The growing prevalence of bone damage caused by ageing, diseases, and accidents makes bone the second-most transplanted tissue in the world, with the bone graft and substitute market valued at $3 billion in 2019 and a projected Compound Annual Growth Rate (CAGR) of 5.5% by 2027. The importance of bone grafts extends to the field of dentistry. Healthy oral-maxillofacial bone tissue is critical for maintaining oral function and quality of life, and bone grafts are widely used by dental surgeons to restore bone in the oralmaxillofacial region, including alveolar ridge augmentation for dental implant installation, mandibular reconstruction after disease or trauma, and cleft reconstruction. The market for dental bone grafts and substitutes is significant, with a value of $551 million in 2020 and a projected CAGR of 9.8% to reach $883 million by 2025.

The multidisciplinary NISO project (National Dental Centre Singapore, Institute of Molecular and Cell Biology, Singapore Institute of Manufacturing Technology, Osteopore International) is helmed by National Dental Centre Singapore (NDCS). The project aims to create jaw implants that promote faster bone growth and simplify future dental procedures, while also reducing the need for complex bone harvesting processes, risk of adverse immune reactions and disease transmission. This innovative technology of a novel Polycaprolactone (PCL)- based synthetic scaffold to successfully regenerate bone, has the potential to revolutionise the field of bone grafting and make the procedure safer and more accessible for patients.

PCL is a bioresorbable, non-toxic, biocompatible polymer that has been approved by the US Food and Drug Administration (FDA) for use as a bone filler in medical devices and has been shown to be effective in promoting bone growth. The PCL-TCP-Mg scaffold developed by the NISO project is loaded with Adipose-Derived Mesenchymal Stem Cells (AD-MSCs) and Heparan Sulphate (HS) for use in non-walled oral-maxillofacial defects such as alveolar or mandibular defects. The ultimate goal is to successfully regenerate bone using this scaffold. The patented biological additives and polymer compounds will be combined and tested for any adverse reactions, any osteogenic differentiation (indicating bone growth), and higher osteogenic differentiation (indicating faster bone growth) through pre-clinical studies and a first trial in human subjects.

Partnership, Roles, and Product Rollout 

The NISO collaboration, valued at $18.3 million, is slated for three years and comprises a core partnership with research and industrial organisations, with each bringing a unique skillset and expertise to the project. 

National Dental Centre Singapore (NDCS) will be responsible for formulating clinical problem statements and coordinating in-vitro studies, preclinical studies, and clinical trials in collaboration with other institutions and companies. 

Institute of Molecular and Cell Biology (IMCB) will be developing biological stimulants that can accelerate bone healing. 

Singapore Institute of Manufacturing Technology (SIMTech) will focus on developing high-value manufacturing technology for the production of regenerative scaffolds that can provide a structure for the growth of new bone tissue. 

Osteopore International, the leading company in the application of tissue engineering technology, will be expanding its product lines to include the new generation of dental implants developed as part of the project. The company also brings a wealth of experience and expertise to the project, making it well-positioned to succeed in its ambitious goals. The project partners are committed to co-developing the know-how portfolio and commercialising the novel PCL-TCP-Mg-HS3- ADMSC scaffold products over the next 3-6 years through four workstreams.

The Impact NISO Project Brings to Dentistry 

The Clinical-Industrial Partnership highlights the value of collaborations in driving innovation and improving healthcare outcomes, by leveraging and synergising the strengths of both sectors. This innovative technology has the potential to revolutionise the field of bone grafting by overcoming the limitations of traditional bone grafts and is expected to be widely adopted by dental practitioners and patients due to its unique, less intrusive nature. Overall, the use of PCL in bone grafting represents an exciting development in healthcare technology. It heralds a promising step forward in the field of dental research with significant advancements in effectively addressing the needs of patients with better surgical outcomes and shorter recovery times.