3D bioprinting of collagen-based materials for oral medicine

(2023) 5:23 Yang et al. Collagen and Leather https://doi.org/10.1186/s42825-023-00129-3 Collagen and Leather Open Access REVIEW 3D bioprinting of collagen‑based materials for oral medicine Bosen Yang1†, Hai Liu1†, Linli Jiang2, Yiwei Zeng2, Yiyuan Han3*, Chuanlu Sha1, Xin Xie1, Hui Li2*, Jiajing Zhou1*   and Wei Lin1 Abstract Oral diseases have emerged as one of the leading public health challenges globally. Although the existing clinical modalities for restoration of dental tissue loss and craniomaxillofacial injuries can achieve satisfactory therapeutic results, they cannot fully restore the original complex anatomical structure and physiological function of the tissue. 3D printing of biological tissues has gained growing interest in the field of oral medicine with the ability to control the bioink component and printing structure for spatially heterogeneous repairing constructs, holding enormous promise for the precise treatment of oral disease. Particularly, collagen-based materials have been recognized as promising biogenic bioinks for the regeneration of several tissues with high cell-activating and biocompatible properties. In this review, we summarize 3D printing methods for collagen-based biomaterials and their mechanisms. Additionally, we highlight the animal sources of collagen and their characteristics, as well as the methods of collagen extraction. Furthermore, this review provides an overview of the 3D bioprinting technology for the regeneration of the pulpal nerve and blood vessels, cartilage, and periodontal tissue. We envision that this technique opens up immense opportunities over the conventional ones, with high replicability and customized function, which can ultimately promote effective oral tissue regeneration. Keywords 3D bioprinting, Oral medicine, Tissue engineering, Collagen, Scaffold materials, Bioink, Hydrogel † Bosen Yang and Hai Liu contributed equally to this work. *Correspondence: Yiyuan Han Hui Li Jiajing Zhou Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Yang et al. Collagen and Leather (2023) 5:23 Page 2 of 19 Graphical Abstract 1 Introduction Oral health is important to the overall health and wellbeing of the public. According to the Global Burden of Disease (GBD) 2015 study, nearly 3.5 billion people worldwide have suffered from pain and discomfort associated with oral disease [1], including dental caries, periodontal disease, craniomaxillofacial tissues damage, etc. For example, dental caries, the most prevalent one, caused by an ecological disorder of the dental biofilm adhering to the surface of tooth enamel [2], can spread to the pulp and cause infection, resulting in severe pain [3]. Periodontal disease is a long-term inflammatory disease that affect tissues surrounding and supporting the teeth, usually caused by trauma or bacterial infection. The injury of periodontal tissues (e.g., gums, periodontal ligaments, dental bone, alveolar bone and other supporting periodontal connective tissues) is a hallmark of these diseases [4–6]. The ultimate goal of oral treatment is to regenerate the original structure and performance of the periodontal complex [7]. However, it is still challenging to realize the recovery of these tissue injuries. Although the existing clinical modalities have shown promising therapeutic efficacy in the restoration of dental tissue loss and craniomaxillofacial injuries, they still cannot restore the original complex anatomical structure and physiological function of the tissue. Three-dimensional (3D) bioprinting has attracted immense interest in the field of biomedical engineering due to the desire for precision and customization in tissue regeneration. This technique, first used by Charles Hull in 1986, employed layered light-cured materials to form a 3D structure in sequence [8]. Specifically, a digital model file is used as the basis for constructing an object in progressive layers utilizing a bondable material master such as powdered metal or plastic. It can directly produce components of virtually any shapes on the basis of the computer graphics data, eliminating the need for complicate processing, significantly shortening product development cycles, lowering production costs, and enhancing product functions [9]. Over the past decade, 3D bioprinting technology has been widely applied in medical fields including regeneration medicine [10], anatomical model construction [11], pharmaceutical formulations [12, 13]. As a result of this technology’s potential to build 3D bionic functional tissues, it has gradually been applied to the field of dentistry to precisely target oral tissue regeneration and repair of craniomaxillofacial injuries. Dental surgery has evolved from a conventional, purely empirical approach to digitalization and precision owing to the usage of 3D printing technologies. The first case of a large periodontal osseous defect being treated in a human using 3D-printed technology was reported by Rasperini et al. [14]. A bioresorbable patient-specific polymer scaffold was designed with signaling growth factor and the treated area underwent good recovery for 12 months during the therapy. This work revealed that 3D-printed image-based scaffolds provide the potential for reconstruction of oral tissues. Yang et al. Collagen and Leather (2023) 5:23 Page 3 of 19 Fig. 1 A Collagen amino acid chain. B 3D bioprinting of collagen-based materials for oral medicine Employing 3D bioprinting to create scaffolds, tissue analogs, and organs is an innovative solution that can help dentists overcome some of the most pressing problems today [15]. Some scholars have demonstrated that the application of 3D printing technology improves operational accuracy by 36.23% and shortens the operational time by 17.63% [16, 17]. For example, the construction of 3D printed scaffolds that allow cell attachment, migration, and proliferation, has been exploited, particularly for the regeneration of complex anatomical structure (e.g., pulpodentinal complex, periodontal tissue complexes) [18–20]. The development of 3D printing te (...truncated)