Role of 3D printing in periodontal regeneration

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3D printing is not the perfect answer to periodontal regeneration, but it is getting close

3D-printing technology is rapidly catching up to provide treatment alternatives for nearly every issue facing periodontists today. (Image: Kasama Kanpittaya/Shutterstock)

TIRUCHENGODE, India: The prevalence of periodontitis is estimated to be around 19% in the global adult population, according to the World Health Organization. The need for regenerative therapy for severe disease and the potential benefits of 3D printing in this regard cannot be overemphasised. A recent review by researchers at the Department of Periodontology at KSR Institute of Dental Science and Research in Tiruchengode provides an excellent guide for clinicians on the emerging role of 3D printing in the field of periodontal regenerative therapy.

Because the main objective of periodontal therapy is to reconstruct or regenerate the lost periodontium, various regenerative modalities have been explored over the years, including bone grafts, guided tissue membranes, growth factors and stem cell technology. However, 3D printing has recently gained prominence as a novel approach that facilitates optimal cell interactions and promotes the regeneration of biological tissue in periodontal defects.

The review covers some of the currently available 3D-printing technologies, such as inkjet printing, extrusion printing, fused deposition modelling, light-assisted printing and electrospinning. For periodontal regeneration specifically, 3D printing includes indirect 3D printing and 3D printing with live cells. Each method offers unique advantages for tissue engineering and scaffold fabrication.

However, it is the 3D-printed scaffolds that play a crucial role in periodontal regeneration, as they provide a framework for cell attachment, migration, proliferation and differentiation. To achieve successful periodontal regeneration, these scaffolds must meet certain requirements to ensure optimal cell interactions and tissue growth. The ideal requirements for 3D-printed scaffolds in periodontal regeneration include biocompatibility, porosity and mechanical strength.

As periodontal regeneration has a myriad of related medical goals, 3D printing has also evolved to address them. These aims include socket preservation, treatment of fenestration and peri-osseous defects, sinus and ridge augmentation, and peri-implant regeneration. Although 3D-printed options are showing exceptional results, there are still some areas where the technology is lagging behind. In the case of socket preservation, the researchers cited a study that found that a custom scaffold 3D-printed from the biodegradable polymer polycaprolactone provided sufficient structure and integrity of the alveolar ridge, but caused soft-tissue dehiscence with minimal bone repair.

Newer studies which used 3D-printed scaffolds made of hydroxyapatite and beta-tricalcium phosphate have shown positive results for treating bony defects. Because the scaffold should promote the formation and integration of bone and periodontal tissue, it should ensure proper attachment of the regenerated structures to the existing natural tissue. The review cited several experimental studies that have demonstrated promising results in using 3D-printed scaffolds for tissue regeneration in these areas.

The authors noted that 3D printing is far from perfected in terms of periodontal regenerative therapy, mainly owing to high costs, biocompatibility concerns and the need for suitable biomaterials. The authors also highlighted the necessity for further human clinical trials to establish robust evidence and support the efficacy of 3D printing in this domain.

Overall, this comprehensive review sheds light on the immense potential of 3D-printing technology in revolutionising the field of periodontal regenerative therapy and addresses the need for further research to establish its efficacy and practicality in clinical settings.

The study, titled “Quintessential commence of three-dimensional printing in periodontal regeneration—a review”, was published online on 6 July 2023 in the Saudi Dental Journal, ahead of inclusion in an issue.

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