An Expandable Silk Fibroin/Montmorillonite Porous Scaffolds Based on Clinical Dual Hemostasis Concept and Its Application in Bone Regeneration of Tooth Extraction Sockets with Coagulation Disorders.

With the global aging population and the rising incidence of cardiovascular diseases, the demand for long-term anticoagulant medication is increasing, leading to a higher risk of bleeding in medical fields such as oral surgery, particularly during tooth extractions. To address this clinical need, a convenient one-step method is developed to fabricate expandable silk fibroin/montmorillonite (SF/MMT) porous scaffolds by leveraging the procoagulant and osteogenic differentiation-promoting effects of montmorillonite (MMT), along with the biocompatibility of silk fibroin. The resulting SF/MMT porous scaffolds exhibit excellent shape recovery, with a volume expansion ratio of up to 400%. Furthermore, through the rapid blood absorption facilitated by the porous structure and the procoagulant effect of MMT, these scaffolds demonstrate superior hemostatic ability in both in vitro coagulation tests and in vivo rat tail amputation/liver laceration models. Finally, this expandable SF/MMT porous scaffolds used as hemostatic fillers showed significantly enhancement on bone regeneration in the tooth extraction socket of rat with coagulation disorders, outperforming commonly used gelatin sponges. In summary, this simple method for preparing expandable SF/MMT porous scaffolds addresses the challenge of managing post-extraction bleeding in patients on anticoagulant therapy and effectively promotes bone regeneration in extraction sockets, demonstrating considerable potential for application in stomatological clinic field.