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Review
. 2020 Oct 12;5(4):51.
doi: 10.3390/biomimetics5040051.

Biomimetic Aspects of Oral and Dentofacial Regeneration

Akshaya Upadhyay  1 , Sangeeth Pillai  1 , Parisa Khayambashi  1 , Hisham Sabri  1 , Kyungjun T Lee  1 , Maryam Tarar  1 , Stephanie Zhou  1 , Ingrid Harb  1 , Simon D Tran  1
Affiliations
Review

Biomimetic Aspects of Oral and Dentofacial Regeneration

Akshaya Upadhyay et al. Biomimetics (Basel). .

Abstract

Biomimetic materials for hard and soft tissues have advanced in the fields of tissue engineering and regenerative medicine in dentistry. To examine these recent advances, we searched Medline (OVID) with the key terms "biomimetics", "biomaterials", and "biomimicry" combined with MeSH terms for "dentistry" and limited the date of publication between 2010-2020. Over 500 articles were obtained under clinical trials, randomized clinical trials, metanalysis, and systematic reviews developed in the past 10 years in three major areas of dentistry: restorative, orofacial surgery, and periodontics. Clinical studies and systematic reviews along with hand-searched preclinical studies as potential therapies have been included. They support the proof-of-concept that novel treatments are in the pipeline towards ground-breaking clinical therapies for orofacial bone regeneration, tooth regeneration, repair of the oral mucosa, periodontal tissue engineering, and dental implants. Biomimicry enhances the clinical outcomes and calls for an interdisciplinary approach integrating medicine, bioengineering, biotechnology, and computational sciences to advance the current research to clinics. We conclude that dentistry has come a long way apropos of regenerative medicine; still, there are vast avenues to endeavour, seeking inspiration from other facets in biomedical research.

Keywords: biomimetics; dentistry; dentofacial; regeneration.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of enamel tissue engineering and regeneration: (a) physiochemical synthesis of apatite crystals, (b) protein-matrix-guided enamel crystal development, (c) enamel surface mineralisation using fluoride toothpastes, and (d) ameloblast (cell-based) tissue engineering of synthetic enamel apatite. Image adapted from [3] Pandya, M.; Diekwisch, T.G.H. Enamel biomimetics-fiction or future of dentistry. Int. J. Oral Sci. 2019, 11, 8. Copyright 2019 Springer Nature.
Figure 2
Figure 2
Strategies for dentin pulp complex regeneration: the cell homing strategy involves injection of growth factors and scaffolds into the pulp tissue, which leads to proliferation and migration of progenitor cells from the apical pulp tissue. In cell transplantation, the stem cells are injected to the pulp space along with growth factors and scaffolds to induce pulp regeneration. In both scenarios, cell growth or proliferation due to growth factors or peripheral induction is followed by scaffold colonization, which in cases with resorbable scaffolds leads to formation of new tissue over time. Image reprinted with permission from Morotomi et al. [64].
Figure 3
Figure 3
Smart scaffolds for dentin pulp regeneration. Image adapted from Perez et al. [118] and Moussa et al. [119].
Figure 4
Figure 4
Macro- and microstructural arrangement of bone: the macroscale structure comprises of dense outer compact bone and spongy inner cancellous bone. Compact bone is arranged into osteons that form haversian canals. These osteons are formed by fibres arranged in geometrical patterns. These fibres are made up of collagen fibrils which have alternating organic phases to form fibril arrays. Each array makes up one collagen fibre. Collagen consists of protein molecules (tropocollagen) formed from three chains of amino acids. Image adapted from Launey et al. [135].
Figure 5
Figure 5
The temporal progression of fracture healing: healing of a fracture involves a complex series of processes which can be broadly divided into four phases, A. inflammatory phase; B. soft callus formation, C. mineralisation of callus, and bone remodelling. Each phase is regulated by key growth factors, as shown in the figure. BMP = bone morphogenetic protein, FGF = fibroblast growth factor, GDF-5 = growth/differentiation factor 5, IGF-1 = insulin-like growth factor 1, M-CSF = macrophage colony-stimulating factor, OPG = osteoprotegerin, PDGF = platelet-derived growth factor, PlGF = placental growth factor, PTH = parathyroid hormone, RANKL = receptor activator of nuclear factor κB ligand, SDF-1 = stromal cell-derived factor 1, TGF-β = transforming growth factor β, TNF-α = tumor necrosis factor α, and VEGF = vascular endothelial growth factor. Image adapted from Yague et al. [216].
Figure 6
Figure 6
(a,b) Auto transplantation procedure for an oral mucosal defect for pleomorphic adenoma at the time of surgery and 12 months after surgery, respectively; (c–f) morphology and keratin expression patterns of amniotic membrane-cultured oral mucosal cells and oral mucosa; haematoxylin and eosin stained mucosal epithelial cells exhibiting seven differentiated and stratified layers (c) as compared to oral mucosa in vivo (d); keratins (green) expressed in the cultured mucosal cells (e) vs. oral mucosa (f); and nuclei stained with propidium iodide (red). Scale bars: (c,e) 100 μm and (d,f) 200 μm. Images derived from Amemiya et al. [236].
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