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Sedaghat S, Krishnakumar A, Selvamani V, Barnard JP, Nejati S, Wang H, Detwiler DA, Seleem MN, Rahimi R. Laser-assisted surface alloying of titanium with silver to enhance antibacterial and bone-cell mineralization properties of orthopedic implants. J Mater Chem B 2024; 12:4489-4501. [PMID: 38644661 PMCID: PMC11078329 DOI: 10.1039/d3tb02481d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/13/2024] [Indexed: 04/23/2024]
Abstract
Orthopedic device-related infection (ODRI) poses a significant threat to patients with titanium-based implants. The challenge lies in developing antibacterial surfaces that preserve the bulk mechanical properties of titanium implants while exhibiting characteristics similar to bone tissue. In response, we present a two-step approach: silver nanoparticle (AgNP) coating followed by selective laser-assisted surface alloying on commonly used titanium alumina vanadium (TiAl6V4) implant surfaces. This process imparts antibacterial properties without compromising the bulk mechanical characteristics of the titanium alloy. Systematic optimization of laser beam power (8-40 W) resulted in an optimized surface (32 W) with uniform TiAg alloy formation. This surface displayed a distinctive hierarchical mesoporous textured surface, featuring cauliflower-like nanostructures measuring between 5-10 nm uniformly covering spatial line periods of 25 μm while demonstrating homogenous elemental distribution of silver throughout the laser processed surface. The optimized laser processed surface exhibited prolonged superhydrophilicity (40 days) and antibacterial efficacy (12 days) against Staphylococcus aureus and Escherichia coli. Additionally, there was a significant twofold increase in bone mineralization compared to the pristine Ti6Al4V surface (p < 0.05). Rockwell hardness tests confirmed minimal (<1%) change in bulk mechanical properties compared to the pristine surface. This innovative laser-assisted approach, with its precisely tailored surface morphology, holds promise for providing enduring antibacterial and osteointegration properties, rendering it an optimal choice for modifying load-bearing implant devices without altering material bulk characteristics.
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Affiliation(s)
- Sotoudeh Sedaghat
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
| | - Akshay Krishnakumar
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Vidhya Selvamani
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
| | - James P Barnard
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Sina Nejati
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
| | - Haiyan Wang
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - David A Detwiler
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
- Nanovis, West Lafayette, West Lafayette, IN 47907, USA
| | - Mohamed N Seleem
- Department of Biomedical Sciences and Pathobiology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - Rahim Rahimi
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
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Distefano F, Epasto G. Effect of density grading on the mechanical behaviour of advanced functionally graded lattice structures. J Mech Behav Biomed Mater 2024; 153:106477. [PMID: 38428204 DOI: 10.1016/j.jmbbm.2024.106477] [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] [Received: 11/25/2023] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 03/03/2024]
Abstract
Lattice structures have found significant applications in the biomedical field due to their interesting combination of mechanical and biological properties. Among these, functionally graded structures sparked interest because of their potential of varying their mechanical properties throughout the volume, allowing the design of biomedical devices able to match the characteristics of a graded structure like human bone. The aim of this works is the study of the effect of the density grading on the mechanical response and the failure mechanisms of a novel functionally graded lattice structure, namely Triply Arranged Octagonal Rings (TAOR). The mechanical behaviour was compared with the same lattice structures having constant density ratio. Electron Beam Melting technology was used to manufacture titanium alloy specimens with global relative densities from 10% to 30%. Functionally graded structures were obtained by increasing the relative density along the specimen, by individually designing the lattice's layers. Scanning electron and a digital microscopy were used to evaluate the dimensional mismatch between actual and designed structures. Compressive tests were carried out to obtain the mechanical properties and to evaluate the collapse modes of the structures in relation to their average relative density and lattice grading. Open-source Digital Image Correlation algorithm was applied to evaluate the deformation behaviour of the structures and to calculate their elastic moduli. The results showed that uniform density structures provide higher mechanical properties than functionally graded ones. The Digital Image Correlation results showed the possibility of effectively designing the different layers of functionally graded structures selecting desired local mechanical properties to mimic the different characteristics of cortical and cancellous bone.
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Affiliation(s)
- Fabio Distefano
- Department of Engineering, University of Messina, Contrada di Dio, Vill. Sant'Agata, 98166, Messina, Italy
| | - Gabriella Epasto
- Department of Engineering, University of Messina, Contrada di Dio, Vill. Sant'Agata, 98166, Messina, Italy.
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Li Z, Luo Y, Lu M, Wang Y, Gong T, He X, Hu X, Long J, Zhou Y, Min L, Tu C. Biomimetic design and clinical application of Ti-6Al-4V lattice hemipelvis prosthesis for pelvic reconstruction. J Orthop Surg Res 2024; 19:210. [PMID: 38561755 PMCID: PMC10983619 DOI: 10.1186/s13018-024-04672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE This study aims to biomimetic design a new 3D-printed lattice hemipelvis prosthesis and evaluate its clinical efficiency for pelvic reconstruction following tumor resection, focusing on feasibility, osseointegration, and patient outcomes. METHODS From May 2020 to October 2021, twelve patients with pelvic tumors underwent tumor resection and subsequently received 3D-printed lattice hemipelvis prostheses for pelvic reconstruction. The prosthesis was strategically incorporated with lattice structures and solid to optimize mechanical performance and osseointegration. The pore size and porosity were analyzed. Patient outcomes were assessed through a combination of clinical and radiological evaluations. RESULTS Multiple pore sizes were observed in irregular porous structures, with a wide distribution range (approximately 300-900 μm). The average follow-up of 34.7 months, ranging 26 from to 43 months. One patient with Ewing sarcoma died of pulmonary metastasis 33 months after surgery while others were alive at the last follow-up. Postoperative radiographs showed that the prosthesis's position was consistent with the preoperative planning. T-SMART images showed that the host bone was in close and tight contact with the prosthesis with no gaps at the interface. The average MSTS score was 21 at the last follow-up, ranging from 18 to 24. There was no complication requiring revision surgery or removal of the 3D-printed hemipelvis prosthesis, such as infection, screw breakage, and prosthesis loosening. CONCLUSION The newly designed 3D-printed lattice hemipelvis prosthesis created multiple pore sizes with a wide distribution range and resulted in good osteointegration and favorable limb function.
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Affiliation(s)
- Zhuangzhuang Li
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Yi Luo
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Minxun Lu
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Yitian Wang
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Taojun Gong
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Xuanhong He
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Xin Hu
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Jingjunjiao Long
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Yong Zhou
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China
| | - Li Min
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China.
| | - Chongqi Tu
- Department of Orthopedics and Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, People's Republic of China.
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Li Z, Lu M, Zhang Y, Wang J, Wang Y, Gong T, He X, Luo Y, Zhou Y, Min L, Tu C. 3D-Printed Personalized Lattice Implant as an Innovative Strategy to Reconstruct Geographic Defects in Load-Bearing Bones. Orthop Surg 2024; 16:821-829. [PMID: 38296795 PMCID: PMC10984818 DOI: 10.1111/os.14003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE Geographic defect reconstruction in load-bearing bones presents formidable challenges for orthopaedic surgeon. The use of 3D-printed personalized implants presents a compelling opportunity to address this issue. This study aims to design, manufacture, and evaluate 3D-printed personalized implants with irregular lattice porous structures for geographic defect reconstruction in load-bearing bones, focusing on feasibility, osseointegration, and patient outcomes. METHODS This retrospective study involved seven patients who received 3D-printed personalized lattice implants for the reconstruction of geographic defects in load-bearing bones. Personalized implants were customized for each patient. Randomized dodecahedron unit cells were incorporated within the implants to create the porous structure. The pore size and porosity were analyzed. Patient outcomes were assessed through a combination of clinical and radiological evaluations. Tomosynthesis-Shimadzu metal artifact reduction technology (T-SMART) was utilized to evaluate osseointegration. Functional outcomes were assessed according to the Musculoskeletal Tumor Society (MSTS) 93 score. RESULTS Multiple pore sizes were observed in porous structures of the implant, with a wide distribution range (approximately 300-900 um). The porosity analysis results showed that the average porosity of irregular porous structures was around 75.03%. The average follow-up time was 38.4 months, ranging from 25 to 50 months. Postoperative X-rays showed that the implants matched the geographic bone defect well. Osseointegration assessments according to T-SMART images indicated a high degree of bone-to-implant contact, along with favorable bone density around the implants. Patient outcomes assessments revealed significant improvements in functional outcomes, with the average MSTS score of 27.3 (range, 26-29). There was no implant-related complication, such as aseptic loosening or structure failure. CONCLUSION 3D-printed personalized lattice implants offer an innovative and promising strategy for geographic defect reconstruction in load-bearing bones. This approach has the potential to match the unique contours and geometry of the geographic bone defect and facilitate osteointegration.
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Affiliation(s)
- Zhuangzhuang Li
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Minxun Lu
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Yuqi Zhang
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Jie Wang
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Yitian Wang
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Taojun Gong
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Xuanhong He
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Yi Luo
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Yong Zhou
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Li Min
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
| | - Chongqi Tu
- Department of OrthopedicsOrthopedic Research Institute, West China Hospital, Sichuan UniversityChengduChina
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan ProvinceChengduChina
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5
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Xu C, Xu Y, Chen H, Han Q, Wu W, Zhang L, Liu Q, Wang J, Ren L. Novel-Ink-Based Direct Ink Writing of Ti6Al4V Scaffolds with Sub-300 µm Structural Pores for Superior Cell Proliferation and Differentiation. Adv Healthc Mater 2024; 13:e2302396. [PMID: 38180708 DOI: 10.1002/adhm.202302396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/29/2023] [Indexed: 01/06/2024]
Abstract
Ti6Al4V scaffolds with pore sizes between 300 and 600 µm are deemed suitable for bone tissue engineering. However, a significant proportion of human bone pores are smaller than 300 µm, playing a crucial role in cell proliferation, differentiation, and bone regeneration. Ti6Al4V scaffolds with these small-sized pores are not successfully fabricated, and their cytocompatibility remains unknown. The study presents a novel ink formula specifically tailored for fabricating Ti6Al4V scaffolds featuring precise and unobstructed sub-300 µm structural pores, achieved by investigating the rheological properties and printability of five inks containing 60-77.5 vol% Ti6Al4V powders and bisolvent binders. Ti6Al4V scaffolds with 50-600 µm pores are fabricated via direct ink writing and subjected to in vitro assays with MC3T3-E1 and bone marrow mesenchymal stem cells. The 100 µm pore-sized scaffolds exhibit the highest cell adhesion and proliferation capacity based on live/dead assay, FITC-phalloidin/4',6-diamidino-2-phenylindole staining, and cell count kit 8 assay. The alizarin red staining, real-time quantitative PCR assay, and immunocytochemical staining demonstrate the superior osteogenic differentiation potential of 100 and 200 µm pore-sized scaffolds. The importance of sub-300 µm structrual pores is highlighted, redefining the optimal pore size for Ti6Al4V scaffolds and advancing bone tissue engineering and clinical medicine development.
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Affiliation(s)
- Chao Xu
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun, 130025, China
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, 130025, China
- Institute of Structured and Architected Materials, Liaoning Academy of Materials, Shenyang, 110167, China
| | - Yan Xu
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, 130025, China
| | - Hao Chen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Qing Han
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Wenzheng Wu
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, 130025, China
| | - Lu Zhang
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun, 130025, China
- College of Construction Engineering, Jilin University, Changchun, 130026, China
| | - Qingping Liu
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun, 130025, China
- Institute of Structured and Architected Materials, Liaoning Academy of Materials, Shenyang, 110167, China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Luquan Ren
- Key Laboratory of Bionic Engineering (Ministry of Education), Jilin University, Changchun, 130025, China
- Institute of Structured and Architected Materials, Liaoning Academy of Materials, Shenyang, 110167, China
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Bandyopadhyay A, Mitra I, Ciliveri S, Avila JD, Dernell W, Goodman SB, Bose S. Additively manufactured Ti-Ta-Cu alloys for the next-generation load-bearing implants. INTERNATIONAL JOURNAL OF EXTREME MANUFACTURING 2024; 6:015503. [PMID: 38021398 PMCID: PMC10654690 DOI: 10.1088/2631-7990/ad07e7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/19/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Bacterial colonization of orthopedic implants is one of the leading causes of failure and clinical complexities for load-bearing metallic implants. Topical or systemic administration of antibiotics may not offer the most efficient defense against colonization, especially in the case of secondary infection, leading to surgical removal of implants and in some cases even limbs. In this study, laser powder bed fusion was implemented to fabricate Ti3Al2V alloy by a 1:1 weight mixture of CpTi and Ti6Al4V powders. Ti-Tantalum (Ta)-Copper (Cu) alloys were further analyzed by the addition of Ta and Cu into the Ti3Al2V custom alloy. The biological, mechanical, and tribo-biocorrosion properties of Ti3Al2V alloy were evaluated. A 10 wt.% Ta (10Ta) and 3 wt.% Cu (3Cu) were added to the Ti3Al2V alloy to enhance biocompatibility and impart inherent bacterial resistance. Additively manufactured implants were investigated for resistance against Pseudomonas aeruginosa and Staphylococcus aureus strains of bacteria for up to 48 h. A 3 wt.% Cu addition to Ti3Al2V displayed improved antibacterial efficacy, i.e. 78%-86% with respect to CpTi. Mechanical properties for Ti3Al2V-10Ta-3Cu alloy were evaluated, demonstrating excellent fatigue resistance, exceptional shear strength, and improved tribological and tribo-biocorrosion characteristics when compared to Ti6Al4V. In vivo studies using a rat distal femur model revealed improved early-stage osseointegration for alloys with 10 wt.% Ta addition compared to CpTi and Ti6Al4V. The 3 wt.% Cu-added compositions displayed biocompatibility and no adverse inflammatory response in vivo. Our results establish the Ti3Al2V-10Ta-3Cu alloy's synergistic effect on improving both in vivo biocompatibility and microbial resistance for the next generation of load-bearing metallic implants.
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Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, United States of America
| | - Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, United States of America
| | - Sushant Ciliveri
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, United States of America
| | - Jose D Avila
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, United States of America
| | - William Dernell
- Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, United States of America
| | - Stuart B Goodman
- Department of Orthopedic Surgery, Stanford University Medical Center, Redwood City, CA 94063, United States of America
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164, United States of America
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Zhang C, Wang Y. Biomechanical Analysis of Axial Gradient Porous Dental Implants: A Finite Element Analysis. J Funct Biomater 2023; 14:557. [PMID: 38132811 PMCID: PMC10743419 DOI: 10.3390/jfb14120557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
The porous structure can reduce the elastic modulus of a dental implant and better approximate the elastic characteristics of the material to the alveolar bone. Therefore, it has the potential to alleviate bone stress shielding around the implant. However, natural bone is heterogeneous, and, thus, introducing a porous structure may produce pathological bone stress. Herein, we designed a porous implant with axial gradient variation in porosity to alleviate stress shielding in the cancellous bone while controlling the peak stress value in the cortical bone margin region. The biomechanical distribution characteristics of axial gradient porous implants were studied using a finite element method. The analysis showed that a porous implant with an axial gradient variation in porosity ranging from 55% to 75% was the best structure. Under vertical and oblique loads, the proportion of the area with a stress value within the optimal stress interval at the bone-implant interface (BII) was 40.34% and 34.57%, respectively, which was 99% and 65% higher compared with that of the non-porous implant in the control group. Moreover, the maximum equivalent stress value in the implant with this pore parameter was 64.4 MPa, which was less than 1/7 of its theoretical yield strength. Axial gradient porous implants meet the strength requirements for bone implant applications. They can alleviate stress shielding in cancellous bone without increasing the stress concentration in the cortical bone margin, thereby optimizing the stress distribution pattern at the BII.
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Affiliation(s)
- Chunyu Zhang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China;
- Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China
- Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha 410008, China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China;
- Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha 410008, China
- Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha 410008, China
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8
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Zhou J, See CW, Sreenivasamurthy S, Zhu D. Customized Additive Manufacturing in Bone Scaffolds-The Gateway to Precise Bone Defect Treatment. RESEARCH (WASHINGTON, D.C.) 2023; 6:0239. [PMID: 37818034 PMCID: PMC10561823 DOI: 10.34133/research.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023]
Abstract
In the advancing landscape of technology and novel material development, additive manufacturing (AM) is steadily making strides within the biomedical sector. Moving away from traditional, one-size-fits-all implant solutions, the advent of AM technology allows for patient-specific scaffolds that could improve integration and enhance wound healing. These scaffolds, meticulously designed with a myriad of geometries, mechanical properties, and biological responses, are made possible through the vast selection of materials and fabrication methods at our disposal. Recognizing the importance of precision in the treatment of bone defects, which display variability from macroscopic to microscopic scales in each case, a tailored treatment strategy is required. A patient-specific AM bone scaffold perfectly addresses this necessity. This review elucidates the pivotal role that customized AM bone scaffolds play in bone defect treatment, while offering comprehensive guidelines for their customization. This includes aspects such as bone defect imaging, material selection, topography design, and fabrication methodology. Additionally, we propose a cooperative model involving the patient, clinician, and engineer, thereby underscoring the interdisciplinary approach necessary for the effective design and clinical application of these customized AM bone scaffolds. This collaboration promises to usher in a new era of bioactive medical materials, responsive to individualized needs and capable of pushing boundaries in personalized medicine beyond those set by traditional medical materials.
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Affiliation(s)
- Juncen Zhou
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Carmine Wang See
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Sai Sreenivasamurthy
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering,
Stony Brook University, Stony Brook, NY, USA
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9
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Lei H, Zhou Z, Liu L, Gao C, Su Z, Tan Z, Feng P, Liu M, Zhou C, Fan Y, Zhang X. Icariin-loaded 3D-printed porous Ti6Al4V reconstruction rods for the treatment of necrotic femoral heads. Acta Biomater 2023; 169:625-640. [PMID: 37536494 DOI: 10.1016/j.actbio.2023.07.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
Avascular necrosis of the femoral head is a prevalent hip joint disease. Due to the damage and destruction of the blood supply of the femoral head, the ischemic necrosis of bone cells and bone marrow leads to the structural changes and the collapse of the femoral head. In this study, an icariin-loaded 3D-printed porous Ti6Al4V reconstruction rod (referred to as reconstruction rod) was prepared by 3D printing technology. The mechanical validity of the reconstruction rod was verified by finite element analysis. Through infilling of mercapto hyaluronic acid hydrogel containing icariin into the porous structure, the loading of icariin was achieved. The biological efficacy of the reconstruction rod was confirmed through in vitro cell experiments, which demonstrated its ability to enhance MC3T3-E1 cell proliferation and facilitate cellular adhesion and spreading. The therapeutic efficacy of the reconstruction rod was validated in vivo through a femoral head necrosis model using animal experiments. The results demonstrated that the reconstruction rod facilitated osteogenesis and neovascularization, leading to effective osseointegration between bone and implant. This study provides innovative strategy for the treatment of early avascular necrosis of the femoral head. STATEMENT OF SIGNIFICANCE: The bioactivity of medical titanium alloy implants plays an important role in bone tissue engineering. This study proposed a medicine and device integrated designed porous Ti6Al4V reconstruction rod for avascular necrosis of the femoral head, whose macroscopic structure was customized by selective laser melting. The bionic porous structure of the reconstruction rod promoted the growth of bone tissue and formed an effective interface integration. Meanwhile, the loaded icariin promoted new bone and vascular regeneration, and increased the bone mass and bone density. Therefore, the implantation of reconstruction rod interfered with the further development of necrosis and provided a positive therapeutic effect. This study provides innovative strategies for the treatment of early avascular necrosis of femoral head.
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Affiliation(s)
- Haoyuan Lei
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China
| | - Zhigang Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Orthopaedics, Jiujiang First People's Hospital, Jiujiang 332000, Jiangxi, China
| | - Lei Liu
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
| | - Canyu Gao
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China
| | - Zixuan Su
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China
| | - Zhen Tan
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Pin Feng
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Liu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China.
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, 610064, Chengdu, China
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10
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Cheng KJ, Shi ZY, Wang R, Jiang XF, Xiao F, Liu YF. 3D printed PEKK bone analogs with internal porosity and surface modification for mandibular reconstruction: An in vivo rabbit model study. BIOMATERIALS ADVANCES 2023; 151:213455. [PMID: 37148594 DOI: 10.1016/j.bioadv.2023.213455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/10/2023] [Accepted: 04/28/2023] [Indexed: 05/08/2023]
Abstract
Polyetheretherketone (PEEK) and its derivative polyetherketoneketone (PEKK) have been used as implant materials for spinal fusing and enjoyed their success for many years because of their mechanical properties similar to bone and their chemical inertness. The osseointegration of PEEKs is datable. Our strategy was to use custom-designed and 3D printed bone analogs with an optimized structure design and a modified PEKK surface to augment bone regeneration for mandibular reconstruction. Those bone analogs had internal porosities and a bioactive titanium oxide surface coating to promote osseointegration between native bone and PEKK analogs. Our workflow was 3D modeling, bone analog designing, structural optimization, mechanical analysis via finite element modeling, 3D printing of bone analogs and subsequently, an in vivo rabbit model study on mandibular reconstruction and histology evaluation. Our results showed the finite element analysis validated that the porous PEKK analogs provided a mechanical-sound structure for functional loadings. The bone analogs offered a perfect replacement for segmented bones in the terms of shape, form and volume for surgical reconstruction. The in vivo results showed that bioactive titanium oxide coating enhanced new bone in-growth into the porous PEKK analogs. We have validated our new approach in surgical mandibular reconstruction and we believe our strategy has a significant potential to improve mechanical and biological outcomes for patients who require mandibular reconstruction procedures.
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Affiliation(s)
- Kang-Jie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou 310023, China; Collaborative Innovation Center of High-end Laser Manufacturing Equipment (National "2011 Plan"), Zhejiang University of Technology, Hangzhou 310023, China
| | - Zhen-Yu Shi
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou 310023, China; Collaborative Innovation Center of High-end Laser Manufacturing Equipment (National "2011 Plan"), Zhejiang University of Technology, Hangzhou 310023, China
| | - Russell Wang
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106-4905, USA
| | - Xian-Feng Jiang
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou 310023, China
| | - Fan Xiao
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou 310023, China; Collaborative Innovation Center of High-end Laser Manufacturing Equipment (National "2011 Plan"), Zhejiang University of Technology, Hangzhou 310023, China
| | - Yun-Feng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou 310023, China; Collaborative Innovation Center of High-end Laser Manufacturing Equipment (National "2011 Plan"), Zhejiang University of Technology, Hangzhou 310023, China.
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11
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Titanium Lattice Structures Produced via Additive Manufacturing for a Bone Scaffold: A Review. J Funct Biomater 2023; 14:jfb14030125. [PMID: 36976049 PMCID: PMC10059040 DOI: 10.3390/jfb14030125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
The progress in additive manufacturing has remarkably increased the application of lattice materials in the biomedical field for the fabrication of scaffolds used as bone substitutes. Ti6Al4V alloy is widely adopted for bone implant application as it combines both biological and mechanical properties. Recent breakthroughs in biomaterials and tissue engineering have allowed the regeneration of massive bone defects, which require external intervention to be bridged. However, the repair of such critical bone defects remains a challenge. The present review collected the most significant findings in the literature of the last ten years on Ti6Al4V porous scaffolds to provide a comprehensive summary of the mechanical and morphological requirements for the osteointegration process. Particular attention was given on the effects of pore size, surface roughness and the elastic modulus on bone scaffold performances. The application of the Gibson–Ashby model allowed for a comparison of the mechanical performance of the lattice materials with that of human bone. This allows for an evaluation of the suitability of different lattice materials for biomedical applications.
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12
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Mechanical behaviour of a novel biomimetic lattice structure for bone scaffold. J Mech Behav Biomed Mater 2023; 138:105656. [PMID: 36623402 DOI: 10.1016/j.jmbbm.2023.105656] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 12/26/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
In this research, a new lattice structure based on the octagonal geometry and produced by Additive Manufacturing (AM) technique was proposed. Eight octagons with the same dimensions are combined to each other forming a ring. To obtain an isotropic lattice structure, cubic symmetry was imposed; thus, the unit cell is made of three rings mutually perpendicular, one ring for each principal direction. The aim of this study is the morphological and mechanical characterization of the novel unit cell to check its suitability to the biomechanical field, along with its comparison with other lattice structures currently used as bone scaffold. Electron Beam Melting (EBM) technique was used to produce Ti6Al4V ELI alloy specimens of the novel unit cell and of the truncated octahedron (Kelvin) cell. Three different unit cell sizes were selected to investigate the effect of cell dimensions on the mechanical properties. Morphological analysis was performed through a scanning electron microscope (SEM), to compare the actual structures to the designed ones. On the whole, the new lattice structure provided adequate mechanical properties to be considered as a bone substitute; further tests will be focused on its osteointegration capability.
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13
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Qian H, Lei T, Hua L, Zhang Y, Wang D, Nan J, Liu W, Sun Y, Hu Y, Lei P. Fabrication, bacteriostasis and osteointegration properties researches of the additively-manufactured porous tantalum scaffolds loading vancomycin. Bioact Mater 2023; 24:450-462. [PMID: 36632499 PMCID: PMC9826894 DOI: 10.1016/j.bioactmat.2022.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/01/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023] Open
Abstract
Infected bone defects (IBDs) remains a challenging problem for orthopedists. Clinically, routine management for IBDs has two stages: debridement and systematic antibiotics administration to control infection, and secondary grafting to repair bone defects. Whereas the efficacy is not satisfactory, because the overuse of antibiotics may lead to systemic toxicity, and the emergence of drug-resistant bacteria, as well as the secondary surgery would cause additional trauma and economic burden to the patients. Therefore, it is imperative to develop a novel scaffold for one-stage repair of IBDs. In this study, vancomycin (Van) was encapsulated into poly(lactic co-glycolic acid) (PLGA) microspheres through the double emulsion method, which were then loaded into the additively-manufactured porous tantalum (AM-Ta) through gelatin methacryloyl (GelMA) hydrogel to produce the composite Ta/GelMA hydrogel (Gel)/PLGA/vancomycin(Van) scaffolds for repairing IBDs. Physiochemical characterization of the newly-developed scaffold indicated that the releasing duration of Van was over 2 weeks. Biological experiments indicated good biocompatibility of the composite scaffold, as well as bacteriostasis and osteointegration properties, which showed great potential for clinical application. The construction of this novel scaffold would provide new sight into the development of orthopaedic implants, shedding a novel light on the treatment of IBDs.
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Affiliation(s)
- Hu Qian
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China,Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China,Xiangya School of Medicine, Central South University, Changsha, 410008, China
| | - Ting Lei
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Long Hua
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Yu Zhang
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Dongyu Wang
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Jiangyu Nan
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Wenbin Liu
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Yan Sun
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Yihe Hu
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China,Department of Orthopedic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, China,Corresponding author. Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China.
| | - Pengfei Lei
- Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China,Department of Orthopedic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, China,Corresponding author. Department of Orthopedic Surgery, Xiangya Hospital Central South University, Changsha, 410008, China.
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14
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Three-dimensional kagome structures in a PCL/HA-based hydrogel scaffold to lead slow BMP-2 release for effective bone regeneration. Biodes Manuf 2022. [DOI: 10.1007/s42242-022-00219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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15
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Rothweiler R, Kuhn S, Stark T, Heinemann S, Hoess A, Fuessinger MA, Brandenburg LS, Roelz R, Metzger MC, Hubbe U. Development of a new critical size defect model in the paranasal sinus and first approach for defect reconstruction-An in vivo maxillary bone defect study in sheep. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:76. [PMID: 36264396 PMCID: PMC9584845 DOI: 10.1007/s10856-022-06698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Fractures of the paranasal sinuses often require surgical intervention. Persisting bone defects lead to permanent visible deformities of the facial contours. Bone substitutes for reconstruction of defects with simultaneous induction of new bone formation are not commercially available for the paranasal sinus. New materials are urgently needed and have to be tested in their future area of application. For this purpose critical size defect models for the paranasal sinus have to be developed. A ≥2.4 cm large bilateral circular defect was created in the anterior wall of the maxillary sinus in six sheep via an extraoral approach. The defect was filled with two types of an osteoconductive titanium scaffold (empty scaffold vs. scaffold filled with a calcium phosphate bone cement paste) or covered with a titanium mesh either. Sheep were euthanized after four months. All animals performed well, no postoperative complications occured. Meshes and scaffolds were safely covered with soft tissue at the end of the study. The initial defect size of ≥2.4 cm only shrunk minimally during the investigation period confirming a critical size defect. No ingrowth of bone into any of the scaffolds was observed. The anterior wall of the maxillary sinus is a region with low complication rate for performing critical size defect experiments in sheep. We recommend this region for experiments with future scaffold materials whose intended use is not only limited to the paranasal sinus, as the defect is challenging even for bone graft substitutes with proven osteoconductivity. Graphical abstract.
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Affiliation(s)
- R Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - S Kuhn
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - T Stark
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, 79111, Freiburg, Germany
| | - S Heinemann
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - A Hoess
- INNOTERE GmbH, Meissner Str. 191, 01445, Radebeul, Germany
| | - M A Fuessinger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - L S Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - R Roelz
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - M C Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - U Hubbe
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
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16
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Chacón JM, Núñez PJ, Caminero MA, García-Plaza E, Vallejo J, Blanco M. 3D printing of patient-specific 316L–stainless–steel medical implants using fused filament fabrication technology: two veterinary case studies. Biodes Manuf 2022. [DOI: 10.1007/s42242-022-00200-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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17
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Hubbe U, Beiser S, Kuhn S, Stark T, Hoess A, Cristina-Schmitz H, Vasilikos I, Metzger MC, Rothweiler R. A fully ingrowing implant for cranial reconstruction: Results in critical size defects in sheep using 3D-printed titanium scaffold. BIOMATERIALS ADVANCES 2022; 136:212754. [PMID: 35929289 DOI: 10.1016/j.bioadv.2022.212754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 06/15/2023]
Abstract
Current alloplastic materials such as PMMA, titanium or PEEK don't show relevant bone ingrowth into the implant when used for cranioplasty, ceramic implants have the drawback being brittle. New materials and implant designs are urgently needed being biocompatible, stable enough for cranioplasty and stimulating bone formation. In an in vivo critical size sheep model circular cranial defects (>2.4 cm) were covered with three different types of a 3D-printed porous titanium scaffolds with multidirectional, stochastically distributed architecture (uncoated scaffold, hydroxyapatite-coated scaffold, uncoated scaffold filled with a calcium phosphate bone cement paste containing β-TCP granules). An empty titanium mesh served as control. Among the different investigated setups the hydroxyapatite-coated scaffolds showed a surprisingly favourable performance. Push-out tests revealed a 2.9 fold higher force needed in the hydroxyapatite-coated scaffolds compared to the mesh group. Mean CT density at five different points inside the scaffold was 2385HU in the hydroxyapatite-coated group compared to 1978HU in the uncoated scaffold at nine months. Average lateral bone ingrowth after four months in the hydroxyapatite-coated scaffold group was up to the implant center, 12.1 mm on average, compared to 2.8 mm in the control group covered with mesh only. These properties make the investigated scaffold with multidirectional, stochastically distributed structure superior to all products currently on the market. The study gives a good idea of what future materials for cranioplasty might look like.
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Affiliation(s)
- U Hubbe
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - S Beiser
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - S Kuhn
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, Freiburg 79111, Germany.
| | - T Stark
- Stryker Leibinger GmbH & Co. KG, Bötzinger Straße 41, Freiburg 79111, Germany.
| | - A Hoess
- INNOTERE GmbH, Meissner Str. 191, Radebeul, 01445, Germany
| | - H Cristina-Schmitz
- Division of Experimental Surgery, Center for Experimental Models and Transgenic Services, Germany; Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
| | - I Vasilikos
- Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, Freiburg 79106, Germany.
| | - M C Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg 79106, Germany.
| | - R Rothweiler
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg 79106, Germany.
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18
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Zhang Y, Sun N, Zhu M, Qiu Q, Zhao P, Zheng C, Bai Q, Zeng Q, Lu T. The contribution of pore size and porosity of 3D printed porous titanium scaffolds to osteogenesis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2022; 133:112651. [PMID: 35034817 DOI: 10.1016/j.msec.2022.112651] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 12/18/2022]
Abstract
Porous titanium implants were popularly fabricated to promote bone formation. A desirable porous scaffold was recommended to be with porosity of >60% or/and pore size of >300 μm for better osteointegration. However, whether the pore size and porosity could be randomly selected within the recommended values? And what is the correlation between pore size and porosity for accelerating osteointegration? In this study, porous titanium with cubic cell structure was produced by selective laser melting. The designed porosities of scaffolds with 700-μm pore size were 40%, 70% and 90%; and the pore sizes of scaffolds with 70% porosity were 400, 700 and 900 μm. The in vitro osteogenic potential and in vivo bone formation were investigated. Results showed that porosity and pore size could be tuned by altering strut size, which was further directly responsible for mechanical properties. Besides, pore size and porosity synergistically contributed to osteogenic activity in vitro and new bone formation in vivo. In regard to pore sizes herein, the optimized one for better osteogenic response and bone forming ability was ~600-700 μm (p70). Too smaller or too larger pore size might more or less hinder cellular behaviors and bone regeneration, even if both pore size (300-900 μm) and porosity (70%) were within the recommended value range. At a constant pore size (~600-700 μm), p70 and p90 with higher porosity was more conductive to biological effects, compared with p40. As a result, pore-size variation revealed more significant influence on osteogenesis, compared with variation of porosity within recommended values. However, the applicable porosity within recommended values should be designed with the consideration of specific load-bearing conditions. This study helps to provide guidance for designing porous scaffolds with appropriate mechanical strengths and effective bone-forming ability, so as to develop better custom-made bone substitutes.
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Affiliation(s)
- Yanni Zhang
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Na Sun
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Mengran Zhu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Quanrun Qiu
- Research Centre for Nano Energy Materials, Queen Mary University of London Engineering School, Northwestern Polytechnical University, Xi'an 710072, China
| | - Pengju Zhao
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Caiyun Zheng
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Que Bai
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Qingyan Zeng
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Tingli Lu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China.
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Shi Q, Sun Y, Yang S, Van Dessel J, Lübbers HT, Zhong S, Gu Y, Bila M, Politis C. Preclinical study of additive manufactured plates with shortened lengths for complete mandible reconstruction: Design, biomechanics simulation, and fixation stability assessment. Comput Biol Med 2021; 139:105008. [PMID: 34741907 DOI: 10.1016/j.compbiomed.2021.105008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND A combination of short titanium plates fabricated using additive manufacturing (AM) provides multiple advantages for complete mandible reconstruction, such as the minimisation of inherent implant deformation formed during AM and the resulting clinical impact, as well as greater flexibility for surgical operation. However, the biomechanical feasibility of this strategy is still unclear, and therefore needs to be explored. METHOD Three different combinations of short mandible reconstruction plates (MRPs) were customised considering implant deformation during the AM process. The resulting biomechanical performance was analysed by finite element analysis (FEA) and compared to a conventional single long MRP. RESULTS The combination of a long plate and a short plate (Design 3 [LL61 mm/RL166 mm]) shows superior biomechanical properties to the conventional single long plate (Design 1 [TL246 mm]) and reveals the most reliable fixation stability among the three designs with short plates. Compared to conventional Design 1, Design 3 provides higher plate safety (maximum tensile stress on plates reduced by 6.3%), lower system fixation instability (relative total displacement reduced by 41.4%), and good bone segment stability (bone segment dislocation below 42.1 μm) under masticatory activities. CONCLUSIONS Preclinical evidence supports the biomechanical feasibility of using short MRPs for complete mandible reconstruction. Furthermore, the results could also provide valuable information when treating other large-sized bone defects using short customised implants, expanding the potential of AM for use in implant applications.
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Affiliation(s)
- Qimin Shi
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yi Sun
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Shoufeng Yang
- University of Southampton, Faculty of Engineering and Physical Sciences, Southampton, SO17 1BJ, UK.
| | - Jeroen Van Dessel
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Heinz-Theo Lübbers
- University Hospital of Zurich, Clinic for Cranio-Maxillofacial Surgery, Frauenklinikstrasse 24, Zurich, CH-8091, Switzerland; Harvard Medical School, Brigham and Women's Hospital, Surgical Planning Laboratory, Francis Street 75, Boston, MA, 02115, USA
| | - Shengping Zhong
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yifei Gu
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Michel Bila
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Constantinus Politis
- KU Leuven, Department of Biomedical Sciences, OMFS-IMPATH Research Group & UZ Leuven (University Hospitals Leuven), Oral and Maxillofacial Surgery, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Wang W, Zhang B, Zhao L, Li M, Han Y, Wang L, Zhang Z, Li J, Zhou C, Liu L. Fabrication and properties of PLA/nano-HA composite scaffolds with balanced mechanical properties and biological functions for bone tissue engineering application. NANOTECHNOLOGY REVIEWS 2021. [DOI: 10.1515/ntrev-2021-0083] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abstract
Repair of critical bone defects is a challenge in the orthopedic clinic. 3D printing is an advanced personalized manufacturing technology that can accurately shape internal structures and external contours. In this study, the composite scaffolds of polylactic acid (PLA) and nano-hydroxyapatite (n-HA) were manufactured by the fused deposition modeling (FDM) technique. Equal mass PLA and n-HA were uniformly mixed to simulate the organic and inorganic phases of natural bone. The suitability of the composite scaffolds was evaluated by material characterization, mechanical property, and in vitro biocompatibility, and the osteogenesis induction in vitro was further tested. Finally, the printed scaffold was implanted into the rabbit femoral defect model to evaluate the osteogenic ability in vivo. The results showed that the composite scaffold had sufficient mechanical strength, appropriate pore size, and biocompatibility. Most importantly, the osteogenic induction performance of the composite scaffold was significantly better than that of the pure PLA scaffold. In conclusion, the PLA/n-HA scaffold is a promising composite biomaterial for bone defect repair and has excellent clinical transformation potential.
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Affiliation(s)
- Wenzhao Wang
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
| | - Boqing Zhang
- National Engineering Research Center for Biomaterials, Sichuan University , Chengdu 610064 , China
- College of Biomedical Engineering, Sichuan University , Chengdu 610064 , China
| | - Lihong Zhao
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
| | - Mingxin Li
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
| | - Yanlong Han
- Department of Orthopedics, The People’s Hospital of Xinjiang Uygur Autonomous Region , Urumqi 830001 , China
| | - Li Wang
- Department of Orthopedics, The People’s Hospital of Xinjiang Uygur Autonomous Region , Urumqi 830001 , China
| | - Zhengdong Zhang
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
- Department of Orthopedics, The First Affiliated Hospital of Chengdu Medical College , Chengdu , Sichuan , China
| | - Jun Li
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, Sichuan University , Chengdu 610064 , China
- College of Biomedical Engineering, Sichuan University , Chengdu 610064 , China
| | - Lei Liu
- Orthopedic Research Institute, Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu 610041 , China
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