Preservation and regeneration of alveolar bone by tissue-engineered implants

Bone maintenance after dental extraction has a significant impact on the success of future treatment. The purpose of this study was to regenerate bone by implanting an engineered porous scaffold seeded with bone marrow mesenchymal stem cells (BMSCs) in a socket created by extraction of the lower left central incisor in rabbits, utilizing the principles of tissue engineering. It involved preparation and characterization of three-dimensional porous hollow root form scaffolds consisting of a poly-L-lactic acid:polyglycolic acid composite (PLG, 50:50), using a solvent casting/compression molding/particulate leaching technique. Porosity of the scaffolds was 83.71% with good interconnectivity and uniform distribution of the various pore sizes. The degraded scaffolds maintained their porosity and form for the first 2 weeks and their mass loss continued up to 6 weeks. The scaffolds developed viscoelastic behavior under dynamic compression; yet they lost their mechanical characteristics as they degraded. The scaffolds were seeded with BMSCs and examined by scanning electron microscopy. Cell proliferation and scaffold degradation were shown up to 2 weeks in vitro. The cultivated scaffolds were implanted in empty extraction sockets immediately after tooth removal. Four weeks later, bone regeneration was evaluated histologically in the healed sockets in three experimental groups: sockets left empty, sockets that received PLG without cells, and sockets that received PLG with cells. Radiographic evaluation, performed 4 weeks later for the three experimental groups, demonstrated preservation of alveolar bone walls in the extraction sockets that received PLG with cells as compared with the other two groups. The bone density profile for the healed sockets confirmed both histological and radiographic findings. The results of this study show promise in the area of dentoalveolar surgery, yet longitudinal studies under variable clinical situations would encourage the current application.