Insulin for oral bone tissue engineering: a review on innovations in targeted insulin-loaded nanocarrier scaffold

The occurrence of oral bone tissue degeneration and bone defects by osteoporosis, tooth extraction, obesity, trauma, and periodontitis are major challenges for clinicians. Traditional bone regeneration methods often come with limitations such as donor site morbidity, limitation of special shape, inflammation, and resorption of the implanted bone. The treatment oriented with biomimetic bone materials has achieved significant attention recently. In the oral bone tissue engineering arena, insulin has gained considerable attention among all the known biomaterials for osteogenesis and angiogenesis. It also exhibits osteogenic and angiogenic properties by interacting with insulin receptors on osteoblasts. Insulin influences bone remodelling both directly and indirectly. It acts directly through the PI3K/Akt and MAPK signalling pathways and indirectly by modulating the RANK/RANKL/OPG pathway, which helps reduce bone resorption. The current review reports the role of insulin in bone remodelling and bone tissue regeneration in the oral cavity in the form of scaffolds and nanomaterials. Different insulin delivery systems, utilising nanomaterials and scaffolds functionalised with polymeric biomaterials have been explored for oral bone tissue regeneration. The review put forward a theoretical basis for future research in insulin delivery in the form of scaffolds and composite materials for oral bone tissue regeneration.