Current Advances of Three-Dimensional Bioprinting Application in Dentistry: A Scoping Review

Abstract

Three-dimensional (3D) bioprinting technology has emerged as an ideal approach to address the challenges in regenerative dentistry by fabricating 3D tissue constructs with customized complex architecture. The dilemma with current dental treatments has led to the exploration of this technology in restoring and maintaining the function of teeth. This scoping review aims to explore 3D bioprinting technology together with the type of biomaterials and cells used for dental applications. Based on PRISMA-ScR guidelines, this systematic search was conducted by using the following databases: Ovid, PubMed, EBSCOhost and Web of Science. The inclusion criteria were (i) cell-laden 3D-bioprinted construct; (ii) intervention to regenerate dental tissue using bioink, which incorporates living cells or in combination with biomaterial; and (iii) 3D bioprinting for dental applications. A total of 31 studies were included in this review. The main 3D bioprinting technique was extrusion-based approach. Novel bioinks in use consist of different types of natural and synthetic polymers, decellularized extracellular matrix and spheroids with encapsulated mesenchymal stem cells, and have shown promising results for periodontal ligament, dentin, dental pulp and bone regeneration application. However, 3D bioprinting in dental applications, regrettably, is not yet close to being a clinical reality. Therefore, further research in fabricating ideal bioinks with implantation into larger animal models in the oral environment is very much needed for clinical translation.

Keywords: 3D bioprinting; bioink; cell-laden; dental tissue regeneration; tissue engineering.

Figure 1

Common 3D bioprinting techniques: (a) inkjet bioprinting, (b) laser-assisted bioprinting (LAB) and (c) extrusion bioprinting [24].

Figure 2

The characteristics distinction between bioink and biomaterial ink. In a bioink, cells are the mandatory component of the printing formulation, which can be in the form of single cells, coated cells and cell aggregates (one or several type of cells). The bioink may contain biomaterials and biologically active components. Meanwhile, the biomaterial ink is where the seeding cells are introduced within biomaterial scaffolds after printing. Reproduced with permission [25]. Copyright 2018 IOP publishing under a Creative Commons Attribution 3.0 Unported (CC BY 3.0). https://creativecommons.org/licenses/by/3.0/ (accessed on 21 August 2022).

Figure 3

Sources of mesenchymal stem cells. This illustration shows human tissue sources: (a) peripheral blood, (b) liver, (c) bone marrow, (d) muscles, (e) skin, (f) adipose tissue and (g) dental tissues: (1. apical dental papilla, 2. dental pulp, 3. pulp from the exfoliated deciduous tooth, 4. periodontal ligament, 5. alveolar bone) [29].

Figure 4

PRISMA flow diagram depicting the results of the search strategy.

Figure 5

Three-dimensional bioprinting strategy for dental application such as regeneration of dentin–pulp complex, periodontal, alveolar bone tissues and craniomaxillofacial bone.

Figure 6

Intra-operative bioprinting (IOB) using laser-assisted bioprinting (LAB) approach in vivo application. LAB setup comprises a pulsed laser beam, a ribbon (transparent glass slide coated with a laser-absorbing layer of metal) and a receiving substrate. Reproduced with permission [56]. Copyright 2017 SpringerNature publishing under a Creative Commons Attribution 4.0 International (CC BY 4.0). (https://creativecommons.org/licenses/by/4.0/ (accessed on 21 August 2022)).