Effect of beta-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), utilize barrier membrane scaffolds to regenerate lost tooth-supporting structures. Recent advancements in tissue engineering have led to the incorporation of nanoparticles to enhance the performance of third-generation membranes, with β–tricalcium phosphate (β-TCP), a bioceramic, becoming a popular reinforcing material. This systematic review examines the tensile strength of scaffolds for GTR and GBR applications reinforced with β-TCP nanoparticles at various concentrations. Conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review evaluated the quality of the reports using Quality Assessment Tool for In-Vitro Studies (QUIN), ultimately including five eligible articles after full-text screening. A narrative synthesis was performed instead of a meta-analysis because of significant clinical and methodological heterogeneity among certain studies, including variations in testing criteria, small sample sizes, differing matrix materials, and fabrication techniques. Overall, the studies reported a positive change in tensile strength up to a certain threshold concentration of β-TCP, when compared to unreinforced scaffolds, beyond which there was a decline. Although this concentration varied across the studies, in general, the range between 3wt% to 10wt% was found to positively increase the tensile strength.