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Bernth JE, Zhang G, Malas D, Abrahams G, Hayee B, Liu H. MorphGI: A Self-Propelling Soft Robotic Endoscope Through Morphing Shape. Soft Robot 2024; 11:670-683. [PMID: 38484296 DOI: 10.1089/soro.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Colonoscopy is currently the best method for detecting bowel cancer, but fundamental design and construction have not changed significantly in decades. Conventional colonoscope (CC) is difficult to maneuver and can lead to pain with a risk of damaging the bowel due to its rigidity. We present the MorphGI, a robotic endoscope system that is self-propelling and made of soft material, thus easy to operate and inherently safe to patient. After verifying kinematic control of the distal bending segment, the system was evaluated in: a benchtop colon simulator, using multiple colon configurations; a colon simulator with force sensors; and surgically removed pig colon tissue. In the colon simulator, the MorphGI completed a colonoscopy in an average of 10.84 min. The MorphGI showed an average of 77% and 62% reduction in peak forces compared to a CC in high- and low-stiffness modes, respectively. Self-propulsion was demonstrated in the excised tissue test but not in the live pig test, due to anatomical differences between pig and human colons. This work demonstrates the core features of MorphGI.
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Affiliation(s)
- Julius E Bernth
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Guokai Zhang
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Dionysios Malas
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - George Abrahams
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Bu Hayee
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Hongbin Liu
- Department of Surgical and Interventional Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Institute of Automation, Chinese Academy of Sciences (CAS), Beijing, China
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Li W, Taboas JM, Almarza AJ. Chondrogenic potential of superficial versus cartilage layer cells of the temporomandibular joint condyle in photopolymerizable gelatin-based hydrogels. Proc Inst Mech Eng H 2024; 238:741-754. [PMID: 39109566 DOI: 10.1177/09544119241267021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
The objectives of this study were to compare the chondrogenic potential of cells derived from different layers of Mandibular condyle cartilage and to gain further understanding of the impact of chondrogenic cues when embedded into a novel hydrogel scaffold (PGH, a polymer blend of poly (ethylene glycol), gelatin, and heparin) compared to a gelatin hydrogel scaffold (GEL). Cartilage layer cells (CLCs) and fibroblastic superficial layer cells (SLCs) were harvested from the mandibular condyle of boer goats obtained from a local abattoir. After expansion, cells were seeded into PGH and GEL hydrogels and cultured in chondrogenic media for 3 weeks. Scaffolds were harvested at 0, 1, and 3 week(s) and processed for gross appearance, histochemical, biochemical, and mechanical assays. In terms of chondrogenesis, major differences were observed between scaffold materials, but not cell types. Glycosaminoglycan (GAG) staining showed GEL scaffolds deposited GAG during the 3 week period, which was also confirmed with the biochemical testing. Moreover, GEL scaffolds had significantly higher compressive modulus and peak stress than PGH scaffolds at all time points with the largest difference seen in week 3. It can be concluded that GEL outperformed PGH in chondrogenesis. It can also be concluded that materials play a more important role in the process of chondrogenesis than the tested cell populations. Fibroblastic SLCs were shown to have similar chondrogenic potential as CLCs cells, suggesting a rich pool of progenitor cells in the superficial fibroblastic layer capable of undergoing chondrogenesis given appropriate physical and chemical cues.
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Affiliation(s)
- Wuyang Li
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juan M Taboas
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alejandro J Almarza
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Dewey MJ, Chang RSH, Nosatov AV, Janssen K, Crotts SJ, Hollister SJ, Harley BAC. Generative design approach to combine architected Voronoi foams with porous collagen scaffolds to create a tunable composite biomaterial. Acta Biomater 2023; 172:249-259. [PMID: 37806375 PMCID: PMC10827241 DOI: 10.1016/j.actbio.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
Regenerative biomaterials for musculoskeletal defects must address multi-scale mechanical challenges. Repairing craniomaxillofacial bone defects, which are often large and irregularly shaped, requires close conformal contact between implant and defect margins to aid healing. While mineralized collagen scaffolds can promote mesenchymal stem cell osteogenic differentiation in vitro and bone formation in vivo, their mechanical performance is insufficient for surgical translation. We report a generative design approach to create scaffold-mesh composites by embedding a macro-scale polymeric Voronoi mesh into the mineralized collagen scaffold. The mechanics of architected foam reinforced composites are defined by a rigorous predictive moduli equation. We show biphasic composites localize strain during loading. Further, planar and 3D mesh-scaffold composites can be rapidly shaped to aid conformal fitting. Voronoi-based composites overcome traditional porosity-mechanics relationship limits while enabling rapid shaping of regenerative implants to conformally fit complex defects unique for individual patients. STATEMENT OF SIGNIFICANCE: Biomaterial strategies for (craniomaxillofacial) bone regeneration are often limited by the size and complex geometry of the defects. Voronoi structures are open-cell foams with tunable mechanical properties which have primarily been used computationally. We describe generative design strategies to create Voronoi foams via 3D-printing then embed them into an osteogenic mineralized collagen scaffold to form a multi-scale composite biomaterial. Voronoi structures have predictable and tailorable moduli, permit stain localization to defined regions of the composite, and permit conformal fitting to effect margins to aid surgical practicality and improve host-biomaterial interactions. Multi-scale composites based on Voronoi foams represent an adaptable design approach to address significant challenges to large-scale bone repair.
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Affiliation(s)
- Marley J Dewey
- Department of Materials Science and Engineering, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Raul Sun Han Chang
- Department of Chemical and Biomolecular Engineering, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Andrey V Nosatov
- Department of Materials Science and Engineering, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Katherine Janssen
- Carl R Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Sarah J Crotts
- Center for 3D Medical Fabrication, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Scott J Hollister
- Center for 3D Medical Fabrication, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Brendan A C Harley
- Department of Chemical and Biomolecular Engineering, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA; Carl R Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA; Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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Gresita A, Raja I, Petcu E, Hadjiargyrou M. Collagen-Coated Hyperelastic Bone Promotes Osteoblast Adhesion and Proliferation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6996. [PMID: 37959593 PMCID: PMC10649997 DOI: 10.3390/ma16216996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023]
Abstract
Successfully reconstructing bone and restoring its dynamic function represents a significant challenge for medicine. Critical size defects (CSDs), resulting from trauma, tumor removal, or degenerative conditions, do not naturally heal and often require complex bone grafting. However, these grafts carry risks, such as tissue rejection, infections, and surgical site damage, necessitating the development of alternative treatments. Three-dimensional and four-dimensional printed synthetic biomaterials represent a viable alternative, as they carry low production costs and are highly reproducible. Hyperelastic bone (HB), a biocompatible synthetic polymer consisting of 90% hydroxyapatite and 10% poly(lactic-co-glycolic acid, PLGA), was examined for its potential to support cell adhesion, migration, and proliferation. Specifically, we seeded collagen-coated HB with MG-63 human osteosarcoma cells. Our analysis revealed robust cell adhesion and proliferation over 7 days in vitro, with cells forming uniform monolayers on the external surface of the scaffold. However, no cells were present on the core of the fibers. The cells expressed bone differentiation markers on days 3 and 5. By day 7, the scaffold began to degrade, developing microscopic fissures and fragmentation. In summary, collagen-coated HB scaffolds support cell adhesion and proliferation but exhibit reduced structural support after 7 days in culture. Nevertheless, the intricate 3D architecture holds promise for cellular migration, vascularization, and early osteogenesis.
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Affiliation(s)
- Andrei Gresita
- Department of Biomedical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (A.G.); (I.R.); (E.P.)
| | - Iman Raja
- Department of Biomedical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (A.G.); (I.R.); (E.P.)
| | - Eugen Petcu
- Department of Biomedical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA; (A.G.); (I.R.); (E.P.)
| | - Michael Hadjiargyrou
- Department of Biological & Chemical Sciences, New York Institute of Technology, Old Westbury, NY 11568, USA
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Dewey MJ, Chang RSH, Nosatov AV, Janssen K, Crotts SJ, Hollister SJ, Harley BAC. Generative design approach to combine architected Voronoi foams with porous collagen scaffolds to create a tunable composite biomaterial. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.05.556448. [PMID: 37732275 PMCID: PMC10508746 DOI: 10.1101/2023.09.05.556448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Regenerative biomaterials for musculoskeletal defects must address multi-scale mechanical challenges. We are developing biomaterials for craniomaxillofacial bone defects that are often large and irregularly shaped. These require close conformal contact between implant and defect margins to aid healing. While we have identified a mineralized collagen scaffold that promotes mesenchymal stem cell osteogenic differentiation in vitro and bone formation in vivo, its mechanical performance is insufficient for surgical translation. We report a generative design approach to create scaffold-mesh composites by embedding a macro-scale polymeric Voronoi mesh into the mineralized collagen scaffold. The mechanics of architected foam reinforced composites are defined by a rigorous predictive moduli equation. We show biphasic composites localize strain during loading. Further, planar and 3D mesh-scaffold composites can be rapidly shaped to aid conformal fitting. Voronoi-based composites overcome traditional porosity-mechanics relationship limits while enabling rapid shaping of regenerative implants to conformally fit complex defects unique for individual patients.
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In Vitro 3D Modeling of Neurodegenerative Diseases. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010093. [PMID: 36671665 PMCID: PMC9855033 DOI: 10.3390/bioengineering10010093] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/29/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
The study of neurodegenerative diseases (such as Alzheimer's disease, Parkinson's disease, Huntington's disease, or amyotrophic lateral sclerosis) is very complex due to the difficulty in investigating the cellular dynamics within nervous tissue. Despite numerous advances in the in vivo study of these diseases, the use of in vitro analyses is proving to be a valuable tool to better understand the mechanisms implicated in these diseases. Although neural cells remain difficult to obtain from patient tissues, access to induced multipotent stem cell production now makes it possible to generate virtually all neural cells involved in these diseases (from neurons to glial cells). Many original 3D culture model approaches are currently being developed (using these different cell types together) to closely mimic degenerative nervous tissue environments. The aim of these approaches is to allow an interaction between glial cells and neurons, which reproduces pathophysiological reality by co-culturing them in structures that recapitulate embryonic development or facilitate axonal migration, local molecule exchange, and myelination (to name a few). This review details the advantages and disadvantages of techniques using scaffolds, spheroids, organoids, 3D bioprinting, microfluidic systems, and organ-on-a-chip strategies to model neurodegenerative diseases.
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Li X, Wang Y, Zhang B, Yang H, Mushtaq RT, Liu M, Bao C, Shi Y, Luo Z, Zhang W. The design and evaluation of bionic porous bone scaffolds in fluid flow characteristics and mechanical properties. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 225:107059. [PMID: 35964422 DOI: 10.1016/j.cmpb.2022.107059] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/06/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE At present, there is a lack of efficient modeling methods for bionic artificial bone scaffolds, and the tissue fluid/nutrient mass transport characteristics of bone scaffolds has not been evaluated sufficiently. This study aims to explore an effective and efficient modeling method for biomimetic porous bone scaffolds for biological three-dimensional printing based on the imitation of the histomorphological characteristics of human vertebral cancellous bone. The fluid mass transport and mechanical characteristics of the porous scaffolds were evaluated and compared with those of a human cancellous bone,and the relationship between the geometric parameters (e.g., the size, number, shape of pores and porosity) and the performence of biomimetic porous bone scaffolds are revealed. METHODS The bionic modeling design method proposed in this study considers the biological characteristics of vertebral cancellous tissue and performs imitation and design of vertebrae-like two-dimensional slices images.It then reconstructs the slices layer-by-layer to form porous scaffolds with a three-dimensional reconstruction method, similar to computed tomography image reconstruction. By controlling the design parameters, this method can easily realize the formation of plate-like (femoral cancellous bone-like) or rod-like (vertebral cancellous bone-like) porous scaffolds. The flow characterization of porous structures was performed using the computational fluid simulation method. RESULTS The flow characterization results showed that the permeability of the porous scaffolds and human bone was 10-8∼10-9m2,and when the porosity of the porous scaffolds was higher than 70%, the permeability was higher than that of human vertebrae with a porosity of 82%. The maximum shear stress of the designed porous scaffolds and human vertebra were less than 0.8Mpa, which was conducive to cell adhesion, cell migration, and cell differentiation. The results of 3D printing and mechanical testing showed good printability and reflected the relationship between the mechanical properties and design parameters. CONCLUSIONS The design method proposed in this study has many controllable parameters, which can be adjusted to generate diversified functional porous structures to meet specific needs, increase the potential of bone scaffold design, and leave room for meeting the new requirements for bone scaffold characteristics in the future.
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Affiliation(s)
- Xinpei Li
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Yanen Wang
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China.
| | - Bo Zhang
- Department of Urology, Tangdu Hospital, Air Force Military Medical University, No.1 Xinsi Road, Xi'an, Shaanxi 710038, PR China.
| | - Haozhe Yang
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Ray Tahir Mushtaq
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Minyan Liu
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Chengwei Bao
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Yikai Shi
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
| | - Zhuojing Luo
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, No. 169 West Changle Road, Xi'an, Shaanxi 710032, PR China
| | - Weihong Zhang
- Industry Engineering Department, School of Mechanical Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, Shaanxi 710072, PR China
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Nyirjesy SC, Heller M, von Windheim N, Gingras A, Kang SY, Ozer E, Agrawal A, Old MO, Seim NB, Carrau RL, Rocco JW, VanKoevering KK. The role of computer aided design/computer assisted manufacturing (CAD/CAM) and 3- dimensional printing in head and neck oncologic surgery: A review and future directions. Oral Oncol 2022; 132:105976. [PMID: 35809506 DOI: 10.1016/j.oraloncology.2022.105976] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/17/2022] [Indexed: 01/12/2023]
Abstract
Microvascular free flap reconstruction has remained the standard of care in reconstruction of large tissue defects following ablative head and neck oncologic surgery, especially for bony structures. Computer aided design/computer assisted manufacturing (CAD/CAM) and 3-dimensionally (3D) printed models and devices offer novel solutions for reconstruction of bony defects. Conventional free hand techniques have been enhanced using 3D printed anatomic models for reference and pre-bending of titanium reconstructive plates, which has dramatically improved intraoperative and microvascular ischemia times. Improvements led to current state of the art uses which include full virtual planning (VP), 3D printed osteotomy guides, and patient specific reconstructive plates, with advanced options incorporating dental rehabilitation and titanium bone replacements into the primary surgical plan through use of these tools. Limitations such as high costs and delays in device manufacturing may be mitigated with in house software and workflows. Future innovations still in development include printing custom prosthetics, 'bioprinting' of tissue engineered scaffolds, integration of therapeutic implants, and other possibilities as this technology continues to rapidly advance. This review summarizes the literature and serves as a summary guide to the historic, current, advanced, and future possibilities of 3D printing within head and neck oncologic surgery and bony reconstruction. This review serves as a summary guide to the historic, current, advanced, and future roles of CAD/CAM and 3D printing within the field of head and neck oncologic surgery and bony reconstruction.
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Affiliation(s)
- Sarah C Nyirjesy
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Margaret Heller
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Natalia von Windheim
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Amelia Gingras
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Stephen Y Kang
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Enver Ozer
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Amit Agrawal
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Matthew O Old
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Nolan B Seim
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Ricardo L Carrau
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - James W Rocco
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Kyle K VanKoevering
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States.
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Abramowicz S, Crotts SJ, Hollister SJ, Goudy S. Tissue-engineered vascularized patient-specific temporomandibular joint reconstruction in a Yucatan pig model. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:145-152. [PMID: 33785329 DOI: 10.1016/j.oooo.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 01/13/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Current pediatric temporomandibular joint (TMJ) reconstruction options are limited. The aim of this project was to develop a proof-of-principle porcine model for a load-bearing, customized, 3D-printed and bone morphogenic protein 2 (BMP-2)-coated scaffold implanted in a pedicled (temporal) flap as a regenerative approach to pediatric TMJ mandibular condyle reconstruction. MATERIALS AND METHODS Scaffolds were customized, 3D-printed based on porcine computed tomography, and coated with BMP-2. Two operations occurred: (1) implantation of the scaffold in temporalis muscle to establish vascularity and, (2) 6 weeks later, unilateral condylectomy and rotation of the vascularized scaffold (with preservation of superficial temporal artery) onto the defect. Six months later, pigs were sacrified. The experimental side (muscle-scaffold) and control side (unoperated condyle) were individually evaluated by clinical, mechanical, radiographic, and histologic methods. RESULTS Scaffolds maintained physical properties similar in appearance to unoperated condyles. Vascularized scaffolds had new bone formation. Condyle height on the reconstructed side was 68% and 78% of the control side. Reconstructed condyle stiffness was between 20% and 45% of the control side. CONCLUSION In our porcine model, customized 3D-printed TMJ scaffolds coated with BMP-2 and implanted in vascularized temporalis muscle have the ability to (1) reconstruct a TMJ, (2) maintain appropriate condylar height, and (3) generate new bone, without impacting functional outcomes.
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Affiliation(s)
- Shelly Abramowicz
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Sarah Jo Crotts
- Center for 3D Medical Fabrication, Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Scott J Hollister
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Steve Goudy
- Pediatric Otolaryngology, Department of Otolaryngology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
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Dewey MJ, Nosatov AV, Subedi K, Shah R, Jakus A, Harley BAC. Inclusion of a 3D-printed Hyperelastic Bone mesh improves mechanical and osteogenic performance of a mineralized collagen scaffold. Acta Biomater 2021; 121:224-236. [PMID: 33227483 PMCID: PMC7856202 DOI: 10.1016/j.actbio.2020.11.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/16/2022]
Abstract
Regenerative repair of craniomaxillofacial bone injuries is challenging due to both the large size and irregular shape of many defects. Mineralized collagen scaffolds have previously been shown to be a promising biomaterial implant to accelerate craniofacial bone regeneration in vivo. Here we describe inclusion of a 3D-printed polymer or ceramic-based mesh into a mineralized collagen scaffold to improve mechanical and biological activity. Mineralized collagen scaffolds were reinforced with 3D-printed Fluffy-PLG (ultraporous polylactide-co-glycolide co-polymer) or Hyperelastic Bone (90wt% calcium phosphate in PLG) meshes. We show degradation byproducts and acidic release from the printed structures have limited negative impact on the viability of mesenchymal stem cells. Further, inclusion of a mesh formed from Hyperelastic Bone generates a reinforced composite with significantly improved mechanical performance (elastic modulus, push-out strength). Composites formed from the mineralized collagen scaffold and either Hyperelastic Bone or Fluffy-PLG reinforcement both supported human bone-marrow derived mesenchymal stem cell osteogenesis and new bone formation. This was observed by increased mineral formation in Fluffy-PLG composites and increased cell viability and upregulation of RUNX2, Osterix, and COL1A2 genes in both composites. Strikingly, composites reinforced with Hyperelastic Bone mesh elicited significantly increased secretion of osteoprotegerin, a soluble glycoprotein and endogenous inhibitor of osteoclast activity. These results suggest that architectured meshes can be integrated into collagen scaffolds to boost mechanical performance and actively instruct cell processes that aid osteogenicity; specifically, secretion of a factor crucial to inhibiting osteoclast-mediated bone resorption. Future work will focus on further adapting the polymer mesh architecture to confer improved shape-fitting capacity as well as to investigate the role of polymer reinforcement on MSC-osteoclast interactions as a means to increase regenerative potential.
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Affiliation(s)
- Marley J Dewey
- Dept. of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States
| | - Andrey V Nosatov
- Dept. of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States
| | - Kiran Subedi
- College of Agriculture and Environmental Sciences, North Carolina Agriculture and Technical State University, Greensboro, NC 27411, United States; Dimension Inx, Chicago, IL 60616, United States.
| | | | - Adam Jakus
- Dimension Inx, Chicago, IL 60616, United States
| | - Brendan A C Harley
- Dept. of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States; Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States.
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11
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Garot C, Bettega G, Picart C. Additive Manufacturing of Material Scaffolds for Bone Regeneration: Toward Application in the Clinics. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2006967. [PMID: 33531885 PMCID: PMC7116655 DOI: 10.1002/adfm.202006967] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Indexed: 05/07/2023]
Abstract
Additive manufacturing (AM) allows the fabrication of customized bone scaffolds in terms of shape, pore size, material type and mechanical properties. Combined with the possibility to obtain a precise 3D image of the bone defects using computed tomography or magnetic resonance imaging, it is now possible to manufacture implants for patient-specific bone regeneration. This paper reviews the state-of-the-art of the different materials and AM techniques used for the fabrication of 3D-printed scaffolds in the field of bone tissue engineering. Their advantages and drawbacks are highlighted. For materials, specific criteria, were extracted from a literature study: biomimetism to native bone, mechanical properties, biodegradability, ability to be imaged (implantation and follow-up period), histological performances and sterilization process. AM techniques can be classified in three major categories: extrusion-based, powder-based and liquid-base. Their price, ease of use and space requirement are analyzed. Different combinations of materials/AM techniques appear to be the most relevant depending on the targeted clinical applications (implantation site, presence of mechanical constraints, temporary or permanent implant). Finally, some barriers impeding the translation to human clinics are identified, notably the sterilization process.
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Affiliation(s)
- Charlotte Garot
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
| | - Georges Bettega
- Service de chirurgie maxillo-faciale, Centre Hospitalier Annecy-Genevois, 1 avenue de l’hôpital, F-74370 Epagny Metz-Tessy, France
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France
| | - Catherine Picart
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
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Chin AR, Taboas JM, Almarza AJ. Regenerative Potential of Mandibular Condyle Cartilage and Bone Cells Compared to Costal Cartilage Cells When Seeded in Novel Gelatin Based Hydrogels. Ann Biomed Eng 2020; 49:1353-1363. [PMID: 33155145 DOI: 10.1007/s10439-020-02674-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022]
Abstract
The field of temporomandibular joint (TMJ) condyle regeneration is hampered by a limited understanding of the phenotype and regeneration potential of cells in mandibular condyle cartilage. It has been shown that chondrocytes derived from hyaline and costal cartilage exhibit a greater chondro-regenerative potential in vitro than those from mandibular condylar cartilage. However, our recent in vivo studies suggest that mandibular condyle cartilage cells do have the potential for cartilage regeneration in osteochondral defects, but that bone regeneration is inadequate. The objective of this study was to determine the regeneration potential of cartilage and bone cells from goat mandibular condyles in two different photocrosslinkable hydrogel systems, PGH and methacrylated gelatin, compared to the well-studied costal chondrocytes. PGH is composed of methacrylated poly(ethylene glycol), gelatin, and heparin. Histology, biochemistry and unconfined compression testing was performed after 4 weeks of culture. For bone derived cells, histology showed that PGH inhibited mineralization, while gelatin supported it. For chondrocytes, costal chondrocytes had robust glycosaminoglycan (GAG) deposition in both PGH and gelatin, and compression properties on par with native condylar cartilage in gelatin. However, they showed signs of hypertrophy in gelatin but not PGH. Conversely, mandibular condyle cartilage chondrocytes only had high GAG deposition in gelatin but not in PGH. These appeared to remain dormant in PGH. These results show that mandibular condyle cartilage cells do have innate regeneration potential but that they are more sensitive to hydrogel material than costal cartilage cells.
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Affiliation(s)
- A R Chin
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA
| | - J M Taboas
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - A J Almarza
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA.
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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Dwivedi R, Mehrotra D. 3D bioprinting and craniofacial regeneration. J Oral Biol Craniofac Res 2020; 10:650-659. [PMID: 32983859 PMCID: PMC7493084 DOI: 10.1016/j.jobcr.2020.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Considering the structural and functional complexity of the craniofacial tissues, 3D bioprinting can be a valuable tool to design and create functional 3D tissues or organs in situ for in vivo applications. This review aims to explore the various aspects of this emerging 3D bioprinting technology and its application in the craniofacial bone or cartilage regeneration. METHOD Electronic database searches were undertaken on pubmed, google scholar, medline, embase, and science direct for english language literature, published for 3D bioprinting in craniofacial regeneration. The search items used were 'craniofacial regeneration' OR 'jaw regeneration' OR 'maxillofacial regeneration' AND '3D bioprinting' OR 'three dimensional bioprinting' OR 'Additive manufacturing' OR 'rapid prototyping' OR 'patient specific bioprinting'. Reviews and duplicates were excluded. RESULTS Search with above described criteria yielded 476 articles, which reduced to 108 after excluding reviews. Further screening of individual articles led to 77 articles to which 9 additional articles were included from references, and 18 duplicate articles were excluded. Finally we were left with 68 articles to be included in the review. CONCLUSION Craniofacial tissue and organ regeneration has been reported a success using bioink with different biomaterial and incorporated stem cells in 3D bioprinters. Though several attempts have been made to fabricate craniofacial bone and cartilage, the strive to achieve desired outcome still continues.
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Affiliation(s)
- Ruby Dwivedi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Divya Mehrotra
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Toledo Stuani VD, do Prado Manfredi GG, Miyahara Kondo VA, Noritomi PY, Lisboa-Filho PN, Passanezi Sant’Ana AC. The use of additively manufactured scaffolds for treating gingival recession associated with interproximal defects. ACTA ACUST UNITED AC 2020. [DOI: 10.2217/3dp-2020-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Gingival recessions are a highly prevalent issue that is often associated with interproximal tissue deficiency. An intervention in these scenarios is of extreme importance since these defects can lead to aesthetic, phonetic and other dental problems. Unfortunately, the treatment of advanced gingival recessions is a major challenge in periodontics because of its unpredictability. In such cases, the use of injectable fillings, connective tissue grafts or bone grafts for vertical regeneration in interproximal area presents limited results. Considering that, this special report reviewed the possible use of additively manufactured scaffolds as a therapeutic option. A 3D-printed personalized therapy is expected to simplify the regeneration of interproximal area, enabling bone regeneration, new papilla formation and root coverage.
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Affiliation(s)
- Vitor de Toledo Stuani
- Discipline of Periodontology, Bauru School of Dentistry – University of Sao Paulo, Bauru, Brazil
| | | | | | - Pedro Yoshito Noritomi
- Nucleus of Three-Dimensional Technologies (NT3D), Center for Information Technology Renato Archer, Campinas, Brazil
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Niu Y, Wang L, Yu N, Xing P, Wang Z, Zhong Z, Feng Y, Dong L, Wang C. An "all-in-one" scaffold targeting macrophages to direct endogenous bone repair in situ. Acta Biomater 2020; 111:153-169. [PMID: 32447062 DOI: 10.1016/j.actbio.2020.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 12/25/2022]
Abstract
Scaffolds for tissue repair are designed in an increasingly complicated manner to meet multi-facet biological needs during the healing process. However, overly sophisticated design, especially the use of multiple components and delivery of exogenous cells, hampers the bench-to-bedside translation. Here, a multi-functional - yet mono-compositional - bioactive scaffold is devised to mediate the full-range, endogenous bone repair. Based on immunoactivity screening, a chemically-modified glucomannan polysaccharide is selected and processed into an anisotropic porous scaffold, which accurately stimulates macrophages to produce pro-regenerative cytokines. These cytokines effectively enhance the recruitment ("R") and induced osteogenesis ("IO") of the bone progenitor cells in situ. Meanwhile, the anisotropic porosity and carbohydrate signal of the scaffold facilitate differential adhesion ("A") and distribution ("D") of the macrophages and bone progenitor cells - enabling the former's accumulation at the surface while encouraging the latter's infiltration into the scaffold. Implanted in a rat calvarial defect model, this "RADIO" system effectively promotes healing over 12 weeks, with the obvious formation of hard callus through the scaffold. In summary, RADIO integrates multiple functions into one single scalable system ("all-in-one") to govern the dynamic bone-repair process, by harnessing the power of host macrophages. RADIO represents an open platform to solving the long-lasting complexity-versus-simplicity dilemma in biomaterials design. STATEMENT OF SIGNIFICANCE: Biomaterials as versatile tools for tissue repair are becoming increasingly complicated, yet overly sophisticated design - especially the use of multiple components, exogenous cells, and overdosed growth factors - hampers their clinical application. The pre-requisite for designing a successful integrative scaffold is to identify an inherent biological target responding to biomaterial signals, thereby efficiently and safely promoting tissue repair via the endogenous healing capability instead of extra multifarious biochemical components. For bone regeneration, the pivotal regulator is macrophages. Through activating host macrophages, our single-component scaffold system coordinates the entire bone regenerative cascade in situ and induces successful bone regeneration in a calvarial defect model. This scaffold represents a scalable and multi-functional approach to effectively simplify the sophisticated design in regenerative medicine.
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Affiliation(s)
- Yiming Niu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China
| | - Lintao Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, 210093, China
| | - Na Yu
- National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Panfei Xing
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China
| | - Zhenzhen Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China
| | - Zhangfeng Zhong
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China
| | - Yanxian Feng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China
| | - Lei Dong
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, 210093, China
| | - Chunming Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Macau SAR, China.
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Almarza AJ, Mercuri LG, Arzi B, Gallo LM, Granquist E, Kapila S, Detamore MS. Temporomandibular Joint Bioengineering Conference: Working Together Toward Improving Clinical Outcomes. J Biomech Eng 2020; 142:020801. [PMID: 31233104 DOI: 10.1115/1.4044090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Indexed: 12/21/2022]
Abstract
The sixth temporomandibular joint (TMJ) Bioengineering Conference (TMJBC) was held on June 14-15 2018, in Redondo Beach, California, 12 years after the first TMJBC. Speakers gave 30 presentations and came from the United States, Europe, Asia, and Australia. The goal of the conference has remained to foster a continuing forum for bioengineers, scientists, and surgeons and veterinarians to advance technology related to TMJ disorders. These collective multidisciplinary interactions over the past decade have made large strides in moving the field of TMJ research forward. Over the past 12 years, in vivo approaches for tissue engineering have emerged, along with a wide variety of degeneration models, as well as with models occurring in nature. Furthermore, biomechanical tools have become more sensitive and new biologic interventions for disease are being developed. Clinical directives have evolved for specific diagnoses, along with patient-specific biological and immunological responses to TMJ replacement devices alloplastic and/or bioengineered devices. The sixth TMJBC heralded many opportunities for funding agencies to advance the field: (1) initiatives on TMJ that go beyond pain research, (2) more training grants focused on graduate students and fellows, (3) partnership funding with government agencies to translate TMJ solutions, and (4) the recruitment of a critical mass of TMJ experts to participate on grant review panels. The TMJ research community continues to grow and has become a pillar of dental and craniofacial research, and together we share the unified vision to ultimately improve diagnoses and treatment outcomes in patients affected by TMJ disorders.
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Affiliation(s)
- Alejandro J Almarza
- Departments of Oral Biology and Bioengineering, Center for Craniofacial Regeneration, McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15213
| | - Louis G Mercuri
- Visiting Professor Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612; TMJ Concepts, Ventura, CA 93003
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich CH-8031, Switzerland
| | - Eric Granquist
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA 19104
| | - Sunil Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94143
| | - Michael S Detamore
- Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, OK 73019
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Tao O, Kort-Mascort J, Lin Y, Pham HM, Charbonneau AM, ElKashty OA, Kinsella JM, Tran SD. The Applications of 3D Printing for Craniofacial Tissue Engineering. MICROMACHINES 2019; 10:E480. [PMID: 31319522 PMCID: PMC6680740 DOI: 10.3390/mi10070480] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Abstract
Three-dimensional (3D) printing is an emerging technology in the field of dentistry. It uses a layer-by-layer manufacturing technique to create scaffolds that can be used for dental tissue engineering applications. While several 3D printing methodologies exist, such as selective laser sintering or fused deposition modeling, this paper will review the applications of 3D printing for craniofacial tissue engineering; in particular for the periodontal complex, dental pulp, alveolar bone, and cartilage. For the periodontal complex, a 3D printed scaffold was attempted to treat a periodontal defect; for dental pulp, hydrogels were created that can support an odontoblastic cell line; for bone and cartilage, a polycaprolactone scaffold with microspheres induced the formation of multiphase fibrocartilaginous tissues. While the current research highlights the development and potential of 3D printing, more research is required to fully understand this technology and for its incorporation into the dental field.
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Affiliation(s)
- Owen Tao
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Jacqueline Kort-Mascort
- Department of Bioengineering, McGill University, 817 Sherbrook Street West, Montreal, QC H3A 0C3, Canada
| | - Yi Lin
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Lingyuan Road West, Guangzhou 510055, China
| | - Hieu M Pham
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - André M Charbonneau
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Osama A ElKashty
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
- Oral Pathology Department, Faculty of Dentistry, Mansoura University, Mansoura 22123, Egypt
| | - Joseph M Kinsella
- Department of Bioengineering, McGill University, 817 Sherbrook Street West, Montreal, QC H3A 0C3, Canada
| | - Simon D Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada.
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18
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Liao W, Xu L, Wangrao K, Du Y, Xiong Q, Yao Y. Three-dimensional printing with biomaterials in craniofacial and dental tissue engineering. PeerJ 2019; 7:e7271. [PMID: 31328038 PMCID: PMC6622164 DOI: 10.7717/peerj.7271] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/10/2019] [Indexed: 02/05/2023] Open
Abstract
With the development of technology, tissue engineering (TE) has been widely applied in the medical field. In recent years, due to its accuracy and the demands of solid freeform fabrication in TE, three-dimensional printing, also known as additive manufacturing (AM), has been applied for biological scaffold fabrication in craniofacial and dental regeneration. In this review, we have compared several types of AM techniques and summarized their advantages and limitations. The range of printable materials used in craniofacial and dental tissue includes all the biomaterials. Thus, basic and clinical studies were discussed in this review to present the application of AM techniques in craniofacial and dental tissue and their advances during these years, which might provide information for further AM studies in craniofacial and dental TE.
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Affiliation(s)
- Wen Liao
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lin Xu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Kaijuan Wangrao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Du
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qiuchan Xiong
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yang Yao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Diermann SH, Lu M, Dargusch M, Grøndahl L, Huang H. Akermanite reinforced PHBV scaffolds manufactured using selective laser sintering. J Biomed Mater Res B Appl Biomater 2019; 107:2596-2610. [DOI: 10.1002/jbm.b.34349] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Sven H. Diermann
- School of Mechanical and Mining EngineeringThe University of Queensland Queensland Australia
| | - Mingyuan Lu
- School of Mechanical and Mining EngineeringThe University of Queensland Queensland Australia
| | - Matthew Dargusch
- School of Mechanical and Mining EngineeringThe University of Queensland Queensland Australia
| | - Lisbeth Grøndahl
- School of Chemistry and Molecular BiosciencesThe University of Queensland Queensland Australia
- Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland Queensland Australia
| | - Han Huang
- School of Mechanical and Mining EngineeringThe University of Queensland Queensland Australia
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VanKoevering KK, Zopf DA, Hollister SJ. Tissue Engineering and 3-Dimensional Modeling for Facial Reconstruction. Facial Plast Surg Clin North Am 2019; 27:151-161. [PMID: 30420069 DOI: 10.1016/j.fsc.2018.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Three-dimensional (3D) printing has transformed craniofacial reconstruction over the last 2 decades. For cutaneous oncologic surgeons, several 3D printed technologies are available to assist with craniofacial bony reconstruction and preliminary soft tissue reconstructive efforts. With improved accessibility and simplified design software, 3D printing has opened the door for new techniques in anaplastology. Tissue engineering has more recently emerged as a promising concept for complex auricular and nasal reconstruction. Combined with 3D printing, several groups have demonstrated promising preclinical results with cartilage growth. This article highlights the applications and current state of 3D printing and tissue engineering in craniofacial reconstruction.
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Affiliation(s)
- Kyle K VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, 1500 East Medical Center Drive, 1904 Taubman Center, Ann Arbor, MI 48109, USA.
| | - David A Zopf
- Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Michigan Medical Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Scott J Hollister
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive Northwest, Atlanta, GA 30332, USA
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Zopf DA, Flanagan CL, Mitsak AG, Brennan JR, Hollister SJ. Pore architecture effects on chondrogenic potential of patient-specific 3-dimensionally printed porous tissue bioscaffolds for auricular tissue engineering. Int J Pediatr Otorhinolaryngol 2018; 114:170-174. [PMID: 30262359 PMCID: PMC6196359 DOI: 10.1016/j.ijporl.2018.07.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to determine the effect of auricular scaffold microarchitecture on chondrogenic potential in an in vivo animal model. METHODS DICOM computed tomography (CT) images of a human auricle were segmented to create an external anatomic envelope. Image-based design was used to generate 1) orthogonally interconnected spherical pores and 2) randomly interspersed pores, and each were repeated in three dimensions to fill the external auricular envelope. These auricular scaffolds were then 3D printed by laser sintering poly-l-caprolactone, seeded with primary porcine auricular chondrocytes in a hyaluronic acid/collagen hydrogel and cultured in a pro-chondrogenic medium. The auricular scaffolds were then implanted subcutaneously in rats and explanted after 4 weeks for analysis with Safranin O and Hematoxylin and Eosin staining. RESULTS Auricular constructs with two micropore architectures were rapidly manufactured with high fidelity anatomic appearance. Subcutaneous implantation of the scaffolds resulted in excellent external appearance of both anterior and posterior auricular surfaces. Analysis on explantation showed that the defined, spherical micropore architecture yielded histologic evidence of more robust chondrogenic tissue formation as demonstrated by Safranin O and Hematoxylin and Eosin staining. CONCLUSIONS Image-based computer-aided design and 3D printing offers an exciting new avenue for the tissue-engineered auricle. In early pilot work, creation of spherical micropores within the scaffold architecture appears to impart greater chondrogenicity of the bioscaffold. This advantage could be related to differences in permeability allowing greater cell migration and nutrient flow, differences in surface area allowing different cell aggregation, or a combination of both factors. The ability to design an anatomically correct scaffold that maintains its structural integrity while also promoting auricular cartilage growth represents an important step towards clinical applicability of this new technology.
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Affiliation(s)
- David A Zopf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1540 E Hospital Dr., Ann Arbor, MI, 48109, USA.
| | - Colleen L Flanagan
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI, 48109, USA
| | - Anna G Mitsak
- Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd., Ann Arbor, MI, 48109, USA
| | - Julia R Brennan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1540 E Hospital Dr., Ann Arbor, MI, 48109, USA
| | - Scott J Hollister
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, GA, 30332, USA
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Rider P, Kačarević ŽP, Alkildani S, Retnasingh S, Schnettler R, Barbeck M. Additive Manufacturing for Guided Bone Regeneration: A Perspective for Alveolar Ridge Augmentation. Int J Mol Sci 2018; 19:E3308. [PMID: 30355988 PMCID: PMC6274711 DOI: 10.3390/ijms19113308] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/18/2018] [Accepted: 10/21/2018] [Indexed: 12/14/2022] Open
Abstract
Three-dimensional (3D) printing has become an important tool in the field of tissue engineering and its further development will lead to completely new clinical possibilities. The ability to create tissue scaffolds with controllable characteristics, such as internal architecture, porosity, and interconnectivity make it highly desirable in comparison to conventional techniques, which lack a defined structure and repeatability between scaffolds. Furthermore, 3D printing allows for the production of scaffolds with patient-specific dimensions using computer-aided design. The availability of commercially available 3D printed permanent implants is on the rise; however, there are yet to be any commercially available biodegradable/bioresorbable devices. This review will compare the main 3D printing techniques of: stereolithography; selective laser sintering; powder bed inkjet printing and extrusion printing; for the fabrication of biodegradable/bioresorbable bone tissue scaffolds; and, discuss their potential for dental applications, specifically augmentation of the alveolar ridge.
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Affiliation(s)
- Patrick Rider
- Botiss Biomaterials GmbH, Hauptstr. 28, 15806 Zossen, Germany.
| | - Željka Perić Kačarević
- Department of Anatomy, Histology and Embryology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Said Alkildani
- Department of Biomedical Engineering, Faculty of Applied Medical Sciences, German-Jordanian University, Amman 11180, Jordan.
| | - Sujith Retnasingh
- Institutes for Environmental Toxicology, Martin-Luther-Universität, Halle-Wittenberg and Faculty of Biomedical Engineering, Anhalt University of Applied Science, 06366 Köthen, Germany.
| | - Reinhard Schnettler
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Mike Barbeck
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
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Vijayavenkataraman S, Yan WC, Lu WF, Wang CH, Fuh JYH. 3D bioprinting of tissues and organs for regenerative medicine. Adv Drug Deliv Rev 2018; 132:296-332. [PMID: 29990578 DOI: 10.1016/j.addr.2018.07.004] [Citation(s) in RCA: 277] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/27/2018] [Accepted: 07/03/2018] [Indexed: 02/07/2023]
Abstract
3D bioprinting is a pioneering technology that enables fabrication of biomimetic, multiscale, multi-cellular tissues with highly complex tissue microenvironment, intricate cytoarchitecture, structure-function hierarchy, and tissue-specific compositional and mechanical heterogeneity. Given the huge demand for organ transplantation, coupled with limited organ donors, bioprinting is a potential technology that could solve this crisis of organ shortage by fabrication of fully-functional whole organs. Though organ bioprinting is a far-fetched goal, there has been a considerable and commendable progress in the field of bioprinting that could be used as transplantable tissues in regenerative medicine. This paper presents a first-time review of 3D bioprinting in regenerative medicine, where the current status and contemporary issues of 3D bioprinting pertaining to the eleven organ systems of the human body including skeletal, muscular, nervous, lymphatic, endocrine, reproductive, integumentary, respiratory, digestive, urinary, and circulatory systems were critically reviewed. The implications of 3D bioprinting in drug discovery, development, and delivery systems are also briefly discussed, in terms of in vitro drug testing models, and personalized medicine. While there is a substantial progress in the field of bioprinting in the recent past, there is still a long way to go to fully realize the translational potential of this technology. Computational studies for study of tissue growth or tissue fusion post-printing, improving the scalability of this technology to fabricate human-scale tissues, development of hybrid systems with integration of different bioprinting modalities, formulation of new bioinks with tuneable mechanical and rheological properties, mechanobiological studies on cell-bioink interaction, 4D bioprinting with smart (stimuli-responsive) hydrogels, and addressing the ethical, social, and regulatory issues concerning bioprinting are potential futuristic focus areas that would aid in successful clinical translation of this technology.
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Weisgerber DW, Milner DJ, Lopez-Lake H, Rubessa M, Lotti S, Polkoff K, Hortensius RA, Flanagan CL, Hollister SJ, Wheeler MB, Harley BAC. A Mineralized Collagen-Polycaprolactone Composite Promotes Healing of a Porcine Mandibular Defect. Tissue Eng Part A 2018; 24:943-954. [PMID: 29264958 DOI: 10.1089/ten.tea.2017.0293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A tissue engineering approach to address craniofacial defects requires a biomaterial that balances macro-scale mechanical stiffness and strength with the micron-scale features that promote cell expansion and tissue biosynthesis. Such criteria are often in opposition, leading to suboptimal mechanical competence or bioactivity. We report the use of a multiscale composite biomaterial that integrates a polycaprolactone (PCL) reinforcement structure with a mineralized collagen-glycosaminoglycan scaffold to circumvent conventional tradeoffs between mechanics and bioactivity. The composite promotes activation of the canonical bone morphogenetic protein 2 (BMP-2) pathway and subsequent mineralization of adipose-derived stem cells in the absence of supplemental BMP-2 or osteogenic media. We subsequently examined new bone infill in the acellular composite, scaffold alone, or PCL support in 10 mm dia. ramus mandibular defects in Yorkshire pigs. We report an analytical approach to quantify radial, angular, and depth bone infill from micro-computed tomography data. The collagen-PCL composite showed improved overall infill, and significantly increased radial and angular bone infill versus the PCL cage alone. Bone infill was further enhanced in the composite for defects that penetrated the medullary cavity, suggesting recruitment of marrow-derived cells. These results indicate a multiscale mineralized collagen-PCL composite offers strategic advantages for regenerative repair of craniofacial bone defects.
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Affiliation(s)
- Daniel W Weisgerber
- 1 Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Derek J Milner
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois.,3 Carl R. Woese Institute of Genomic Biology, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Heather Lopez-Lake
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Marcello Rubessa
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois.,3 Carl R. Woese Institute of Genomic Biology, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Sammi Lotti
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Kathryn Polkoff
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Rebecca A Hortensius
- 4 Department of Bioengineering, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Colleen L Flanagan
- 5 Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan
| | - Scott J Hollister
- 6 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, Georgia
| | - Matthew B Wheeler
- 2 Department of Animal Sciences, University of Illinois at Urbana-Champaign , Urbana, Illinois.,3 Carl R. Woese Institute of Genomic Biology, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | - Brendan A C Harley
- 3 Carl R. Woese Institute of Genomic Biology, University of Illinois at Urbana-Champaign , Urbana, Illinois.,7 Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign , Urbana, Illinois
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Cone SG, Warren PB, Fisher MB. Rise of the Pigs: Utilization of the Porcine Model to Study Musculoskeletal Biomechanics and Tissue Engineering During Skeletal Growth. Tissue Eng Part C Methods 2017; 23:763-780. [PMID: 28726574 PMCID: PMC5689129 DOI: 10.1089/ten.tec.2017.0227] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/14/2017] [Indexed: 12/17/2022] Open
Abstract
Large animal models play an essential role in the study of tissue engineering and regenerative medicine (TERM), as well as biomechanics. The porcine model has been increasingly used to study the musculoskeletal system, including specific joints, such as the knee and temporomandibular joints, and tissues, such as bone, cartilage, and ligaments. In particular, pigs have been utilized to evaluate the role of skeletal growth on the biomechanics and engineered replacements of these joints and tissues. In this review, we explore the publication history of the use of pig models in biomechanics and TERM discuss interspecies comparative studies, highlight studies on the effect of skeletal growth and other biological considerations in the porcine model, and present challenges and emerging opportunities for using this model to study functional TERM.
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Affiliation(s)
- Stephanie G. Cone
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Paul B. Warren
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Matthew B. Fisher
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
- Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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26
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Thompson A, McNally D, Maskery I, Leach RK. X-ray computed tomography and additive manufacturing in medicine: a review. INTERNATIONAL JOURNAL OF METROLOGY AND QUALITY ENGINEERING 2017. [DOI: 10.1051/ijmqe/2017015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Youssef A, Hollister SJ, Dalton PD. Additive manufacturing of polymer melts for implantable medical devices and scaffolds. Biofabrication 2017; 9:012002. [DOI: 10.1088/1758-5090/aa5766] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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28
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Powder-based 3D printing for bone tissue engineering. Biotechnol Adv 2016; 34:740-753. [DOI: 10.1016/j.biotechadv.2016.03.009] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/20/2016] [Accepted: 03/27/2016] [Indexed: 12/19/2022]
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30
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Evaluation of multi-scale mineralized collagen-polycaprolactone composites for bone tissue engineering. J Mech Behav Biomed Mater 2016; 61:318-327. [PMID: 27104930 DOI: 10.1016/j.jmbbm.2016.03.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022]
Abstract
A particular challenge in biomaterial development for treating orthopedic injuries stems from the need to balance bioactive design criteria with the mechanical and geometric constraints governed by the physiological wound environment. Such trade-offs are of particular importance in large craniofacial bone defects which arise from both acute trauma and chronic conditions. Ongoing efforts in our laboratory have demonstrated a mineralized collagen biomaterial that can promote human mesenchymal stem cell osteogenesis in the absence of osteogenic media but that possesses suboptimal mechanical properties in regards to use in loaded wound sites. Here we demonstrate a multi-scale composite consisting of a highly bioactive mineralized collagen-glycosaminoglycan scaffold with micron-scale porosity and a polycaprolactone support frame (PCL) with millimeter-scale porosity. Fabrication of the composite was performed by impregnating the PCL support frame with the mineral scaffold precursor suspension prior to lyophilization. Here we evaluate the mechanical properties, permeability, and bioactivity of the resulting composite. Results indicated that the PCL support frame dominates the bulk mechanical response of the composite resulting in a 6000-fold increase in modulus compared to the mineral scaffold alone. Similarly, the incorporation of the mineral scaffold matrix into the composite resulted in a higher specific surface area compared to the PCL frame alone. The increased specific surface area in the collagen-PCL composite promoted increased initial attachment of porcine adipose derived stem cells versus the PCL construct.
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31
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Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review. Biomaterials 2016. [DOI: 10.1016/j.biomaterials.2016.01.012 pmid: 26773669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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32
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Morrison RJ, Hollister SJ, Niedner MF, Mahani MG, Park AH, Mehta DK, Ohye RG, Green GE. Mitigation of tracheobronchomalacia with 3D-printed personalized medical devices in pediatric patients. Sci Transl Med 2016; 7:285ra64. [PMID: 25925683 DOI: 10.1126/scitranslmed.3010825] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Three-dimensional (3D) printing offers the potential for rapid customization of medical devices. The advent of 3D-printable biomaterials has created the potential for device control in the fourth dimension: 3D-printed objects that exhibit a designed shape change under tissue growth and resorption conditions over time. Tracheobronchomalacia (TBM) is a condition of excessive collapse of the airways during respiration that can lead to life-threatening cardiopulmonary arrests. We demonstrate the successful application of 3D printing technology to produce a personalized medical device for treatment of TBM, designed to accommodate airway growth while preventing external compression over a predetermined time period before bioresorption. We implanted patient-specific 3D-printed external airway splints in three infants with severe TBM. At the time of publication, these infants no longer exhibited life-threatening airway disease and had demonstrated resolution of both pulmonary and extrapulmonary complications of their TBM. Long-term data show continued growth of the primary airways. This process has broad application for medical manufacturing of patient-specific 3D-printed devices that adjust to tissue growth through designed mechanical and degradation behaviors over time.
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Affiliation(s)
- Robert J Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Scott J Hollister
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Matthew F Niedner
- Department of Pediatrics, Division of Critical Care Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Albert H Park
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT 84132, USA
| | - Deepak K Mehta
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
| | - Richard G Ohye
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Glenn E Green
- Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Michigan, Ann Arbor, MI 48109, USA.
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Wang X, Xu S, Zhou S, Xu W, Leary M, Choong P, Qian M, Brandt M, Xie YM. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review. Biomaterials 2016; 83:127-41. [PMID: 26773669 DOI: 10.1016/j.biomaterials.2016.01.012] [Citation(s) in RCA: 660] [Impact Index Per Article: 82.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 12/31/2015] [Accepted: 01/01/2016] [Indexed: 02/06/2023]
Abstract
One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations.
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Affiliation(s)
- Xiaojian Wang
- Centre for Innovative Structures and Materials, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Shanqing Xu
- Centre for Innovative Structures and Materials, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Shiwei Zhou
- Centre for Innovative Structures and Materials, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Wei Xu
- Centre for Additive Manufacturing, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Martin Leary
- Centre for Additive Manufacturing, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Peter Choong
- Department of Surgery, University of Melbourne, St. Vincent's Hospital, Melbourne 3001, Victoria, Australia
| | - M Qian
- Centre for Additive Manufacturing, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Milan Brandt
- Centre for Additive Manufacturing, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia
| | - Yi Min Xie
- Centre for Innovative Structures and Materials, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia; Centre for Additive Manufacturing, School of Engineering, RMIT University, GPO Box 2476, Melbourne 3001, Victoria, Australia.
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Salash JR, Hossameldin RH, Almarza AJ, Chou JC, McCain JP, Mercuri LG, Wolford LM, Detamore MS. Potential Indications for Tissue Engineering in Temporomandibular Joint Surgery. J Oral Maxillofac Surg 2015; 74:705-11. [PMID: 26687154 DOI: 10.1016/j.joms.2015.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/05/2015] [Accepted: 11/10/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Musculoskeletal tissue engineering has advanced to the stage where it has the capability to engineer temporomandibular joint (TMJ) anatomic components. Unfortunately, there is a paucity of literature identifying specific indications for the use of TMJ tissue engineering solutions. The objective of this study was to establish an initial set of indications and contraindications for the use of engineered tissues for replacement of TMJ anatomic components. FINDINGS There was consensus among the authors that the management of patients requiring TMJ reconstruction as the result of 1) irreparable condylar trauma, 2) developmental or acquired TMJ pathology in skeletally immature patients, 3) hyperplasia, and 4) documented metal hypersensitivities could be indications for bioengineered condyle and ramus TMJ components. There was consensus that Wilkes stage III internal derangement might be an indication for use of a bioengineered TMJ disc or possibly even a disc-like bioengineered "fossa liner." However, there was some controversy as to whether TMJ arthritic disease (e.g., osteoarthritis) and reconstruction after failed alloplastic devices should be indications. Further research is required to determine whether tissue-engineered TMJ components could be a viable option for such cases. Contraindications for the use of bioengineered TMJ components could include patients with TMJ disorders and multiple failed surgeries, parafunctional oral habits, persistent TMJ infection, TMJ rheumatoid arthritis, and ankylosis unless the underlying pathology can be resolved. CONCLUSIONS Biomedical engineers must appreciate the specific indications that might warrant TMJ bioengineered structures, so that they avoid developing technologies in search of problems that might not exist for patients and clinicians. Instead, they should focus on identifying and understanding the problems that need resolution and then tailor technologies to address those specific situations. The aforementioned indications and contraindications are designed to serve as a guide to the next generation of tissue engineers in their strategic development of technologies to address specific clinical issues.
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Affiliation(s)
- Jean R Salash
- Graduate Student, Bioengineering Graduate Program, University of Kansas, Lawrence, KS
| | - Reem H Hossameldin
- Oral Surgeon, Department of Oral and Maxillofacial Surgery, Faculty of Oral Medicine, Cairo University, Cairo, Egypt
| | - Alejandro J Almarza
- Associate Professor, Departments of Oral Biology and Bioengineering, McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Joli C Chou
- Clinical Associate Professor, The Craniofacial Center of Western New York, Buffalo, NY
| | - Joseph P McCain
- Clinical Associate Professor and Chief, Department of Oral and Maxillofacial Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami; Department of Oral and Maxillofacial Surgery, Baptist Health Systems, Miami, FL
| | - Louis G Mercuri
- Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; TMJ Concepts, Ventura, CA
| | - Larry M Wolford
- Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX
| | - Michael S Detamore
- Professor, Department of Chemical and Petroleum Engineering and Bioengineering Graduate Program, University of Kansas, Lawrence, KS.
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Saito E, Suarez-Gonzalez D, Murphy WL, Hollister SJ. Biomineral coating increases bone formation by ex vivo BMP-7 gene therapy in rapid prototyped poly(L-lactic acid) (PLLA) and poly(ε-caprolactone) (PCL) porous scaffolds. Adv Healthc Mater 2015; 4:621-32. [PMID: 25515846 DOI: 10.1002/adhm.201400424] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Indexed: 11/12/2022]
Abstract
Porousbiodegradable polymer scaffolds are widely utilized for bone tissue engineering, but are not osteoconductive like calcium phosphate scaffolds. We combine indirect solid freeform fabrication (SFF), ex vivo gene therapy, with biomineral coating to compare the effect of biomineral coating on bone regeneration for Poly (L-lactic acid) (PLLA) and Poly (ε-caprolactone) (PCL) scaffolds with the same porous architecture. Scanning electron microscope (SEM) and micro-computed tomography (μ-CT) demonstrate PLLA and PCL scaffolds have the same porous architecture and are completely coated. All scaffolds are seeded with human gingival fibroblasts (HGF) transduced with adenovirus encoded with either bone morphogenetic protein 7 (BMP-7) or green fluorescent protein (GFP), and implanted into mice subcutaneously for 3 and 10 weeks. Only scaffolds with BMP-7 transduced HGFs show mineralized tissue formation. At 3 weeks some blood vessel-like structures are observed in coated PLLA and PCL scaffolds, but there is no significant difference in bone ingrowth between the coated and uncoated scaffolds for either PLLA or PCL. At 10 weeks, however, coated scaffolds (both PLLA and PCL) have significantly more bone ingrowth than uncoated scaffolds, which have more fibrous tissue. Coated PLLA scaffolds have improved mechanical properties compared with uncoated PLLA scaffolds due to increased bone ingrowth.
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Affiliation(s)
- Eiji Saito
- Department of Biomedical Engineering; 1101 Beal Ave. University of Michigan; Ann Arbor MI 48109-2099 USA
| | | | - William L. Murphy
- Materials Science Program; University of Wisconsin; Madison WI 53706 USA
- Department of Biomedical Engineering; University of Wisconsin; Madison WI 53706 USA
- Department of Orthopedics and Rehabilitation; University of Wisconsin; Madison WI 53706 USA
| | - Scott J. Hollister
- Department of Biomedical Engineering; 1101 Beal Ave. University of Michigan; Ann Arbor MI 48109-2099 USA
- Department of Mechanical Engineering; University of Michigan; Ann Arbor MI 48109-2125 USA
- Department of Surgery; University of Michigan; Ann Arbor MI 48109-032 USA
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Hollister SJ, Flanagan CL, Zopf DA, Morrison RJ, Nasser H, Patel JJ, Ebramzadeh E, Sangiorgio SN, Wheeler MB, Green GE. Design control for clinical translation of 3D printed modular scaffolds. Ann Biomed Eng 2015; 43:774-86. [PMID: 25666115 PMCID: PMC4407657 DOI: 10.1007/s10439-015-1270-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/30/2015] [Indexed: 10/24/2022]
Abstract
The primary thrust of tissue engineering is the clinical translation of scaffolds and/or biologics to reconstruct tissue defects. Despite this thrust, clinical translation of tissue engineering therapies from academic research has been minimal in the 27 year history of tissue engineering. Academic research by its nature focuses on, and rewards, initial discovery of new phenomena and technologies in the basic research model, with a view towards generality. Translation, however, by its nature must be directed at specific clinical targets, also denoted as indications, with associated regulatory requirements. These regulatory requirements, especially design control, require that the clinical indication be precisely defined a priori, unlike most academic basic tissue engineering research where the research target is typically open-ended, and furthermore requires that the tissue engineering therapy be constructed according to design inputs that ensure it treats or mitigates the clinical indication. Finally, regulatory approval dictates that the constructed system be verified, i.e., proven that it meets the design inputs, and validated, i.e., that by meeting the design inputs the therapy will address the clinical indication. Satisfying design control requires (1) a system of integrated technologies (scaffolds, materials, biologics), ideally based on a fundamental platform, as compared to focus on a single technology, (2) testing of design hypotheses to validate system performance as opposed to mechanistic hypotheses of natural phenomena, and (3) sequential testing using in vitro, in vivo, large preclinical and eventually clinical tests against competing therapies, as compared to single experiments to test new technologies or test mechanistic hypotheses. Our goal in this paper is to illustrate how design control may be implemented in academic translation of scaffold based tissue engineering therapies. Specifically, we propose to (1) demonstrate a modular platform approach founded on 3D printing for developing tissue engineering therapies and (2) illustrate the design control process for modular implementation of two scaffold based tissue engineering therapies: airway reconstruction and bone tissue engineering based spine fusion.
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Affiliation(s)
- Scott J Hollister
- Department of Biomedical Engineering, The University of Michigan, Rm 2214 Lurie Biomedical Engineering Bldg, 1101 Beal Ave, Ann Arbor, MI, USA,
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Weisgerber D, Caliari S, Harley B. Mineralized collagen scaffolds induce hMSC osteogenesis and matrix remodeling. Biomater Sci 2015; 3:533-42. [PMID: 25937924 PMCID: PMC4412464 DOI: 10.1039/c4bm00397g] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Biomaterials for bone tissue engineering must be able to instruct cell behavior in the presence of the complex biophysical and biomolecular environments encountered in vivo. While soluble supplementation strategies have been identified to enhance osteogenesis, they are subject to significant diffusive loss in vivo or the need for frequent re-addition in vitro. This investigation therefore explored whether biophysical and biochemical properties of a mineralized collagen-GAG scaffold were sufficient to enhance human mesenchymal stem cell (hMSC) osteogenic differentiation and matrix remodeling in the absence of supplementation. We examined hMSC metabolic health, osteogenic and matrix gene expression profiles, as well as matrix remodeling and mineral formation as a function of scaffold mineral content. We found that scaffold mineral content enhanced long term hMSC metabolic activity relative to non-mineralized scaffolds. While osteogenic supplementation or exogenous BMP-2 could enhance some markers of hMSC osteogenesis in the mineralized scaffold, we found the mineralized scaffold was itself sufficient to induce osteogenic gene expression, matrix remodeling, and mineral formation. Given significant potential for unintended consequences with the use of mixed media formulations and potential for diffusive loss in vivo, these findings will inform the design of instructive biomaterials for regenerative repair of critical-sized bone defects, as well as for applications where non-uniform responses are required, such as in biomaterials to address spatially-graded interfaces between orthopedic tissues.
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Affiliation(s)
- D.W. Weisgerber
- Dept. of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - S.R. Caliari
- Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - B.A.C. Harley
- Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA, Phone: 217-244-7112, Fax: 217-333-5052
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38
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Patel JJ, Flanagan CL, Hollister SJ. Bone Morphogenetic Protein-2 Adsorption onto Poly-ɛ-caprolactone Better Preserves Bioactivity In Vitro and Produces More Bone In Vivo than Conjugation Under Clinically Relevant Loading Scenarios. Tissue Eng Part C Methods 2015; 21:489-98. [PMID: 25345571 DOI: 10.1089/ten.tec.2014.0377] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND One strategy to reconstruct large bone defects is to prefabricate a vascularized flap by implanting a biomaterial scaffold with associated biologics into the latissimus dorsi and then transplanting this construct to the defect site after a maturation period. This strategy, similar to all clinically and regulatory feasible biologic approaches to surgical reconstruction, requires the ability to quickly (<1 h within an operating room) and efficiently bind biologics to scaffolds. It also requires the ability to localize biologic delivery. In this study, we investigated the efficacy of binding bone morphogenetic protein-2 (BMP2) to poly-ɛ-caprolactone (PCL) using adsorption and conjugation as a function of time. METHODS BMP2 was adsorbed (Ads) or conjugated (Conj) to PCL scaffolds with the same three-dimensional printed architecture while altering exposure time (0.5, 1, 5, and 16 h), temperature (4°C, 23°C), and BMP2 concentration (1.4, 5, 20, and 65 μg/mL). The in vitro release was quantified, and C2C12 cell alkaline phosphatase (ALP) expression was used to confirm bioactivity. Scaffolds with either 65 or 20 μg/mL Ads or Conj BMP2 for 1 h at 23°C were implanted subcutaneously in mice to evaluate in vivo bone regeneration. Micro-computed tomography, compression testing, and histology were performed to characterize bone regeneration. RESULTS After 1 h exposure to 65 μg/mL BMP2 at 23°C, Conj and Ads resulted in 12.83 ± 1.78 and 10.78 ± 1.49 μg BMP2 attached, respectively. Adsorption resulted in a positive ALP response and had a small burst release; whereas conjugation provided a sustained release with negligible ALP production, indicating that the conjugated BMP2 may not be bioavailable. Adsorbed 65 μg/mL BMP2 solution resulted in the greatest regenerated bone volume (15.0 ± 3.0 mm³), elastic modulus (20.1 ± 3.0 MPa), and %bone ingrowth in the scaffold interior (17.2% ± 5.4%) when compared with conjugation. CONCLUSION Adsorption may be optimal for the clinical application of prefabricating bone flaps due to BMP2 binding in a short exposure time, retained BMP2 bioactivity, and bone growth adhering to scaffold geometry and into pores with healthy marrow development.
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Affiliation(s)
- Janki J Patel
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan
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Zopf DA, Mitsak AG, Flanagan CL, Wheeler M, Green GE, Hollister SJ. Computer aided-designed, 3-dimensionally printed porous tissue bioscaffolds for craniofacial soft tissue reconstruction. Otolaryngol Head Neck Surg 2015; 152:57-62. [PMID: 25281749 PMCID: PMC4760858 DOI: 10.1177/0194599814552065] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 08/29/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the potential of an integrated, image-based computer-aided design (CAD) and 3-dimensional (3D) printing approach to engineer scaffolds for head and neck cartilaginous reconstruction for auricular and nasal reconstruction. STUDY DESIGN Proof of concept revealing novel methods for bioscaffold production with in vitro and in vivo animal data. SETTING Multidisciplinary effort encompassing 2 academic institutions. SUBJECTS AND METHODS Digital Imaging and Communications in Medicine (DICOM) computed tomography scans were segmented and utilized in image-based CAD to create porous, anatomic structures. Bioresorbable polycaprolactone scaffolds with spherical and random porous architecture were produced using a laser-based 3D printing process. Subcutaneous in vivo implantation of auricular and nasal scaffolds was performed in a porcine model. Auricular scaffolds were seeded with chondrogenic growth factors in a hyaluronic acid/collagen hydrogel and cultured in vitro over 2 months' duration. RESULTS Auricular and nasal constructs with several types of microporous architecture were rapidly manufactured with high fidelity to human patient anatomy. Subcutaneous in vivo implantation of auricular and nasal scaffolds resulted in an excellent appearance and complete soft tissue ingrowth. Histological analysis of in vitro scaffolds demonstrated native-appearing cartilaginous growth that respected the boundaries of the scaffold. CONCLUSION Integrated, image-based CAD and 3D printing processes generated patient-specific nasal and auricular scaffolds that supported cartilage regeneration.
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Affiliation(s)
- David A Zopf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
| | - Anna G Mitsak
- Departments of Biomedical Engineering, Mechanical Engineering, and Surgery, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
| | - Colleen L Flanagan
- Departments of Biomedical Engineering, Mechanical Engineering, and Surgery, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
| | - Matthew Wheeler
- Institute for Genomic Biology, Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA
| | - Glenn E Green
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
| | - Scott J Hollister
- Departments of Biomedical Engineering, Mechanical Engineering, and Surgery, University of Michigan, Ann Arbor, Ann Arbor, Michigan, USA
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Giannitelli SM, Accoto D, Trombetta M, Rainer A. Current trends in the design of scaffolds for computer-aided tissue engineering. Acta Biomater 2014; 10:580-94. [PMID: 24184176 DOI: 10.1016/j.actbio.2013.10.024] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/28/2013] [Accepted: 10/22/2013] [Indexed: 02/07/2023]
Abstract
Advances introduced by additive manufacturing have significantly improved the ability to tailor scaffold architecture, enhancing the control over microstructural features. This has led to a growing interest in the development of innovative scaffold designs, as testified by the increasing amount of research activities devoted to the understanding of the correlation between topological features of scaffolds and their resulting properties, in order to find architectures capable of optimal trade-off between often conflicting requirements (such as biological and mechanical ones). The main aim of this paper is to provide a review and propose a classification of existing methodologies for scaffold design and optimization in order to address key issues and help in deciphering the complex link between design criteria and resulting scaffold properties.
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Affiliation(s)
- S M Giannitelli
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - D Accoto
- Biomedical Robotics and Biomicrosystems Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - M Trombetta
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - A Rainer
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy.
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Weisgerber DW, Kelkhoff DO, Caliari SR, Harley BAC. The impact of discrete compartments of a multi-compartment collagen-GAG scaffold on overall construct biophysical properties. J Mech Behav Biomed Mater 2013; 28:26-36. [PMID: 23973610 DOI: 10.1016/j.jmbbm.2013.07.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/10/2013] [Accepted: 07/15/2013] [Indexed: 01/08/2023]
Abstract
Orthopedic interfaces such as the tendon-bone junction (TBJ) present unique challenges for biomaterials development. Here we describe a multi-compartment collagen-GAG scaffold fabricated via lyophilization that contains discrete mineralized (CGCaP) and non-mineralized (CG) regions joined by a continuous interface. Modifying CGCaP preparation approaches, we demonstrated scaffold variants of increasing mineral content (40 vs. 80wt% CaP). We report the impact of fabrication parameters on microstructure, composition, elastic modulus, and permeability of the entire multi-compartment scaffold as well as discrete mineralized and non-mineralized compartments. Notably, individual mineralized and non-mineralized compartments differentially impacted the global properties of the multi-compartment composite. Of particular interest for the development of mechanically-loaded multi-compartment composites, the elastic modulus and permeability of the entire construct were governed primarily by the non-mineralized and mineralized compartments, respectively. Based on these results we hypothesize spatial variations in scaffold structural, compositional, and mechanical properties may be an important design parameter in orthopedic interface repair.
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Affiliation(s)
- D W Weisgerber
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Mangano F, Macchi A, Shibli JA, Luongo G, Iezzi G, Piattelli A, Caprioglio A, Mangano C. Maxillary ridge augmentation with custom-made CAD/CAM scaffolds. A 1-year prospective study on 10 patients. J ORAL IMPLANTOL 2013; 40:561-9. [PMID: 23343341 DOI: 10.1563/aaid-joi-d-12-00122] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several procedures have been proposed to achieve maxillary ridge augmentation. These require bone replacement materials to be manually cut, shaped, and formed at the time of implantation, resulting in an expensive and time-consuming process. In the present study, we describe a technique for the design and fabrication of custom-made scaffolds for maxillary ridge augmentation, using three-dimensional computerized tomography (3D CT) and computer-aided design/computer-aided manufacturing (CAD/CAM). CT images of the atrophic maxillary ridge of 10 patients were acquired and modified into 3D reconstruction models. These models were transferred as stereolithographic files to a CAD program, where a virtual 3D reconstruction of the alveolar ridge was generated, producing anatomically shaped, custom-made scaffolds. CAM software generated a set of tool-paths for manufacture by a computer-numerical-control milling machine into the exact shape of the reconstruction, starting from porous hydroxyapatite blocks. The custom-made scaffolds were of satisfactory size, shape, and appearance; they matched the defect area, suited the surgeon's requirements, and were easily implanted during surgery. This helped reduce the time for surgery and contributed to the good healing of the defects.
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Mazzoli A. Selective laser sintering in biomedical engineering. Med Biol Eng Comput 2012; 51:245-56. [PMID: 23250790 DOI: 10.1007/s11517-012-1001-x] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 11/17/2012] [Indexed: 12/15/2022]
Abstract
Selective laser sintering (SLS) is a solid freeform fabrication technique, developed by Carl Deckard for his master's thesis at the University of Texas, patented in 1989. SLS manufacturing is a technique that produces physical models through a selective solidification of a variety of fine powders. SLS technology is getting a great amount of attention in the clinical field. In this paper the characteristics features of SLS and the materials that have been developed for are reviewed together with a discussion on the principles of the above-mentioned manufacturing technique. The applications of SLS in tissue engineering, and at-large in the biomedical field, are reviewed and discussed.
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Affiliation(s)
- Alida Mazzoli
- Department of Scienze e Ingegneria della Materia, dell'Ambiente ed Urbanistica SIMAU, Faculty of Engineering, Università Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona, Italy.
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Mangano F, Bazzoli M, Tettamanti L, Farronato D, Maineri M, Macchi A, Mangano C. Custom-made, selective laser sintering (SLS) blade implants as a non-conventional solution for the prosthetic rehabilitation of extremely atrophied posterior mandible. Lasers Med Sci 2012; 28:1241-7. [PMID: 22976817 DOI: 10.1007/s10103-012-1205-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 09/03/2012] [Indexed: 11/28/2022]
Abstract
The treatment of severely atrophied posterior mandibles with standard-diameter root-form implants may present a challenge. Bone reconstructive surgery represents the treatment of choice; however, it may not be accepted by some patients for economic reasons or due to higher morbidity. Computer-aided design/computer-aided manufacturing (CAD/CAM) technologies have recently opened new frontiers in biomedical applications. Selective laser sintering (SLS) is a CAD/CAM technique that allows the fabrication of complex three-dimensional (3D) structures created by computer-generated image-based design techniques. The aim of this study is to present a protocol for the manufacture and clinical use of custom-made SLS titanium blade implants as a non-conventional therapeutic treatment for the prosthetic rehabilitation of extremely atrophied posterior mandibles. Computed tomography datasets of five patients were transferred to a specific reconstruction software, where a 3D projection of the atrophied mandible was obtained, and custom-made endosseous blade implants were designed. The custom-made implants were fabricated with SLS technique, placed in the extremely atrophied posterior (<4 mm width) mandible, and immediately restored with fixed partial restorations. After 2 years of loading, all implants were in function, showing a good esthetic integration. Blade implants can be fabricated on an individual basis as a custom-designed device. This non-conventional approach may represent an option for restoring the atrophied posterior mandible of elderly patients.
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Affiliation(s)
- F Mangano
- Dental School, Oral Surgery Unit, University of Varese, Piazza Trento 4, 22015, Gravedona, Como, Italy.
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Mangano F, Zecca P, Pozzi-Taubert S, Macchi A, Ricci M, Luongo G, Mangano C. Maxillary sinus augmentation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Int J Med Robot 2012; 9:331-8. [PMID: 22961733 DOI: 10.1002/rcs.1460] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2012] [Indexed: 01/13/2023]
Abstract
BACKGROUND Maxillary sinus augmentation is a common method for increasing bone height for insertion of dental implants. In most cases, the graft is manually cut into a roughly appropriate shape by visual estimation during the operation; accordingly, the shape of the graft depends considerably on the experience of the surgeon. We have developed a computer-aided design/computer-aided manufacturing (CAD/CAM) technique to generate custom-made block grafts for sinus augmentation, and a customized cutting guide to precisely position the lateral wall and facilitate membrane elevation, using cone-beam computed tomography (CBCT). METHODS Custom-made blocks of hydroxyapatite (HA) were preoperatively cut to the required shape, based on a three-dimensional (3D) simulation, using CAD/CAM technology. The custom-made HA blocks were used for sinus augmentation. RESULTS Five patients underwent bilateral sinus elevation with custom-made HA blocks. Six months later, implants were placed. Two years after placement, all implants were in function. No clinical or prosthetic complications were encountered. CONCLUSIONS We present a CAD/CAM technique for the fabrication of custom-made block grafts for sinus augmentation.
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Affiliation(s)
- F Mangano
- Department of Morphological and Surgical Science, Oral Surgery, Dental School, University of Varese, Italy
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Lohfeld S, Cahill S, Barron V, McHugh P, Dürselen L, Kreja L, Bausewein C, Ignatius A. Fabrication, mechanical and in vivo performance of polycaprolactone/tricalcium phosphate composite scaffolds. Acta Biomater 2012; 8:3446-56. [PMID: 22652444 DOI: 10.1016/j.actbio.2012.05.018] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 05/14/2012] [Accepted: 05/18/2012] [Indexed: 11/27/2022]
Abstract
This paper explores the use of selective laser sintering (SLS) for the generation of bone tissue engineering scaffolds from polycaprolactone (PCL) and PCL/tricalcium phosphate (TCP). Different scaffold designs are generated, and assessed from the point of view of manufacturability, porosity and mechanical performance. Large scaffold specimens are produced, with a preferred design, and are assessed through an in vivo study of the critical size bone defect in sheep tibia with subsequent microscopic, histological and mechanical evaluation. Further explorations are performed to generate scaffolds with increasing TCP content. Scaffold fabrication from PCL and PCL/TCP mixtures with up to 50 mass% TCP is shown to be possible. With increasing macroporosity the stiffness of the scaffolds is seen to drop; however, the stiffness can be increased by minor geometrical changes, such as the addition of a cage around the scaffold. In the animal study the selected scaffold for implantation did not perform as well as the TCP control in terms of new bone formation and the resulting mechanical performance of the defect area. A possible cause for this is presented.
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Becker S, Bolte H, Schünemann K, Seitz H, Bara J, Beck-Broichsitter B, Russo P, Wiltfang J, Warnke P. Endocultivation: the influence of delayed vs. simultaneous application of BMP-2 onto individually formed hydroxyapatite matrices for heterotopic bone induction. Int J Oral Maxillofac Surg 2012; 41:1153-60. [DOI: 10.1016/j.ijom.2012.03.031] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 01/16/2012] [Accepted: 03/20/2012] [Indexed: 11/25/2022]
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Abstract
Laser sintering (LS) utilises a laser to sinter powder particles. A volumetric model is sliced and processed cross section by cross section to create a physical part. In theory, all powdered materials are suitable for sintering; however, only few have been tested successfully. For tissue engineering (TE) applications of this rapid prototyping technology it is an advantage that no toxic solvents or binders are necessary. This chapter reviews the direct and indirect use of LS to fabricate scaffolds for TE from single and multiphase materials.
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Affiliation(s)
- Stefan Lohfeld
- National Centre for Biomedical Engineering Science, National University of Ireland Galway, Galway, Ireland
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Hollister SJ, Murphy WL. Scaffold translation: barriers between concept and clinic. TISSUE ENGINEERING. PART B, REVIEWS 2011; 17:459-74. [PMID: 21902613 PMCID: PMC3223015 DOI: 10.1089/ten.teb.2011.0251] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 07/26/2011] [Indexed: 01/29/2023]
Abstract
Translation of scaffold-based bone tissue engineering (BTE) therapies to clinical use remains, bluntly, a failure. This dearth of translated tissue engineering therapies (including scaffolds) remains despite 25 years of research, research funding totaling hundreds of millions of dollars, over 12,000 papers on BTE and over 2000 papers on BTE scaffolds alone in the past 10 years (PubMed search). Enabling scaffold translation requires first an understanding of the challenges, and second, addressing the complete range of these challenges. There are the obvious technical challenges of designing, manufacturing, and functionalizing scaffolds to fill the Form, Fixation, Function, and Formation needs of bone defect repair. However, these technical solutions should be targeted to specific clinical indications (e.g., mandibular defects, spine fusion, long bone defects, etc.). Further, technical solutions should also address business challenges, including the need to obtain regulatory approval, meet specific market needs, and obtain private investment to develop products, again for specific clinical indications. Finally, these business and technical challenges present a much different model than the typical research paradigm, presenting the field with philosophical challenges in terms of publishing and funding priorities that should be addressed as well. In this article, we review in detail the technical, business, and philosophical barriers of translating scaffolds from Concept to Clinic. We argue that envisioning and engineering scaffolds as modular systems with a sliding scale of complexity offers the best path to addressing these translational challenges.
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Affiliation(s)
- Scott J Hollister
- Scaffold Tissue Engineering Group, Department of Biomedical Engineering, The University of Michigan, Ann Arbor, Michigan 48109, USA.
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Dormer NH, Busaidy K, Berkland CJ, Detamore MS. Osteochondral interface regeneration of rabbit mandibular condyle with bioactive signal gradients. J Oral Maxillofac Surg 2011; 69:e50-7. [PMID: 21470747 DOI: 10.1016/j.joms.2010.12.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 12/28/2010] [Indexed: 12/22/2022]
Abstract
PURPOSE Tissue engineering solutions focused on the temporomandibular joint (TMJ) have expanded in number and variety during the past decade to address the treatment of TMJ disorders. The existing data on approaches for healing small defects in the TMJ condylar cartilage and subchondral bone, however, are sparse. The purpose of the present study was thus to evaluate the performance of a novel gradient-based scaffolding approach to regenerate osteochondral defects in the rabbit mandibular condyle. MATERIALS AND METHODS Miniature bioactive plugs for regeneration of small mandibular condylar defects in New Zealand white rabbits were fabricated. The plugs were constructed from poly(D,L-lactic-co-glycolic acid) microspheres with a gradient transition between cartilage-promoting and bone-promoting growth factors. RESULTS At 6 weeks of healing, the results suggested that the implants provided support for the neosynthesized tissue as evidenced by the histologic and 9.4 T magnetic resonance imaging findings. CONCLUSION The inclusion of bioactive factors in a gradient-based scaffolding design is a promising new treatment strategy for focal defect repair in the TMJ.
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Affiliation(s)
- Nathan H Dormer
- Bioengineering Program, University of Kansas, Lawrence, KS 66045, USA
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