Engineering Proprioceptive Implants via Surgical and Regenerative Approaches: Preliminary Interpretations

Abstract

The periodontal ligaments are a group of specialized connective tissue fibres with vascular and neural elements that essentially attach a tooth to the alveolar bone. Endosseous dental implant replacing a lost tooth, gets ankylosed to the alveolar bone without intervening periodontal fibres (osseointegration). Hence, proprioception, one of the most important function of periodontal ligament is not elicited by commercial dental implants currently in use. To salvage the flaw, in our proof-of-principle trial in rabbits, biodegradable nanofibres were coiled around the additive manufactured (AM) customized titanium implants. Further, human dental pulp stem cells (DPSCs), adult mesenchymal stem cells of neuro-ectodermal origin, were seeded on the nanofibrous coated, orthotopically placed 3D-printed titanium implants and were induced to differentiate into neural cell lineages. The invivo anchoring mechanism of these biodegradable neuro-supportive scaffold coated implants could probably be "proprioceptive osseointegration" instead of defaults events leading to normal "osseointegration" and could exhibit features similar to periodontium, having possible anastomosis between the severed nerve terminals present in the wall of the extraction socket relaying to/from brain and newly differentiated neural cells present in the regenerated neo-tissue complex, gradually replacing the biodegradable scaffold and may eventually results in the development of proprioceptive osseointegrated root-form endosseous dental implants in near future.