Mechanical properties and cell cultural response of polycaprolactone scaffolds designed and fabricated via fused deposition modeling

A number of different processing techniques have been developed to design and fabricate three-dimensional (3D) scaffolds for tissue-engineering applications. The imperfection of the current techniques has encouraged the use of a rapid prototyping technology known as fused deposition modeling (FDM). Our results show that FDM allows the design and fabrication of highly reproducible bioresorbable 3D scaffolds with a fully interconnected pore network. The mechanical properties and in vitro biocompatibility of polycaprolactone scaffolds with a porosity of 61 +/- 1% and two matrix architectures were studied. The honeycomb-like pores had a size falling within the range of 360 x 430 x 620 microm. The scaffolds with a 0/60/120 degrees lay-down pattern had a compressive stiffness and a 1% offset yield strength in air of 41.9 +/- 3.5 and 3.1 +/- 0.1 MPa, respectively, and a compressive stiffness and a 1% offset yield strength in simulated physiological conditions (a saline solution at 37 degrees C) of 29.4 +/- 4.0 and 2.3 +/- 0.2 MPa, respectively. In comparison, the scaffolds with a 0/72/144/36/108 degrees lay-down pattern had a compressive stiffness and a 1% offset yield strength in air of 20.2 +/- 1.7 and 2.4 +/- 0.1 MPa, respectively, and a compressive stiffness and a 1% offset yield strength in simulated physiological conditions (a saline solution at 37 degrees C) of 21.5 +/- 2.9 and 2.0 +/- 0.2 MPa, respectively. Statistical analysis confirmed that the five-angle scaffolds had significantly lower stiffness and 1% offset yield strengths under compression loading than those with a three-angle pattern under both testing conditions (p < or = 0.05). The obtained stress-strain curves for both scaffold architectures demonstrate the typical behavior of a honeycomb structure undergoing deformation. In vitro studies were conducted with primary human fibroblasts and periosteal cells. Light, environmental scanning electron, and confocal laser microscopy as well as immunohistochemistry showed cell proliferation and extracellular matrix production on the polycaprolactone surface in the 1st culturing week. Over a period of 3-4 weeks in a culture, the fully interconnected scaffold architecture was completely 3D-filled by cellular tissue. Our cell culture study shows that fibroblasts and osteoblast-like cells can proliferate, differentiate, and produce a cellular tissue in an entirely interconnected 3D polycaprolactone matrix.

An introduction to biodegradable materials for tissue engineering applications

Tissue generation by autogenous cell transplantation is one of the most promising treatment concepts being developed as it eliminates problems of donor site scarcity, immune rejection and pathogen transfer. Cultured cells are seeded onto a three-dimensional biocompatible scaffold that will slowly degrade and resorb as the soft and hard structures grow and assimilate in vitro and/or in vivo. The 3-D scaffold provides the necessary template for cells to proliferate and maintain their differentiated state. Ultimately, it defines the overall shape of the tissue-engineered transplant. The aim of this review is to describe and discuss the scaffold materials of natural and synthetic origin that are of specific interest to tissue engineers. This review is based on previous publications and our own experience in the use of biomaterials of natural and synthetic origin for tissue engineering applications. Biodegradable polymers which have been used for tissue engineering applications are mainly based on clinically established medical devices and implants. In the group of macromolecules of natural origin collagen, alginate, agarose, hyaluronic acid derivatives, chitosan, and fibrin glue have been used as scaffolds. Man-made polymers such as polyglycolide (PGA), polylactides (PLLA, PDLA), poly(caprolactone) (PCL), and poly(dioxanone) (PDS) have been studied as matrix material to guide the differentiation and proliferation of cells into the targeted functional premature and/or mature tissue. Appropriate selection of scaffold material with respect to the targeted tissue is essential. Today, biomaterials of choice remain to be those approved by the US Food and Drug Administration. In spite of that, novel biomaterials should be developed specifically designed for tissue engineering applications.

Influence of water exposure on three-body wear of composite restoratives

The objective of this investigation was to study the influence of water exposure on the three-body wear of composite restoratives. A three-body wear instrumentation was used to investigate the wear resistance of five composite restoratives [Silux Plus (SX), Z100 (ZO), Ariston pHc (AR), Surefil (SF) and Tetric Ceram (TC)] with and without exposure to water. An amalgam alloy [Dispersalloy (DA)] was used as control. Ten specimens were made for each material. The specimens were conditioned in artificial saliva at 37 degrees C for 24 h and randomly divided into two groups of 5. The first group was subjected to wear testing immediately after the 24 h conditioning period, while the second group was conditioned in distilled water at 37 degrees C for 7 days prior to wear testing. All materials were wear tested at 15 N contact force against SS304 counter-bodies for 20,000 cycles with millet seed slurry as third-body. Wear depth (microm) was measured using profilometry, and results were analyzed by ANOVA/Scheffe's and independent sample t-tests at significance level 0.05. Ranking of wear resistance was as follows: without water exposure: DA > ZO > SF > AR > SX > TC; with water exposure: DA > ZO > SX > SF > AR > TC. Wear factor ranged from 2.20 for ZO to 7.13 for TC without water exposure and from 46.00 for ZO to 143.00 for TC with exposure to water. Exposure to water significantly increased three-body wear for all composite restoratives, but did not affect wear of the amalgam alloy. The effects of water exposure must be considered for the evaluation of wear in all polymeric composite restoratives.

Bruxing-type dental wear simulator for ranking of dental restorative materials

An instrumented dental wear test simulator was developed to simulate jaw movement in the chewing process between two molar teeth. It simulated the natural impact with sliding masticatory action, known as bruxing (defined as the gnashing, grinding, or clenching of teeth) type of wear, in order to simulate a worst-case dental wear scenario. In vitro wear testing of dental restorative materials was performed. Impact and sliding wear were simulated on the machine, with water as the lubricant, on three metal alloys (Tytin, Valiant Ph.D., Galloy) and three composite resins (Silux Plus, Z100, P50). The impact force for each machine cycle was brought closer to the maximum natural masticatory forces by the use of a shock absorbing layer. To replicate the natural masticatory action, the specimens had a surface profile with the shape of a conical depression. Ranking of the materials' performance on the wear test simulator was seen to be consistent with published clinical ranking. Metal alloys showed greater wear resistance than composite resins. Among the different metal alloys, those with lower hardness and compressive strengths exhibited greater wear. Composite resins with large filler particles wore worse than those with small filler particles. Results were compared with previous work on impact with sliding on a flat surface without a cushioning layer. It was concluded that the magnitude of the impact force and the angle of approach during impact with sliding wear are important parameters in the in vitro wear ranking of dental restorative materials.

Comparative wear ranking of dental restoratives with the BIOMAT wear simulator. Part II. An SEM evaluation

The qualitative wear of amalgam alloys and composite resins opposing cast chromium alloys after impact-sliding wear simulation with the BIOMAT wear simulator was assessed. An impact stress of 28 MPa was adopted to allow for stresses generated during parafunctional activities. The worn specimens were examined using SEM at both impact sites and region of sliding wear. For amalgam alloys, ranking from the smoothest to the roughest surface under SEM observation was as follows: unicompositional alloy>admixed alloy>gallium alloy. For composite resins the ranking was: microfilled composite>small particle composite>hybrid composite. The qualitative SEM assessment results were consistent with our earlier volumetric wear results and supports the hypothesis that surface microstructure affects wear. Composite selection for teeth opposing cast chrome prostheses should be done with caution and knowledge of the composition of the material as three-body wear may occur.

Tissue engineering research: the engineer's role

Tissue engineering holds the promise of revolutionary advances for health care. Academic, clinical and industrial efforts are increasingly directed towards the development of autogenic substitutes to restore, maintain, or improve tissue and organ functions. This article summarizes the role of the engineer in the multidisciplinary environment of tissue engineering research.

Development of thin elastomeric composite membranes for biomedical applications

A breakthrough has been made in blending of two immiscible biocompatible polymers to form thin transparent interpenetrating network composite membranes (CM) with exceptional improvement in properties. Two immiscible polymers, namely the biaxially drawn ultra high molecular weight polyethylene (UHMWPE) film and polyether polyurethane (PU) were used. The fabrication included solution casting and heat compaction. During the fabrication, the CM still preserved the orientation of UHMWPE fibers but introduced the interpenetration of PU in UHMWPE film. The intimate interaction of PU with UHMWPE fibers was viewed through the transparency of CM. Differential scanning calorimetry (DSC) data showed the melting temperature (Tm) of UHMWPE increased by about 10 degrees C in CM and about 5 degrees C in heat-compacted membranes (HCM). Morphological observations indicated that CM presented a layered structure while HCM was a dense material without obvious void inclusions. The ultimate tensile strength and relative Young's modulus of CM are about 62 MPa and 460 MPa, respectively. They are about four times greater in strength and 150 times greater in modulus compared with those of PU. Heat compaction resulted in a membrane with nearly five times the tensile strength and 50 times the Young's modulus of PU. The engineered ultimate strain of CM is about 26%, 8% more than that of the porous UHMWPE film while about 70% of HCM, which is a 50% increase achieved through heat compaction. The tensile fracture toughness is about 93 mJ for CM and 211 mJ for HCM, two and five times that for the porous UHMWPE film, respectively. The significant modification on the properties of the heat-compacted composite may raise broad interest in using the CM to develop membrane-related devices and organ covers in biomedical applications.

Comparative wear ranking of dental restoratives with the BIOMAT wear simulator

Fundamental in vitro wear tests are important for the study of wear mechanisms, provision of data during material development and screening of materials prior to clinical trials. The aim of this project was to compare the wear of six dental restoratives using the BIOMAT wear simulator which was developed to simulate jaw movements and stresses generated in the occlusal contact areas during the chewing process. The correlation of wear to hardness of the restoratives was also assessed. Wear ranking from the least to the most volumetric wear was as follows: high copper unicompositional alloy, Tytin (T) < high copper admixed alloy, Valiant PhD (V) < microfilled composite resin, Silux Plus (S) < gallium alloy, Galloy (G) < heavily filled composite resin, Z100 (Z) < hybrid composite resin, P50 (P). The high copper amalgam alloys had significantly greater wear resistance when compared with all the composite resins. The gallium alloy, microfilled and heavily filled composite resins also exhibited significantly less wear than the hybrid resin. Wear ranking with the BIOMAT simulator was similar to that obtained in vivo. Ranking from the hardest to softest material: high copper unicompositional alloy, T < gallium alloy, G < high copper admixed alloy, V < hybrid composite resin, P < heavily filled composite resin, Z < microfilled composite resin, S. The amalgam alloys were significantly harder than the heavily filled and microfilled composite resins. There was no apparent correlation between wear performance and material hardness.

Use of titanium prosthesis to bridge a vertebral gap in the spine--a preliminary experimental study

Resection of a vertebral body for spine tumour or fracture results in a vertebral gap which has to be bridged by autogenous graft, allograft, bone cement or metal spacer. Recently, there have been several metal spacers in the market. We have designed a titanium vertebral spacer which is extensible by way of a threaded mechanism. Coating with hydroxyapatite enables bone ingrowth onto the surface of the titanium spacer. Biomechanical analysis, using the Instron biaxial electro-servohydraulic testing machine, showed that the segment bridging the spacer was rigid and stiffer than the adjacent vertebral body motion segment. Histological study showed that there was bone growth across the vertebral gap indicating fusion had taken place.

Comparative wear ranking of dental restorative materials utilizing different wear simulation modes

The aim of this study was to compare the wear of seven different restorative materials using two different wear simulation modes. This included a non-impact sliding wear test (rotary pin and disc) and an impact-cum-sliding wear test (masticatory simulator). The difference in wear ranking between the two wear tests was compared as well as the correlation of wear to the hardness of the materials. Hardness ranking in the order of decreasing hardness was as follows: Dispersalloy (DA), P50 (P50), Hi-Dense (HD), TPH (TPH), Fuji II LC (FJ), Dyract (DR) and Vitremer (VM). For volumetric wear using the non-impact sliding test, the following ranking in the order of decreasing wear resistance was obtained: DA, TPH, DR, HD, VM, FJ, P50. The results for volumetric wear with impact-cum-sliding wear testing in the order of decreasing wear resistance were: TPH, DR, P50, AR, FJ, VM, HD. Results showed that there is no correlation between hardness and wear resistance. There is also no correlation between impact-cum-sliding wear and non-impact sliding wear. Impact wear should be considered in future two-body wear assessment of materials.

Hybrid biomaterials based on the interaction of polyurethane oligomers with porcine pericardium

Hybrid biomaterials have been produced by the interaction of polyurethane oligomers with both fresh and glutaraldehyde-fixed porcine pericardium. The hybrid biomaterials so formed were translucent with occasional white streaks and/or spots, had increased stiffness (to touch) but remained pliable. No shrinkage temperature was detected for fresh porcine pericardium hybrid up to 100 degrees C compared to porcine pericardium (approximately 67 degrees C) and glutaraldehyde-fixed porcine pericardium (approximately 87 degrees C). Amino acid analysis of the fresh porcine pericardium hybrid showed a reduction in lysine content after active isocyanate-terminated polyurethane oligomers exposure, indicating cross-linking between the polymer and tissue. Histological examination of the hybrid material shows a thin grey coating on both surfaces of the tissue, implying at least surface cross-linking of the tissue with polyurethane. The results suggest that fresh porcine pericardium can be reacted with active isocyanate-terminated polyurethane oligomers to produce hybrid biomaterials with covalent bonding.

Cold extrusion deformation of UHMWPE in total knee replacement prostheses

The use of metal-backed tibial plates in total knee replacement prostheses can result in the flow of ultra-high molecular weight polyethylene (UHMWPE) from the tibial insert into a cavity on the metal tray surface. A study of the relationship between the thickness of UHMWPE inserts and the amount of cold extrusion is reported here. An attempt was made to correlate the occurrence of cold extrusion with computer-aided analysis. UHMWPE samples of varying thickness, from 3 mm to 10 mm, were placed over cobalt-chrome (Co-Cr) discs. The Co-Cr discs had a 5 mm diameter hole placed centrally to simulate a tibial tray cavity. A cyclic load was applied at 20 Hz through a Co-Cr spherical indentor for a million cycles. The application of cyclic loading on UHMWPE samples resulted in cold-extrusion values comparable to those reported for retrieval analysis studies. Results after fatigue loading show that the samples do not suffer any gross surface damage. A shiny depression was visible at the load application site and the surface roughness value was decreased. The amount of cold extrusion increased with decreasing UHMWPE sample thickness. From the results, a minimum UHMWPE thickness of 12 mm is required if cold extrusion of UHMWPE is to be eliminated.

In vitro strain measurement of a mechanical heart valve in a pulse simulator

To ascertain the stress magnitude at the stress concentration areas, in vitro strain measurements on a St. Vincent's mechanical heart valve were carried out in a pulse simulator. Results were combined with a finite element (FEM) stress analysis of the titanium valve housing. The maximum stress at the site of stress concentration of the titanium valve housing was 51 MPa. This is well below the fatigue endurance limit of titanium. The imposed stress on the occluder by the upper strut was less than 2 MPa. This is below the lower stress limit of Delrin and may explain why no fracture of the Delrin disk occluder has been reported. The combined use of microstrain analysis and FEM proved to be essential in the determination of dynamic stresses during the opening and closing of the mechanical heart valve.

Effect of pore sizes and cholesterol-lipid solution on the fracture toughness of pure titanium sintered compacts

Commercial pure titanium has been widely used as an implant material because of its excellent biocompatibility and good ductility. To determine the effect of pore size on the fracture resistance of porous titanium compacts, a series of fracture toughness (KQ) tests were performed on commercial pure titanium powder compacted to 0.17 and 0.62 GPa. Pore sizes ranged from 25 to 103 microns, with porosity between 8.5 and 35%. Two sets of fracture toughness tests using disc-shaped compacts (ASTM E 399-90) were performed, the first in air at 37 degrees C and the second with compacts treated in cholesterol-lipid solution at 37 degrees C. The KQ value of compacts with a smaller mean pore size (ca. 50 microns) was approximately twice that of the compacts with a larger mean pore size (100 microns). The effect of cholesterol-lipid solution treatment was detrimental, perhaps due to preferential lipid absorption by the titanium oxide and/or the presence of chlorides. For the smaller pore size compacts, the KQ values decreased by up to 20%. For the larger pore size compacts, the effect of cholesterol-lipid solution was less significant. Morphologically, compacts with smaller pore size had a predominantly ductile fracture with significantly higher dimple density than the larger pore size compacts.

Effect of saline solution on creep fracture of Delrin

Delrin as an implant material has been widely used for more than 26 yr. To determine the combined effect of stress and body fluid environment on the stress limits of polyacetal, the creep rupture behaviour of Delrin in saline (0.9% NaCl) solution at 37 degrees C was studied. A creep rupture model was used to predict the upper (immediate fracture) and lower (no fracture) stress limits and the elastic ratio (Ee/Ea). The results showed that saline solution adversely affected the lower stress limit and Ee/Ea, but not the upper stress limit. Brittle fracture with a strain < 5% occurred for most specimens. This may explain why Delrin can fail prematurely in orthopaedic implants. Design stresses using Delrin as implant material have to be reduced by four times to 5 MPa and the strain limited to 5% as opposed to 20%, as previously believed. The increase in Ee/Ea also implied that the microdeformation mechanism is changed. The presence of surface cracks indicated that Delrin is susceptible to environmental stress cracking in saline solution.

Computer-Aided Design and Computer-Aided Manufacture (CAD-CAM) applications in cosmetic below-elbow prostheses

Computer-Aided Design and Computer-Aided Manufacture (CAD/CAM) techniques, though often technologically associated with engineering and applied sciences, has opened new horizons in the medical field. In CAD, a product is first geometrically modelled in three dimensions in a computer and it can be viewed and examined from any direction. This model can then be used for many downstream applications such as manufacturing and analysis. In CAM, numerically controlled machining processes are used for cutting out a prosthetic device of the hand for prosthesis. The paper aims at establishing the basis of using CAD/CAM techniques in prostheses in particular, a review of our present work done in the area of below-elbow prostheses using CAD/CAM. A laser scanning device has been used to capture the geometry of human hands. The algorithm used in processing the images is discussed. The processed 3D data file is then interfaced with a CAD modeller where reconstruction, mirroring, scaling, etc., can be performed. The resultant CAD model is then passed on to CAM, which concentrates purely on producing a "positive core" mould for moulding the prosthetic device.

Delrin as an occluder material

Delrin (DR) has been used in biomedical applications for more than 25 years. Because of durability concerns, it was replaced by the expensive Pyrolytic Carbon (PC) in numerous cardiac valves. However, the durability problem could be related to design rather than poor materials selection. Recent reports on brittle fracture of PC, leading to sudden deaths, have prompted a critical comparison between DR and PC in the St. Vincents Mechanical (SVM) heart valves. Three SVM-DR and SVM-PC valves were subjected to accelerated life cycle tests, and examined for wear at 400 million cycles. These results were compared to those of Björk-Shiley Delrin (BS-DR) valves. Wear in BS-DR valves in vivo for more than 17 years were also analyzed and compared. Using a linear (wear depth)-log (cycles) plot, wear rates in mm/log (million cycles) were obtained. The results showed that the wear rates for DR and PC in SVM valves are close. The double reduction in wear rate of the SVM-DR, compared to BS-DR, is probably due to the lower contact stresses of the SVM valves. SVM-DR in vivo should, therefore, have lower wear. The PC discs also showed edge chipping and hairline cracks. The authors conclude that the durability of DR can be improved by design and, since it is more impact resistant than PC, it is a safer, more inexpensive occluder material for cardiac valves.