological cues of natural ECM is advantageous for facilitating cell recruitment,
seeding, adhesion, proliferation, differentiation, and neo tissue genesis
[42]
. Thus, as mentioned
above, biomimetic features and excellent physicochemical properties of nanomaterials play a key
role in stimulating cell growth and guiding tissue regeneration. Nanotechnology is expected to
play an important role in the design and application of biofunctionalized biomaterials in the
periodontal tissue repair process. For example, alginate/nano bioactive glass ceramic (nBGC)
(synthesis of nBGC particles) composite scaffolds were successfully fabricated using lyophiliza-
tion technique and characterized. The scaffolds were found to have characteristic materialistic
and biological properties essential to facilitate periodontal regeneration
[44]
. The composite
scaffolds had a pore size of about 100
m, controlled porosity and swelling ability, lim-
ited degradation and enhanced biomineralization, due to the presence of nBGC in the alginate
scaffold. Incorporation of nBGC did not alter the viability of MG-63 and hPDLF cells and
also helped to attain good protein adsorption, cell attachment, and cell proliferation onto the
scaffolds. The hPDLF cells also showed distinct osteoblast-like behavior with enhanced alka-
line phosphatase activity. All these results suggested that alginate/nBGC composite scaffold
serves as an appropriate bioactive matrix for periodontal tissue regeneration, thus indicating
signs of another successive outbreak in the field of periodontal tissue engineering. In another
study, Yang et al.
[45]
developed an electrospun nano-apatite/PCL composite membrane for
GTR/GBR application, the results showed that the electrospun membrane incorporating nano-
apatite is strong, enhances bioactivity and supports osteoblast-like cell proliferation and differ-
entiation. The membrane system can be used as a prototype for the further development of an
optimal membrane for clinical use.
300
μ
