Journal of Science: Advanced Materials and Devices (Dec 2022)
Advances in neoteric modular tissue engineering strategies for regenerative dentistry
Abstract
Regenerative and translational dentistry marks a shift in the paradigm of endodontic and periodontic therapy from simple pulp capping and root planning to dental tissue reconstruction. The construction of complex soft and hard tissue-based dental structures and whole bioengineered tooth aims to repair and refurbish tissues partly or wholly. Anatomic complexity of tooth challenges to engineering native tissue-mimetic microenvironment with the reinstallation of angio/vasculogenesis and innervation. Dental biomaterials and regenerative engineering have exponentially advanced diverse therapeutic strategies, categorized into scaffold-based and scaffold-free. Scaffold-based stratagems use cells, signals, biodegradable and mechanically stable polymeric scaffolds to address specific clinical requirements and achieve cell retention with high survival. Restricted scientific ambiguity, scalability, costs, lack of federal approval, and technology transfer from ‘lab bench to dental chair’ necessitates alternates complying with the regulatory framework and reproducible clinical outcomes. Dental stem cells/cells intrinsically secrete cytokines and matrix molecules, balance local inflammation, and form exclusive tissue analogous constructs devoid of exogenous biomaterials as scaffold-free strategies. Scaffold-free tissue engineering explores prefabricated multicellular building blocks: cell sheets, spheroids, exosomes, hypoxic- and heat shock protein-based and, more lately, tissue strands as the newest addition. The modular bottom-up strategy mimics the tissue microenvironment through the self-assembly of monodispersed cells into three-dimensional (3D) tissue with cell–cell/matrix communications. This review compiles the neoteric scaffold-less strategies exploited for endodontic and periodontic regeneration, emphasizing clinical translation and commercialization of some scaffold-less cell-based systems. Additionally, the synergy between the endo-perio continuum in deferred oral healing and the cutting-edge 3D bio fabrication strategy of scaffold-free systems has been highlighted.
