Could 3D printing be the future for oral soft tissue regeneration

Abstract Oral soft tissue defects are a frequently encountered problem in dental praxis. Tooth loss, tooth root or implant recessions, infections or trauma require soft tissue reconstruction. The autologous graft remains the gold standard for gingiva and oral mucosa augmentation. However, prolonged pain, limited amount of harvested tissue, and increased risk of infection have prompted the search for off-shelf alternatives. Several acellularized dermal matrices have been studied without satisfactory results. A newly developed collagen-based sponge is currently in clinical studies for long term evaluation. In these approaches however, the matrix needs to be tailored chair-side for each specific defect. 3D printing technology represents a promising solution as it offers precise production of an individualized 3D graft based on a defined shape and inner structure via a specific computer-aided design using a biomaterial of choice. Combined with smart biocompatible polymers (bioinks) that can be co-printed with cells in a specific architectural design, a more natural-like tissues can be engineered. More natural oral mucosa and gingiva will find application in regenerative dental medicine, offer relevant organotypic cultures for basic research and provide testing platforms for drugs or chemical compounds. Tissue-engineered gingival equivalents comprising epithelial and connective tissues layers have been developed. 3D printing approaches have been applied for skin regeneration and the formation of vascular channels. Combining the gained knowledge from these studies may offer valuable cues on how to choose the best approach to create 3D printed patient-tailored gingival tissue to achieve the functionally and esthetically satisfying solution for the patient.