Xiaoxuan Deng

Background: The bioactive molecules released from dentine are key to stem‐cell recruitment, proliferation and differentiation in regenerative endodontics. However, there is limited and conflicting information regarding current and potential agents for releasing dentine bioactive molecules for regenerative endodontic procedures. Objectives: To answer a focused and PICOS‐designed question: are there any available experimental agents [Intervention (I)] comparable to EDTA [Comparison/Control (C)] in releasing bioactive molecules [Outcome (O)] from dentine [Population (P)] for regenerative endodontic procedures? Method: A systematic search was conducted (PubMed, Web of Science, Scopus, Medline [Ovid], Embase [Ovid], ProQuest Central, Google Scholar and citation searching: backwards and forwards), from inception until August 2025. The selection process followed the PICOS model to define inclusion and exclusion criteria. Original studies investigating experimental agents for the release of bioactive molecules from the dentine, compared with EDTA, were included. The risk of bias was strictly assessed using the QUIN tool for in vitro dental studies. Qualitative analysis was performed, while meta‐analysis was not possible. Results: Out of the 1364 studies screened, 32 were included. These studies from 2000 to 2025 investigated 23 experimental agents in comparison with EDTA. All were in vitro; of the studies, two had a low risk of bias, 25 had a moderate risk (11 with the minimum score) and five had a high risk of bias. A lack of methodological rigour was identified in approximately 80% of the included studies, including omissions of pH measurements for experimental groups, deficiencies in data assessment or normalisation to account for potential inter‐sample variability and deficiencies in validation against detection limits. The qualitative analysis indicated that 9% etidronic acid (known as HEBP), 1% phytic acid, chitosan and 10% citric acid released TGF‐β1 and/or VEGF levels as effectively as both 10% and 17% EDTA. Conclusion: Qualitative analysis suggested that 9% etidronic acid (HEBP), 1% phytic acid, chitosan and 10% citric acid might serve as alternatives to 17% EDTA use for releasing bioactive molecules from dentine. However, the methodological issues and lack of robust evidence limit the strength and comparability of the findings, highlighting the need for further well‐designed and rigorous studies before clinical translation. Registration: Open Science Framework (OSF) registries: 10.17605/OSF.IO/SPDUQ (Registration DOI: https://doi.org/10.17605/OSF.IO/SPDUQ )

Wound healing is a physiological process including haemostasis, inflammation, proliferation, and remodelling. Acute wounds typically follow a predictable healing process, whereas chronic wounds cause prolonged inflammation and infection, failing to progress through typical healing phases and presenting significant clinical challenges. A combination of wound care techniques and therapeutic agents is required to manage chronic wounds effectively. Curcumin is a bioactive compound derived from Curcuma longa and has gained attention for its potent antioxidant, anti-inflammatory, and antibacterial properties. The first part of this review aims to provide a comprehensive overview of the physiology of wound healing, focusing on the pathophysiology and management of acute and chronic wounds, followed by the biological activity of curcumin in wound healing, emphasising its impact on promoting tissue repair. Finally, this review explores curcumin-loaded dressings, such as hydrogels, nanofibrous membranes, polymeric micelles, and films, offering controlled drug release and targeted curcumin delivery to enhance wound healing.

A surgical suture is a critical medical device used to close and secure body tissues following surgery, injury, or other medical procedures, but it is often associated with the risk of surgical site infections (SSIs). To mitigate this risk, drug‐eluting sutures with antimicrobial or anti‐inflammatory properties have been developed. However, the incorporation of active pharmaceutical ingredients (APIs) frequently compromises the mechanical properties of the sutures. To address these challenges, curcumin‐loaded microspheres were first produced via the emulsion solvent evaporation method and then embedded into polymeric carriers of PCL‐PEG using a melt‐extrusion technique to achieve optimal suture diameters, thereby enhancing mechanical strength and creating an innovative drug‐delivery suture system. Notably, sutures containing Cur‐PLA‐PEG‐PCL microspheres demonstrated the highest tensile strength (170.20 ± 22.73 MPa) due to the presence of PCL. Meanwhile, sutures with Cur‐PLA‐PEG microspheres exhibited high breaking strength and stability during degradation, retaining 89.96% of their initial strength by Day 14. All suture samples also exhibited antibacterial and anti‐inflammatory activity, with a direct correlation between incubation duration and antioxidant potential. These findings suggest that the sutures hold significant potential for clinical applications in improving wound healing and reducing infections.Highlights: Curcumin‐loaded microspheres were produced via emulsion solvent evaporation and embedded into PCL‐PEG polymer carriers using melt extrusion. PLA‐PEG‐PCL sutures offer a high tensile strength of 170.20 MPa. Sutures retain 89.96% strength by Day 14, showing stability in degradation. Sustained release of curcumin from the sutures provides prolonged therapeutic effects. Sutures mitigate inflammation, reducing IL‐6 expression in keratinocytes.

As dental pulp contains the stem cells necessary for regeneration, the tooth should hold the intrinsic capacity for self-repair. A triphasic hybrid dental biocomposite (3HB) composed of biocompatible biopolymers to provide strength, antibacterial properties and protein-based cell support could provide a conducive microenvironment for the regeneration of dental structures. 3HB was incorporated into Mineral Trioxide Aggregate (ProRoot MTA) to construct a malleable injectable implant. Human tooth pulp cells (hDPCs) significantly increased proliferation in the presence of 3HB+MTA compared to 3HB or MTA alone. Cell viability decreased with MTA alone but increased with 3HB and 3HB+MTA. 3HB+MTA was implanted into the residual tooth of drilled Wistar rat M2 molars for up to 45 days. Stereological analysis from micro-CT images showed the volume of the tooth remaining. Histologically, regenerative pulpal architecture was seen invading 3HB. A continuous odontoblastic profile lined a deposit of dentin-like material suggesting reparative dentinogenesis. Overall, no infection or encapsulation was seen. Immunohistochemically, odontoblasts were seen along the margins of the wounded tooth undergoing repair. Mesenchymal cells (MSCs) were seen at the base of the drilled tooth and by 21 days had translocated into the implant itself. Cells stimulating remineralization were highly expressed in the tooth undergoing repair. CD146-positive MSCs were seen in the center of the implant, possibly stimulating remineralization. In conclusion, behavior of 3HB⁺ in vitro and in vivo provided a promising start as 3HB+MTA may serve as a viable regenerative scaffold for pulp regeneration; however, this should be further studied before clinical use can be considered.

Sutures are commonly used in surgical procedures and have immense potential for direct drug delivery into the wound site. However, incorporating active pharmaceutical ingredients into the sutures has always been challenging as their mechanical strength deteriorates. This study proposes a new method to produce microspheres-embedded surgical sutures that offer adequate mechanical properties for effective wound healing applications. The study used curcumin, a bioactive compound found in turmeric, as a model drug due to its anti-inflammatory, antioxidant, and anti-bacterial properties, which make it an ideal candidate for a surgical suture drug delivery system. Curcumin-loaded microspheres were produced using the emulsion solvent evaporation method with polyvinyl alcohol (PVA) as the aqueous phase. The microspheres’ particle sizes, drug loading (DL) capacity, and encapsulation efficiency (EE) were investigated. Microspheres were melt-extruded with polycaprolactone and polyethylene glycol via a 3D bioplotter, followed by a drawing process to optimise the mechanical strength. The sutures’ thermal, physiochemical, and mechanical properties were investigated, and the drug delivery and biocompatibility were evaluated. The results showed that increasing the aqueous phase concentration resulted in smaller particle sizes and improved DL capacity and EE. However, if PVA was used at 3% w/v or below, it prevented aggregate formation after lyophilisation, and the average particle size was found to be 34.32 ± 12.82 μm. The sutures produced with the addition of microspheres had a diameter of 0.38 ± 0.02 mm, a smooth surface, minimal tissue drag, and proper tensile strength. Furthermore, due to the encapsulated drug-polymer structure, the sutures exhibited a prolonged and sustained drug release of up to 14 d. Microsphere-loaded sutures demonstrated non-toxicity and accelerated wound healing in the in vitro studies. We anticipate that the microsphere-loaded sutures will serve as an excellent biomedical device for facilitating wound healing.

Montmorillonite (MMT) is a biocompatible, cost-effective phyllosilicate mineral clay material with a nanolayered structure belonging to the smectite group. MMT is frequently used as an adsorbent catalyst in organic synthesis, food additives, cosmetics, medical applications and many other applications in varying industries. MMT has been incorporated into numerous experimental dental restorative materials as a reinforcing filler due to its high aspect ratio, forming interfacial solid bonds with the polymer matrix. The relatively high cation exchange capacity and layered structure of MMT pave the way as a medium for drug delivery systems. Furthermore, the incorporation of ions such as calcium, fluoride, silver, and zinc potentially increase the remineralization properties and antibacterial properties of MMT-based dental materials. Despite modern dental restorative materials having advanced significantly with innovations in material nanoscience, challenges such as biocompatibility, inadequate mechanical properties, marginal leakage, polymerization shrinkage, aesthetic concerns, and overall costs remain to be addressed. This review investigates the potential of montmorillonite (MMT) in dentistry, emphasizing its distinctive properties, composite formulations, and applications. It assesses the current state of research in these areas, aiming to highlight existing gaps in knowledge, emerging trends, and lesser-known applications of MMT-based materials. The review underscores MMT’s promise as an alternative material across various dental applications while noting the scarcity of research on completed products and in vivo clinical studies.

Wound healing is a complex process that is critical in restoring the skin's barrier function. This process can be interrupted by numerous diseases resulting in chronic wounds that represent a major medical burden. Such wounds fail to follow the stages of healing and are often complicated by a pro‐inflammatory milieu attributed to increased proteinases, hypoxia, and bacterial accumulation. The comprehensive treatment of chronic wounds is still regarded as a significant unmet medical need due to the complex symptoms caused by the metabolic disorder of the wound microenvironment. As a result, several advanced medical devices, such as wound dressings, wearable wound monitors, negative pressure wound therapy devices, and surgical sutures, have been developed to correct the chronic wound environment and achieve skin tissue regeneration. Most medical devices encompass a wide range of products containing natural (e.g., chitosan, keratin, casein, collagen, hyaluronic acid, alginate, and silk fibroin) and synthetic (e.g., polyvinyl alcohol, polyethylene glycol, poly[lactic‐co‐glycolic acid], polycaprolactone, polylactic acid) polymers, as well as bioactive molecules (e.g., chemical drugs, silver, growth factors, stem cells, and plant compounds). This review addresses these medical devices with a focus on biomaterials and applications, aiming to deliver a critical theoretical reference for further research on chronic wound healing.