Advances in Dental and Maxillofacial Tissue Engineering

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Regenerative Engineering".

Deadline for manuscript submissions: closed (15 September 2023) | Viewed by 22231

Special Issue Editors


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Guest Editor
Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
Interests: growth and development of the mandible and maxilla; biologic mechanisms of tooth movement; class III orthodontic problems; impacted teeth
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Guest Editor
Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627, USA
Interests: salivary gland tissue chip; microbubble array; high throughput drug screening; biomedical nanotechnology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In dental medicine, tissue reconstruction has attracted an increasing amount of interest in oral and maxillofacial disciplines. Scaffolds, stem cells and biomaterials promise a bright future ahead in the treatment of craniofacial defects, clefts, TMJ disorders, tooth regeneration and periodontal problems. Additive 3D manufacturing technologies can also be used in oral and maxillofacial surgery. Pulp tissue regeneration, enamel and dentin development can also be attempted with these new emerging possibilities. Stem cells and/or scaffolds loaded with active growth factors can be commonly used in orthodontics to enhance orthodontic tooth movement and target the control of growth at the right time, with the desirable outcomes. As technology constantly progresses, further research is urgently needed to determine the possibilities of tissue engineering so as to modernize clinical practice and offer new opportunities.

This Special Issue focuses on the most recent “Advances in Dental and Maxillofacial Tissue Engineering”. The topics of interest include but are not limited to:

  • Enamel, dentin and pulp tissue regeneration;
  • Regeneration of periodontal tissue defects;
  • 3D bioprinting of tissue and additive manufacturing technologies;
  • Treatment advances in clefts and maxillofacial–craniofacial defects;
  • Tissue regenerative treatments for TMJ disorders;
  • Novel approaches in orthodontics with materials, cells and growth factors.

Original research contributions will be prioritized, but reviews about the state of the art, current limitations and future perspectives are also welcome.

Dr. Apostolos Tsolakis
Dr. Lisa DeLouise
Guest Editors

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Keywords

  • tissue regeneration
  • oral tissue bioengineering
  • dental bioengineering
  • maxillofacial bioengineering
  • regenerative treatments

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Published Papers (8 papers)

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Research

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14 pages, 1814 KiB  
Article
TyroFill–Titanium Implant Constructs for the Coordinated Repair of Rabbit Mandible and Tooth Defects
by Weibo Zhang, Joachim Kohn and Pamela C. Yelick
Bioengineering 2023, 10(11), 1277; https://doi.org/10.3390/bioengineering10111277 - 2 Nov 2023
Viewed by 1749
Abstract
Currently used methods to repair craniomaxillofacial (CMF) bone and tooth defects require a multi-staged surgical approach for bone repair followed by dental implant placement. Our previously published results demonstrated significant bioengineered bone formation using human dental pulp stem cell (hDPSC)-seeded tyrosine-derived polycarbonate scaffolds [...] Read more.
Currently used methods to repair craniomaxillofacial (CMF) bone and tooth defects require a multi-staged surgical approach for bone repair followed by dental implant placement. Our previously published results demonstrated significant bioengineered bone formation using human dental pulp stem cell (hDPSC)-seeded tyrosine-derived polycarbonate scaffolds (E1001(1K)-bTCP). Here, we improved upon this approach using a modified TyroFill (E1001(1K)/dicalcium phosphate dihydrate (DCPD)) scaffold-supported titanium dental implant model for simultaneous bone–dental implant repair. TyroFill scaffolds containing an embedded titanium implant, with (n = 3 each time point) or without (n = 2 each time point) seeded hDPCs and Human Umbilical Vein Endothelial Cells (HUVECs), were cultured in vitro. Each implant was then implanted into a 10 mm full-thickness critical-sized defect prepared on a rabbit mandibulee. After 1 and 3 months, replicate constructs were harvested and analyzed using Micro-CT histological and IHC analyses. Our results showed significant new bone formation surrounding the titanium implants in cell-seeded TyroFill constructs. This study indicates the potential utility of hDPSC/HUVEC-seeded TyroFill scaffolds for coordinated CMF bone–dental implant repair. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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16 pages, 12942 KiB  
Article
A Synthetic Bio-Absorbable Membrane in Guided Bone Regeneration in Dehiscence-Type Defects: An Experimental In Vivo Investigation in Dogs
by Rafael Pla, Javier Sanz-Esporrin, Fernando Noguerol, Fabio Vignoletti, Pablo Gamarra and Mariano Sanz
Bioengineering 2023, 10(7), 841; https://doi.org/10.3390/bioengineering10070841 - 15 Jul 2023
Cited by 1 | Viewed by 1395
Abstract
This study aimed to determine the performance and characteristics of a synthetic barrier membrane of polylactic acid and acetyl butyl citrate (PLAB) for the lateral bone augmentation of peri-implant dehiscence defects (mean height × depth = 3 mm × 1 mm). In eight [...] Read more.
This study aimed to determine the performance and characteristics of a synthetic barrier membrane of polylactic acid and acetyl butyl citrate (PLAB) for the lateral bone augmentation of peri-implant dehiscence defects (mean height × depth = 3 mm × 1 mm). In eight dogs, three treatment groups were randomly allocated at each chronic peri-implant dehiscence-type defect: (i) a deproteinized bovine bone mineral covered by a synthetic barrier membrane (test group), (ii) a deproteinized bovine bone mineral covered by a natural collagen membrane (positive control), and (iii) a synthetic barrier membrane (negative control). After 4 and 12 weeks of submerged healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for tissue and bone width were performed, and bone-to-implant contact and alkaline phosphatase expression where measured. After 4 and 12 weeks of healing, no statistical differences between the groups were observed for the histometric measurements. The expression of alkaline phosphatase was higher in the positive control group after 4 weeks followed by the positive and negative controls (5.25 ± 4.09, 4.46 ± 3.03, and 4.35 ± 2.28%, p > 0.05) and 12 weeks followed by the negative and positive controls (4.3 ± 2.14, 3.21 ± 1.53, and 2.39 ± 1.03%, p > 0.05). Concerning the bone-to-implant contact, after 4 weeks, the test group obtained the highest results (39.54 ± 48.7) vs. (31.24 ± 42.6) and (20.23 ± 36.1), respectively, while after 12 weeks, the positive control group obtained the highest Bone to imaplant contact (BIC) results, followed by the test and negative controls, (35.91 ± 24.9) vs. (18.41 ± 20.5) and (24.3 ± 32.1), respectively; no statistically significant differences were obtained. Within the limitations of the study, new bone formation can be achieved in guided bone regeneration procedures simultaneously with implant placement either with the use of a PLAB membrane or a native collagen membrane, although these differences were not statistically significant. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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16 pages, 4688 KiB  
Article
Mechanical Regulation of Oral Epithelial Barrier Function
by Eun-Jin Lee, Yoontae Kim, Paul Salipante, Anthony P. Kotula, Sophie Lipshutz, Dana T. Graves and Stella Alimperti
Bioengineering 2023, 10(5), 517; https://doi.org/10.3390/bioengineering10050517 - 25 Apr 2023
Cited by 12 | Viewed by 3255
Abstract
Epithelial cell function is modulated by mechanical forces imparted by the extracellular environment. The transmission of forces onto the cytoskeleton by modalities such as mechanical stress and matrix stiffness is necessary to address by the development of new experimental models that permit finely [...] Read more.
Epithelial cell function is modulated by mechanical forces imparted by the extracellular environment. The transmission of forces onto the cytoskeleton by modalities such as mechanical stress and matrix stiffness is necessary to address by the development of new experimental models that permit finely tuned cell mechanical challenges. Herein, we developed an epithelial tissue culture model, named the 3D Oral Epi-mucosa platform, to investigate the role mechanical cues in the epithelial barrier. In this platform, low-level mechanical stress (0.1 kPa) is applied to oral keratinocytes, which lie on 3D fibrous collagen (Col) gels whose stiffness is modulated by different concentrations or the addition of other factors such as fibronectin (FN). Our results show that cells lying on intermediate Col (3 mg/mL; stiffness = 30 Pa) demonstrated lower epithelial leakiness compared with soft Col (1.5 mg/mL; stiffness = 10 Pa) and stiff Col (6 mg/mL; stiffness = 120 Pa) gels, indicating that stiffness modulates barrier function. In addition, the presence of FN reversed the barrier integrity by inhibiting the interepithelial interaction via E-cadherin and Zonula occludens-1. Overall, the 3D Oral Epi-mucosa platform, as a new in vitro system, will be utilized to identify new mechanisms and develop future targets involved in mucosal diseases. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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18 pages, 5114 KiB  
Article
Biomechanical Modulation of Dental Pulp Stem Cell (DPSC) Properties for Soft Tissue Engineering
by Tara Gross, Martin Philipp Dieterle, Kirstin Vach, Markus Joerg Altenburger, Elmar Hellwig and Susanne Proksch
Bioengineering 2023, 10(3), 323; https://doi.org/10.3390/bioengineering10030323 - 3 Mar 2023
Cited by 5 | Viewed by 2590
Abstract
Dental pulp regeneration strategies frequently result in hard tissue formation and pulp obliteration. The aim of this study was to investigate whether dental pulp stem cells (DPSCs) can be directed toward soft tissue differentiation by extracellular elasticity. STRO-1-positive human dental pulp cells were [...] Read more.
Dental pulp regeneration strategies frequently result in hard tissue formation and pulp obliteration. The aim of this study was to investigate whether dental pulp stem cells (DPSCs) can be directed toward soft tissue differentiation by extracellular elasticity. STRO-1-positive human dental pulp cells were magnetically enriched and cultured on substrates with elasticities of 1.5, 15, and 28 kPa. The morphology of DPSCs was assessed visually. Proteins relevant in mechanobiology ACTB, ITGB1, FAK, p-FAK, TALIN, VINCULIN, PAXILLIN, ERK 1/2, and p-ERK 1/2 were detected by immunofluorescence imaging. Transcription of the pulp marker genes BMP2, BMP4, MMP2, MMP3, MMP13, FN1, and IGF2 as well as the cytokines ANGPT1, VEGF, CCL2, TGFB1, IL2, ANG, and CSF1 was determined using qPCR. A low stiffness, i.e., 1.5 kPa, resulted in a soft tissue-like phenotype and gene expression, whereas DPSCs on 28 kPa substrates exhibited a differentiation signature resembling hard tissues with a low cytokine expression. Conversely, the highest cytokine expression was observed in cells cultured on intermediate elasticity, i.e., 15 kPa, substrates possibly allowing the cells to act as “trophic mediators”. Our observations highlight the impact of biophysical cues for DPSC fate and enable the design of scaffold materials for clinical pulp regeneration that prevent hard tissue formation. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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11 pages, 3224 KiB  
Article
A Comparative Immunohistochemical Study of Wound Healing after Dental Diode Laser Treatment in the Rat Oral Mucosa
by Hye Rin Kim, Keunbada Son, Young-Tak Son, Yong-Gun Kim, Kyu-Bok Lee, Seung Cheol Lee, Jo-Young Suh and Jae Mok Lee
Bioengineering 2022, 9(9), 466; https://doi.org/10.3390/bioengineering9090466 - 13 Sep 2022
Cited by 3 | Viewed by 2398
Abstract
This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery through histological and immunohistochemical methods. Twenty 12-week-old male rats were assigned to three groups [...] Read more.
This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery through histological and immunohistochemical methods. Twenty 12-week-old male rats were assigned to three groups (3, 7, and 14 days). Square-shaped erosion wounds (2 × 2 mm2 diameter) were created on the hard palate of each rat. Two wounds were created using Laser A and a steel scalpel (Bard-Parker No. 15) on the right palate and using Laser B and a steel scalpel on the left side. Rats were sacrificed after 3, 7, and 14 days. Tissues were collected with a margin of 1 mm from the border of the erosional wound of the maxillary hard palate. Histological and immunohistochemical analyses were performed on the tissue samples after 3, 7, and 14 days. The tissue healing pattern and expression of inducible nitric oxide synthase (iNOS) and cluster of differentiation (CD) were observed under a light microscope. Statistical analysis was conducted using the Kruskal–Wallis H test for comparison among the groups (α = 0.05). In comparison to the wounds made with the scalpel, wounds treated with lasers A and B showed delayed healing patterns. There was no significant difference between the two laser treatment groups (p > 0.05). The expression of iNOS and CD68 was not significantly different among the three groups after 3 and 7 days (p > 0.05). On day 14, the groups treated with the dental diode lasers showed higher expression than the group treated with the steel scalpel, but no significant difference was observed (p > 0.05). Laser-induced wounds tended to heal slower than surgical wounds performed using a steel scalpel, but histological and immunohistochemical results showed no significant difference between the dental diode laser and scalpel groups. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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18 pages, 6448 KiB  
Article
Two-Axis Continuous Distractor for Mandibular Reconstruction
by Shahrokh Hatefi, Milad Etemadi Sh, Javad Alizargar, Venous Behdadipour and Khaled Abou-El-Hossein
Bioengineering 2022, 9(8), 371; https://doi.org/10.3390/bioengineering9080371 - 6 Aug 2022
Cited by 2 | Viewed by 2545
Abstract
The application of Distraction Osteogenesis (DO) techniques in the reconstruction of skeletal deficiencies is a relatively new topic in the fields of oral and maxillofacial surgeries. In many reconstruction applications, using DO is the preferred technique, as opposed to conventional reconstruction techniques, as [...] Read more.
The application of Distraction Osteogenesis (DO) techniques in the reconstruction of skeletal deficiencies is a relatively new topic in the fields of oral and maxillofacial surgeries. In many reconstruction applications, using DO is the preferred technique, as opposed to conventional reconstruction techniques, as there are more advantages and fewer side effects when it is used. The first generation of DO devices is made up of manual distractors that can apply an intermittent distraction force to the bone segment during the distraction process. Manual DO techniques have shown the functionality of the DO technique. Further research has recently been performed on the development of automatic devices for generating a controlled continuous force. However, the existing automatic techniques have limitations, and are yet to be used in reconstruction applications in humans. There is still a gap between the developed techniques and an ideal distractor to be used in mandibular reconstruction surgeries. In this research, a two-axis continuous distractor is proposed for use in mandibular reconstruction applications. The proposed distractor can generate two continuous distraction forces that can be applied to two independent distraction vectors. The proposed device can perform the standard distraction process using the predetermined distraction factors. The control system has a high positioning accuracy and resolution in controlling the position of the intra-oral end effectors while applying two continuous forces for moving the bone segment. The proposed two-axis continuous distractor meets the current requirements, and can be used as an ideal continuous DO device for different mandibular reconstruction applications. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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Review

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14 pages, 686 KiB  
Review
Molecular and Biological Aspects of Orthodontic Tooth Movement: Possibilities for Bioengineering Intervention: A Narrative Review
by Ioannis A. Tsolakis, Isidora Christopoulou, Symeon Sitaras, Ioannis Lyros, Aliki Rontogianni, Maria Dalampira and Apostolos I. Tsolakis
Bioengineering 2023, 10(11), 1275; https://doi.org/10.3390/bioengineering10111275 - 2 Nov 2023
Cited by 1 | Viewed by 5112
Abstract
Background: The current review’s goal is to examine, with a critical eye, the effect of various biomedical parameters on orthodontic tooth movement in an attempt to provide the reader with related mechanisms of this issue focusing on certain key points. Methods: This critical [...] Read more.
Background: The current review’s goal is to examine, with a critical eye, the effect of various biomedical parameters on orthodontic tooth movement in an attempt to provide the reader with related mechanisms of this issue focusing on certain key points. Methods: This critical review was conducted using the following keywords in the search strategy: “biomedical molecules”, “biomarkers”, “orthodontics”, “orthodontic tooth movement”, “acceleration”, “gene therapy”, and “stem cells”. Cochrane Library, Medline (PubMed), and Scopus were the databases that were used for the electronic search. Studies published until June 2023 were considered. Results: The use of biomedical approaches in orthodontic tooth movement has been investigated via different procedures and applications. Surgical approaches, biomarkers affecting orthodontic tooth movement, different biological events and mechanisms, RANK, RANK-L, OPG molecular triad, and vibration methods are the basic parameters of biomedical interventions that are examined in the present review. Conclusions: The biomedical approach seems to offer a variety of applications to control orthodontic tooth movement. The scarcity of human studies, as well as the high cost and complexity of these methods, currently limit the available accurate data concerning this issue. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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12 pages, 613 KiB  
Review
Applications of Biotechnology to the Craniofacial Complex: A Critical Review
by Ioannis A. Tsolakis, Isidora Christopoulou, Erofili Papadopoulou, William Papaioannou, Konstantina-Eleni Alexiou, Ioannis Lyros, Aliki Rontogianni, Christina-Efthymia Souliou and Apostolos I. Tsolakis
Bioengineering 2022, 9(11), 640; https://doi.org/10.3390/bioengineering9110640 - 3 Nov 2022
Cited by 1 | Viewed by 2007
Abstract
Background: Biotechnology shows a promising future in bridging the gap between biomedical basic sciences and clinical craniofacial practice. The purpose of the present review is to investigate the applications of biotechnology in the craniofacial complex. Methods: This critical review was conducted by using [...] Read more.
Background: Biotechnology shows a promising future in bridging the gap between biomedical basic sciences and clinical craniofacial practice. The purpose of the present review is to investigate the applications of biotechnology in the craniofacial complex. Methods: This critical review was conducted by using the following keywords in the search strategy: “biotechnology”, “bioengineering”, “craniofacial”, “stem cells”, “scaffolds”, “biomarkers”, and ”tissue regeneration”. The databases used for the electronic search were the Cochrane Library, Medline (PubMed), and Scopus. The search was conducted for studies published before June 2022. Results: The applications of biotechnology are numerous and provide clinicians with the great benefit of understanding the etiology of dentofacial deformities, as well as treating the defected areas. Research has been focused on craniofacial tissue regeneration with the use of stem cells and scaffolds, as well as in bioinformatics with the investigation of growth factors and biomarkers capable of providing evidence for craniofacial growth and development. This review presents the biotechnological opportunities in the fields related to the craniofacial complex and attempts to answer a series of questions that may be of interest to the reader. Conclusions: Biotechnology seems to offer a bright future ahead, improving and modernizing the clinical management of cranio-dento-facial diseases. Extensive research is needed as human studies on this subject are few and have controversial results. Full article
(This article belongs to the Special Issue Advances in Dental and Maxillofacial Tissue Engineering)
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