Report on the Bone Tissue Engineering in Oral Cavity

   Through certain different kind of the definitions, tissue engineering has been defined as the interdisciplinary field which use the different principles of an engineering and it also life sciences towards the development of some biological substitutes that helps in the restoration, helping and improvement of the different function of tissue. This tissue engineering process involves a complete use of a tissue scaffold for the formation of the new tissues that are viable in nature for different medical purposes. This Tissue Engineering is one of the most important fields of the regenerative medicine for the tissue repairing (for example, it the damage has been caused by any accident or the disease). For offering to this kind of stability, stem cells are known to be very important tools that owns to their capacity that further gets differentiated into the large number of cells according to the provided stimuli. Tissue Engineering us being done on a large scale and there is not just one kind if tissue engineering that is being done these days, but here in this essay we are going to study about the Bone Tissue Engineering in the case of Hemimandibulectomy that how is it being done and how this method is providing benefit to the patients. (Salgado, Coutinho, & Reis, 2004)

Bone Tissue Engineering is mainly concerned with the creation of implantable bone substitutes for some of the critical skeletal defects which can’t get healed on their own. Defect in the bone may be caused by any of the trauma to a person, bone resection because of the ablative surgery or even the correction of some congenital deformities are much common problems that are being seen these days in number of different patients. There are different cases and according to them, there are number of different patients that have the self-healing capability in which the defected part of the body gets healed on its own. On a rough average scale, roughly there comes almost 1 million different cases for the injury, at times the defect size is too big or there also lies some of the conditions that are not optimal at all that allows for the process of self-healing a person. In all such cases, external help is being required in the form of this bone draft procedures of the tissue engineering to get them on their place (Bueno & Glowacki, 2009)

                                                                                                                       Image showing how tissue engineering takes place

There are many certain unpaired defects that are also being linked with the defacement, loss of speech along with the reduced masticatory ability that affects the quality of life of such patients in a much severe way. In an ideal, this continuity defect of the reconstruction have no need at all for restoring of the anatomical height along with contouring of some of the missing parts but this should allow the re-establishment of an oral function obviously in one way or the other. Till now, autogenous transplantation of the bone and particularly free vascularized transfer of a tissue is known to be the gold standard of care for the reconstruction of mandibular in those patients that are undergoing some of the major ablative surgery. This bone grafts is responsible for providing all of the critical factors for the bone regeneration like scaffold for the osteo-conduction, some of the different growth factors for the osteo-induction along with different kind of the cells for osteogenesis. Major problem that here lies is the requirement for the donor of a tissue that also results in the donor site morbidity. (Fröhlich, Grayson, Wan, Marolt, Drobnic, & Vunjak-Novakovic, 2008)

Development of the reliable tissue engineering techniques is considered to be the next step in the evolution of mandibular reconstruction. Through certain different kind of the definitions, tissue engineering has been defined as the interdisciplinary field which use the different principles of engineering and it also life sciences towards the development of some biological substitutes that helps in the restoration, helping and improvement of the different function of tissue. This bone tissue engineering method is one of the newly adapted methods that have been introduced recently and still there are many of the medical centers that don’t implement this procedure completely. In this method different scaffolds are being used along with some of the bioactive substances along with the cells/tissues with some of the osteogenic potential. In an idea, these scaffolds should be, (Pilipchuk, et al., 2015)

1. Three dimensional in shape along with high porous structure as well having an interconnected pore network for the growth of cells along with the flow transportation of the different nutrients and the metabolic waste too.

2. Bioresorbable along with the biocompatible having controllable degradation and the rate of resorption for the matching of cell or growth of tissue.

3. These scaffolds should have suitable surface for the attachment of cell, differentiation along with the proliferation as well.

4. Different kind of the mechanical properties to get matched with the tissues on the site of implantation.

5. In the present days, these multitudes of the scaffolds make certain various materials in the combination with certain bioactive substances or even the osteogenic bone marrow stromal cells that are also termed as BMSCs for the initiation or enhancing of the bone formation that are still under process. (Zy, Wang, & Bao, 2009)

                                                       Image showing the Bone Tissue Scaffold.                                                                Steps how scaffold works as discussed above

Back in year 2006, Ikada is the one who defined the concept of methodology in tissue engineering as:

1. Placing of the construct scaffold in the bioreactor to for the reconstruction of an engineered tissue in the in-vitro tissue engineering.

2. Implanting the constructed scaffold in the body of a person until or unless the new tissues don’t get regenerated. (Mohamed, Waly, Aboul-Ezz, & Hameed, 2017)

In fact, the construct completely lacks the already present vasculature. Survival of the cell along with the formation of a new tissue completely depends on the local vasculature along with the maximum speed at which the fully functional local vascular supply will be formed.

Clinical problems of bone tissue engineering in oral cavity

There are different kind of the bone defects in an individual that may take place due to several different reasons. All of these bone defects may impede all of the normal biomechanics along with the structural ability of a bone as a complete organ. In certain different cases, to make these bones correct or to bring them back on their position it obviously requires the surgical process for which the tissue engineering is one best treatment. There are many other treatments as well that are not as sure as this bone tissue engineering method is along with this, other mechanisms are also very slow in showing their action and takes a long time period. Due to the slow recovery, there are chances that infection may take place at the parts where treatment is being done. Because of this reason, search for the surgical alternatives is continued to the present time and showing some of the major problems in this terminology. The RIA system that is being abbreviated as reamer-irrigator-aspirator system, which was being devised for avoiding some problems or challenges that can rise along with the autograft harvesting (D, 2004). There is another approach or technique that is being termed as the Masquelet technique, this is the technique that consists of the reconstructing of a very long defect in the bone through the help of an induced membrane that is being grown on to the cement of an acrylic and then the rod gets inserted for the filling of a defect. Then another step comes that is also related to the surgery, once a membrane gets constituted, the rod gets removed and in the next step cancellous autograft gets used to fill up the defects. Transportation of the bone through the compression distraction along with lengthening of different principles is being implemented commonly for treating the bones that are large in size and mass. There comes different complications and challenges with all these techniques that are directly associated to the bone tissue engineering (Ceccarelli , Presta, Benedetti, De Angelis, Lupi, & Baena, 2017). There is no doubt in this fact that there has been done a massive research on the tissue engineering in last three decades but still there are multiple challenges that have been seen, what are those challenges? Well, this bone tissue engineering in oral cavity is one multidisciplinary field that involves different disciplines of health sciences, engineering along with the basic sciences. Complexity along with the lacking in scientific knowledge is another major factor that makes this bone tissue engineering a challenging thing. Another challenge is that how all these tissues are being recreated by the nature itself. Ethical concern is another major as well as the non-scientific challenge for the conduction of stem cell research, in fact the nature all these ethical concerns gets vary from area to area. (Saito, Ogawa, Hata, & Bessho, 2004)

Soft tissue repairing is also one of the most challenging area for the tissue engineering because of complicated 3D structure that are in the form of interwoven fibers along with the relevant variations for the mechanical properties that are present in the certain tissues. Need for the elasticity, functional gradients of different mechanical properties among different requirements has led this for the development of different families along with the scaffolds for regeneration and repairing of soft tissues but still research is going on to find out the best solution.

Benefits to the patients of Bone Tissue Engineering in Oral Cavity

This bone tissue engineering in the oral cavity is being required by the number of different patients worldwide. This tissue engineering seeks to devise for the functional along with the healthy soft and hard oral tissues to get replaced by the ones that are diseased or non-functional in nature. This tissue engineering process for the reconstruction of the tissues in the oral cavity has number of different advantages to certain patients and these advantages may vary from person to person. In this field of tissue engineering, all of the naturally derived along with the synthetic derivatives or the polymers are being populated with different kind of the cells that are being used in the field of dentistry for the reconstruction of tissue. (Hosseinpour, Ahsaie, Rad, & Baghani, 2017)

There are multiple factors that can’t be treated just by the simple techniques and for those this bone tissue engineering is the method that is worth it. No doubt that method is not that easy and economical but along with this I believe that this is one of the most useful technique that helps in making all the defects right that are being found in the oral cavity. (Amini, Laurencin, & Nukavarapu, 2012)

By the help of bone tissue engineering, periodontal tissue regeneration can also take place easily without getting any difficulty at all. Periodontal disease is the one that results in to the loss of an attachment that supports the different structures that further lead towards the loss of a tooth. This kind of conventional periodontal therapy interfere the process of disease that further stops the deterioration of different supporting structures. By the use of this bone tissue engineering in oral cavity helps in the approach by the incorporation of different bioactive molecules or even some growth factors also result into the better migration of the cells along with their behavior as well. (Cordeiro, et al., 2008)

So in short this bone tissue engineering is a process that is much useful as well as helpful in treating the certain defects that are being found in different body parts. This process can be used at any place but this whole essay was about the bone tissue engineering in the oral cavity, different types of techniques that are being used in it along with their useful impact on the patients as well.

References of Bone Tissue Engineering in Oral Cavity:

Almushayt A, N. K. (2006). Dentin matrix protein 1 induces cytodiDerentiation of dental pulp stem cells into odontoblasts. Gene Therapy. 611-620.

Amini, A. R., Laurencin, C. T., & Nukavarapu, S. P. (2012). Bone Tissue Engineering: Recent Advances and Challenges. Crit Rev Biomed Eng, 40(5), 363–408.

Bueno, E. M., & Glowacki, J. (2009). Cell-free and cell-based approaches for bone regeneration,. Nature Reviews Rheumatology, 5(12), 685-697.

Ceccarelli , G., Presta, R., Benedetti, L., De Angelis, M. G., Lupi, S. M., & Baena, R. R. (2017). Emerging Perspectives in Scaffold for Tissue Engineering in Oral Surgery. Stem cells international.

Cordeiro, M. M., Dong, Z., Kaneko, T., Zhang, Z., Miyazawa, M., Shi, S., et al. (2008). Dental Pulp Tissue Engineering With Stem Cells From Exfoliated Deciduous Teeth. Journal of Endodontics, 34(8), 962-969.

D, T. (2004). The Future Role of a Molecular Approach to Pulp-Dentinal Regeneration. Caries Research, 314-320.

Fröhlich, M., Grayson, W. L., Wan, L. Q., Marolt, D., Drobnic, M., & Vunjak-Novakovic, G. (2008). Tissue Engineered Bone Grafts: Biological Requirements, Tissue Culture and Clinical Relevance. Curr Stem Cell Res Ther, 3(4), 254-264.

Hosseinpour, S., Ahsaie, M. G., Rad, M. R., & Baghani, M. t. (2017). Application of selected scaffolds for bone tissue engineering: a systematic review. Oral and Maxillofacial Surgery, 21(2).

Mohamed, S. E.-D., Waly, N. G., Aboul-Ezz, E. H., & Hameed, M. A. (2017). IN VIVO BONE TISSUE ENGINEERING USING DENTAL STEM CELLS ON NOVEL SCAFFOLD. DENTAL JOURNAL, 1468.

Pilipchuk, S. P., Plonka, A. B., Monje, A., Taut, A. D., Lanis, A., Kang, B., et al. (2015). Tissue engineering for bone regeneration and osseointegration in the oral cavity. Dental Materials, 317-338.

Saito, T., Ogawa, M., Hata, Y., & Bessho, K. (2004). Acceleration eect of human re-combinant bone morphogenetic protein-2 on dierentiation of human pulp cells into odontoblasts. Journal of Endodontics, 205-208.

Salgado, A., Coutinho, O. P., & Reis, R. L. (2004). Bone tissue engineering: state of the art and future trends,. Macromolecular Bioscience, 4(8), 743-765.

Zy, L., Wang, H., & Bao, T. (2009). Tissue engineering teeth using bone marrow mesenchymal stem cells with odontogenic potential compounding collagen/nano-hdroxyapatite composite scaffold. International Journal of Oral & Maxillofacial Surgery, 525-526.