Current possibilities and prospects of alveolar bone defect replacement and covering tissues: Narrative literature review

Abstract

Dental implantation is widely used to achieve functional results of dentoalveolar region rehabilitation. Moreover, an increase in the volume of supporting tissues of approximately 43–77% is needed. In addition, current approaches for the augmentation of tissue structures do not always show the expected results. Problems with the growth of new supporting tissues are commonly caused by the reduced activity of inducing factors of local and systemic levels in the human body. A critical deficiency of the support structures significantly affects the result of ridge augmentation interventions. In this regard, a regenerative approach using biomaterials with inducing properties is relevant for modeling early processes of neovascularization and osteohistogenesis in the area of interest and achieves functional outcomes. To review modern achievements of intraoral reconstruction of supporting tissue defects, including bioengineering for the regeneration of the alveolar ridge and covering structures. An electronic search of literature sources was performed in PubMed using the keywords mentioned in PubMed and MeSH headings. The formats “review”, “systematic review”, and “clinical trial” were requested. The search depth was 20 years. Of the 378 articles found, 44 met the inclusion criteria set for this review. The prerequisites for the reconstruction of the alveolar ridge focusing on early vascularization of de novo tissues were outlined, and the advantages and disadvantages of bone and soft tissue grafts using osteosubstituting biomaterials for bone augmentation and integumentary tissues were characterized. The results of research efforts in the framework of the use of mesenchymal stem cells, which play a crucial role in the regeneration of the alveolar bone and gum, were presented. The evolution of tissue engineering structures for intraoral integumentary tissues — from thin layers of epithelial cells to three-dimensional structures, which are the epithelized equivalents of the oral mucosa, was presented. The rapidly increasing number of studies of the biomaterial properties of various chemisms, growth factors, and stem cells and the active development of tissue engineering currently indicate the prospects of scientific thought for the development of next-generation biomaterials, which can work effectively owing to their tissue regeneration activity and unique architecture.