开发牙龈结缔组织的体外模型,模仿牙龈的原始结构和组成进行临床移植与牙龈缺失的个性化治疗有关。使用组织工程技术允许绕过现有解决方案所遇到的限制以增加口腔软组织体积。这篇综述旨在系统分析目前用于体内应用的不同细胞化材料和技术,以设计牙龈替代品。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。在PubMed上进行电子搜索,Scopus,进行了WebofScience和CochraneLibrary数据库以确定合适的研究。包括关于牙龈替代物和含有口腔细胞的移植物与对照的体内研究,以研究移植物重塑。使用实验动物实验系统审查中心(SYRCLE)10项清单评估纳入研究的偏倚风险。在631项筛查研究中,包括19个。动物模型主要是啮齿动物,最常用的植入是皮下植入。根据SYRCLE工具,低到不清楚的偏倚风险普遍存在.研究检查了在植入细胞化的生物材料后长达60天的血管化和细胞外重塑。使用的细胞主要是成纤维细胞和来自口腔来源的干细胞。植入后具有血管化潜力的移植物是通过组织工程技术生产的,包括14个细胞接种或包埋,2个细胞片,1个微球和2个挤出3D生物打印。用于构建包含细胞的支架的组件都是天然来源的,主要是纤维蛋白,明胶,胶原蛋白,琼脂糖,海藻酸盐,丝心蛋白,瓜尔胶,透明质酸,和去细胞化的细胞外基质。最重复的交联方法是使用化学品。除1项研究外,所有研究均报道了植入后移植物的血管化以及一些详细的细胞外基质重塑。目前的解决方案不够有效。通过评估有关该主题的相关研究,本系统综述显示,多种细胞化生物材料替代牙龈结缔组织可实现血管化和细胞外重塑。在计数中获取这篇评论的结果可以帮助改善3D生物打印中使用的当前生物墨水,以在体内应用中补偿牙龈损失。
Developing an in vitro model of gingival connective tissue that mimics the original structure and composition of gingiva for clinical grafting is relevant for personalized treatment of missing gingiva. Using tissue engineering techniques allows bypassing limitations encountered with existing solutions to increase oral soft tissue volume. This
review aims to systematically analyze the different currently existing cellularized materials and technologies used to engineer gingival substitutes for in vivo applications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic search on PubMed, Scopus, Web of Science, and Cochrane Library databases was conducted to identify suitable studies. In vivo studies about gingival substitutes and grafts containing oral cells compared with a control to investigate the graft remodeling were included. Risk of bias in the included studies was assessed using the Systematic
Review Center for Laboratory animal Experimentation (SYRCLE) 10-item checklist. Out of 631 screened studies, 19 were included. Animal models were mostly rodents, and the most used implantation was subcutaneous. According to the SYRCLE tool, low-to-unclear risk of bias was prevalent. Studies checked vascularization and extracellular
remodeling up to 60 days after implantation of the cellularized biomaterial. Cells used were mostly fibroblasts and stem cells from oral origin. Grafts presenting vascularization potential after implantation were produced by tissue engineering technologies including cell seeding or embedding for 14, cell sheets for 2, microsphere for 1, and extrusion 3D bioprinting for 2. Components used to build the scaffold containing the cells are all naturally derived and are mainly fibrin, gelatin, collagen, agarose, alginate, fibroin, guar gum, hyaluronic acid, and decellularized extracellular matrix. The most recurring crosslinking method was using chemicals. All studies except one reported vascularization of the graft after implantation, and some detailed extracellular matrix remodeling. Current solutions are not efficient enough. By assessing the relevant studies on the subject, this systematic review showed that a diversity of cellularized biomaterials substituting gingival connective tissue enables vascularization and extracellular
remodeling. Taking the results of this
review into account could help improve current bio-inks used in 3D bioprinting for in vivo applications compensating for gingival loss.