Technical validation of the construction of a gingival bioprinted reconstructor based on mesenchymal cells or extracellular vesicles in hyaluronic acid scaffold

Abstract

Gingival recession is a condition characterized by oral exposure of the root surface due to a displacement of the apical gingival margin to the cemento-enamel junction. As causes can be related to anatomical gingival factors of the individual, chronic trauma, periodontitis and dental alignment. The most common consequences of gingival recession are the deterioration of dental aesthetics, as well as hypersensitivity of the buccal cervical dentin. Currently, one of the most used procedures for root recovery is the use of connective tissue wuth advanced coronary flap (CTG + CAF). However, surgeries that involve a graft collection are collapsed and can have a high morbidity, due to the need for a second surgical site, in addition to increasing or disconnecting the patient, post-surgical bleeding and supplying the limit of donor tissue. For these reasons, they are alternative techniques to CTG + CAF to reduce recessions. The use of cell therapy to regenerate oral tissues has been increasingly explored as promising results are being obtained in dentistry. It has been shown that mesenchymal cells when inserted in polylactic acid membranes with polyglycolic acid help in the average root coverage. In addition, it is known that part of the effect of CMs is due to the release of cellular structures called extracellular vesicles (EVs). Since EVs will potentiate cell proliferation and angiogenesis, it was found that EVs may also be important for the regeneration of oral tissues, such as periodontal tissues, possibly by increasing the reproduction and proliferation of cells of the periodontal ligament. It is important to emphasize that when considering EV therapy, an administration strategy must be considered and to use a scaffold that does not impair cell performance is essential. Hyaluronic acid (HA) is a natural biodegradable, biocompatible, non-immunogenic polysaccharide that, therefore, assumes several functions in the medical field and can be used as a cellular scaffold. Thus, for the treatment of gingival recession it is relevant or the development of a product that joins a good scaffold like hyaluronic acid, cell therapy and its by-products and that is efficient in the reconstruction, technical repair and promotion of cell multiplication and angiogenesis, and yet, that is not of xenogenic origin. Furthermore, in addition, for an efficient application of the cell therapy and its derived products that use tissue bioengineering, it is necessary to find a system that is scalable, fast and efficient for the in vitro manufacture of cellular frameworks. In this context, a 3D bioprint is a great tool. For all these reasons, we propose the creation of a product from 3D bioprinting that helps the cell proliferation of gingival tissue, promotes neovascularization and is derived from cell therapy is interesting. (AU)