Biomaterials in Implantology and Periodontics: the evolving future

Fernando Mauad and Roberta Sakamoto debate the role of biomaterials in the progress of science and the importance of caution in validating the results obtained.

The development of biomaterials for treatments in Implantology and Periodontics involves research and innovations that must be widely studied so that the clinical application is safe and effective. It is through this validation that Dentistry moves forward, offering better and better solutions and results.

To discuss the cellular response related to biomaterials and the advances in this area, we promoted a conversation between Roberta Sakamoto, PhD in Physiology and post-doctor in Surgery and Integrated Clinic, and Fernando Mauad, post-doctor in Cell Biology. They reflect on the progress of Science and the importance of being cautious when validating the results obtained when it comes to bone regeneration and repair. Follow this chat.

Fernando Mauad - Talk about what your team is researching about the cellular response to biomaterials.

Roberta Sakamoto - In our laboratory, we have a tradition with in vivo research and histological analysis. We went through all the transitions of this specialization and new tools were emerging. Currently, we are witnessing a search for answers that are increasingly specified in terms of signaling pathways. Thus, what we previously observed in relation to cellular response and matrix synthesis, without distinguishing which proteins would actually be working, today it is possible to specify the moments in which these proteins act and even more specific and recent pathways, such as the pathways of tumor necrosis and route 20. The trend is this: as the methodological tools are emerging, we are able to apply them to obtain increasingly specialized studies in relation to signaling pathways.

Mauad - Conceptually, there is no consensus between regeneration and repair. Some authors say they are totally different, while others talk about a mixture of both, such as restorative regeneration or physiological regeneration. What is your opinion on this issue?

Roberta - Since the beginning of our academic activities, we already knew that there was no consensus on this topic and that each school saw it in its own way. We saw three concepts: regeneration, healing and repair. In this context, regeneration exists when there is a proliferation of labile cells, with restitution of both the shape and function of the tissue that was injured; healing refers only to restoring form; and repair is presented as a more comprehensive term, which encompasses both regeneration and healing. Today, in studies, we see repair as a process in which the tissue is restored from a process that involves the formation of granulation tissue. In regeneration, there is the proliferation of cells that will restore form and function, a situation in which we managed to have the cells proliferating through the action of growth factors, achieving the restoration of everything that was lost.

Mauad - Currently, among clinicians there is a tendency to associate matrices with bioactive molecules, such as PRF and matrix derived from enamel. What can you tell us about it?

Roberta - I think it's fantastic, mainly because it functionalizes the surfaces of materials with bioactive molecules and the association with growth factors. Although it is interesting, it needs to be very well executed, carefully in relation to the protocol, the standardization of techniques and analyzes, to assess whether the association was indeed relevant, in addition to checking all the pros and cons, and how this set will relate to the clinical outcome.

Mauad - We have cell biology therapies and therapies with constructs in Tissue Engineering. What are the future challenges in tissue reconstruction?

Roberta - There is a wide future ahead: many molecules to be studied and growth factors in association with the frameworks, making the triad to obtain the ideal biomaterial. In fact, we need to be very careful about how to interpret the results. Depending on the analyzes carried out, results may appear that are not as close to reality as regards the biological response. I look forward to the future, however, I emphasize the caution necessary to analyze and interpret the results. We have biomaterials that will generate good responses, especially if this association is made properly.

Mauad - Suddenly, can a very promising result change direction due to the lack of a predicted criterion?

Roberta - Yes. We have materials with very good answers, but we know that there are limitations. With respect to Tissue Engineering and molecules, we know that some associations can give interesting results and in others limitations will arise. When thinking mainly about in vivo experiments, when we introduce the biomaterial into the living organism that has so many signaling pathways and compensatory mechanisms, chances are we will not get such good results. This occurs, in fact, due to the limitation of the model, so it is necessary to be very careful. In the area of ​​Physiology, we think a lot about these reactions.

Mauad - Besides research on biomaterials, what are your other lines of research?

Roberta - We have a strand that works with biomaterials, but we also study biological responses, bone repairs and events related to repair processes. However, our main focus has been to work with compromised use. Due to my background in Physiology, I end up working with animals that have systemic impairment, such as osteoporosis (both male and female), hypertension, diabetes and metabolic syndrome. One of the main focuses in the laboratory has been to assess how the repair is in the bone compromised by systemic interference. In this way, we started to work with implants and alveolar repair.

Mauad - Is working with a compromised animal an interesting model for studying biomaterials?

Roberta - Yes. For example, when we talk about surface changes, sometimes, we don't see so many answers in the case of animals in balance. In situations where there is a compromised bone, it is very advantageous to see changes in these materials to improve biological responses and, thus, try to compensate for that systemic interference that would harm the reparational response. Particularly, as I am in the area of ​​Physiology, I have a special look at systemic compromises.

Source: Implant News Perio. Available at: https://implantnewsperio.com.br/biomateriais-o-futuro-em-evolucao/. Access on: 08/24/2020.