Effect of Βeta - Tricalcium Phosphate Nanoparticle Reinforcement on the Tensile Strength of Bioresorbable Membranes for Guided Tissue and Bone Regeneration – A Systematic Review

Periodontal regenerative strategies like Guided Tissue Regeneration (GTR) and Guided Bone Regeneration (GBR) employ the use of barrier membrane scaffolds for the regenera-tion of lost tooth-supporting structures. Recently tissue engineering approaches have adopted reinforcement techniques with nanoparticles to develop high-performance third-generation membranes. β – tricalcium phosphate (β-TCP) bioceramic has emerged as a popular reinforcing material. Although much is known about its osteoconductive abilities, little is known about how this material can impact on the mechanical properties of barrier membranes, especially at the nanoscale. This systematic review aims to analyze the tensile strength of scaffolds used for GTR and GBR applications reinforced with β-tricalcium phosphate (β-TCP) nanoparticles at various concentrations. The review was framed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and quality assessment was done us-ing the QUIN tool (Quality Assessment Tool for In-Vitro Studies). After full-text screening 5 articles that met the eligibility criteria were included. A narrative synthesis was per-formed due to the inability to conduct a meta-analysis because of the high clinical and methodological heterogeneity in terms of the matrix material used, use of wet and dry samples for assessment, different measurement criteria, and lack of mean values that were projected in certain studies. Overall, the studies reported a positive change in tensile strength with increasing concentrations of β-TCP compared to the unreinforced scaffolds. However, this effect was reversed with a decline in tensile strength when the concentrations were increased beyond a critical concentration. Apart from its effect on tensile strength, β-TCP nanoparticles also influenced other properties. There was no specific concentration that was observed from the studies at which β-TCP nanoparticles increased the tensile strength. However, it is suggested to reinforce these nanoparticles from the lowest possible concentration to achieve the maximum desired effect.