Icariin-loaded 3D-printed porous Ti6Al4V reconstruction rods for the treatment of necrotic femoral heads

Influence of porous titanium-based jaw implant structure on osseointegration mechanisms

The reconstruction of maxillofacial defects caused by anomalies, fractures, or cancer is challenging for dentofacial surgeons. To produce efficient, patient-specific implants with long-term performance and biological suitability, numerous methods of manufacturing are utilized. Because additive manufacturing makes it possible to fabricate complex pore structure samples, it is now recognized as an acceptable option to design customized implants. It is well recognized that a porous structure with proper design promotes accelerated cell proliferation, which enhances bone remodeling. Porosity can also be employed to modify the mechanical characteristics of fabricated implants. Thus, design and choice of rational lattice structure is an important task. The influence of the structure of jaw implants made of highly porous titanium-based materials on their mechanical properties and bone tissue growth was studied. Based on a 3D computer model of Wigner-Seitz lattice structure, the model samples were fabricated from Ti6Al4V powder by selective laser melting to characterize the mechanical properties of the samples depending on their macroporosity. Then two types of jaw bone implants were manufactured to conduct studies of bone tissue ingrowth when implanted in laboratory animals. The research was carried out in several stages: design and production of the implants for replacing incomplete defects of the lower jaw; implantation of SLM-printed implants in laboratory animals into an artificially produced defect of the lower jaw; analysis of the degree of fixation of the "implant - bone" connection (for implantation periods from 2 weeks to 9 months). During the research, Ti-alloy structures with cell diameters of 2-3 mm and macroporosity of 90-97% mimicking the spongy structure of trabecular bone tissue, were characterized by a compressive strength of 12.47-37.5 MPa and an elastic modulus of 0.19-1.23 GPa, corresponding to the mechanical properties of bone tissue. Active processes of tissue growth into implant cells were detected 2 weeks after implantation, the significant differences in the volume and types of filling tissue depending on the size of the cell were described. Recommendations for choosing the cell size depending on the type of bone tissue damage were given. When using SLM-printed implants with lattice structure (cell sizes from 1 to 3 mm), an active osteosynthesis processes occurred, which culminated in the formation of bone tissue inside the implant cells 9 months after implantation, with 68% of the samples characterized by the maximum degree of implant fixation. Implants with 3 mm cells with macropores diameters of 850 μm were recommended for replacing cavities after removal of perihilar cysts. To replace complete and partial defects, it was recommended to use implants with a cell size of 2 and 3 mm.

Unleashing innovation: 3D-printed biomaterials in bone tissue engineering for repairing femur and tibial defects in animal models - a systematic review and meta-analysis

Introduction

3D-printed scaffolds have emerged as an alternative for addressing the current limitations encountered in bone reconstruction. This study aimed to systematically review the feasibility of using 3D bio-printed scaffolds as a material for bone grafting in animal models, focusing on femoral and tibial defects. The primary objective of this study was to evaluate the efficacy, safety, and overall impact of these scaffolds on bone regeneration.

Methods

Electronic databases were searched using specific search terms from January 2013 to October 2023, and 37 relevant studies were finally included and reviewed. We documented the type of scaffold generated using the 3D printed techniques, detailing its characterization and rheological properties including porosity, compressive strength, shrinkage, elastic modulus, and other relevant factors. Before incorporating them into the meta-analysis, an additional inclusion criterion was applied where the regenerated bone area (BA), bone volume (BV), bone volume per total volume (BV/TV), trabecular thickness (Tb. Th.), trabecular number (Tb. N.), and trabecular separation (Tb. S.) were collected and analyzed statistically.

Results

3D bio-printed ceramic-based composite scaffolds exhibited the highest capacity for bone tissue regeneration (BTR) regarding BV/TV of femoral and tibial defects of animal models. The ideal structure of the printed scaffolds displayed optimal results with a total porosity >50% with a pore size ranging between 300- and 400 µM. Moreover, integrating additional features and engineered macro-channels within these scaffolds notably enhanced BTR capacity, especially observed at extended time points.

Discussion

In conclusion, 3D-printed composite scaffolds have shown promise as an alternative for addressing bone defects.

Impacts of permeability and effective diffusivity of porous scaffolds on bone ingrowth: In silico and in vivo analyses

The permeability and the effective diffusivity of a porous scaffold are critical in the bone-ingrowth process. However, design guidelines for porous structures are still lacking due to inadequate understanding of the complex physiological processes involved. In this study, a model integrating the fundamental biological processes of bone regeneration was constructed to investigate the roles of permeability and effective diffusivity in regulating bone deposition in scaffolds. The in silico analysis results were confirmed in vivo by examining bone depositions in three diamond lattice scaffolds manufactured using selective laser melting. The findings show that the scaffolds with better permeability and effective diffusivity had deeper bone ingrowth and greater bone volume. Compared to permeability, effective diffusivity exhibited greater sensitivity to the orientation of porous structures, and bone ingrowth was deeper in the directions with higher effective diffusivity in spite of identical pore size. A 4.8-fold increase in permeability and a 1.6-fold increase in effective diffusivity by changing the porous structure led to a 1.5-fold increase in newly formed bone. The effective diffusivity of the porous scaffold affects the distribution of osteogenic growth factor, which in turn impacts cell migration and bone deposition through chemotaxis effects. Therefore, effective diffusivity may be a more suitable indicator for porous scaffolds because our study shows changes in this parameter determine changes in bone distribution and bone volume.

Dual-functional 3D-printed porous bioactive scaffold enhanced bone repair by promoting osteogenesis and angiogenesis

The treatment of bone defects is a difficult problem in orthopedics. The excessive destruction of local bone tissue at defect sites destroys blood supply and renders bone regeneration insufficient, which further leads to delayed union or even nonunion. To solve this problem, in this study, we incorporated icariin into alginate/mineralized collagen (AMC) hydrogel and then placed the drug-loaded hydrogel into the pores of a 3D-printed porous titanium alloy (AMCI/PTi) scaffold to prepare a bioactive scaffold with the dual functions of promoting angiogenesis and bone regeneration. The experimental results showed that the ACMI/PTi scaffold had suitable mechanical properties, sustained drug release function, and excellent biocompatibility. The released icariin and mineralized collagen (MC) synergistically promoted angiogenesis and osteogenic differentiation in vitro. After implantation into a rabbit radius defect, the composite scaffold showed a satisfactory effect in promoting bone repair. Therefore, this composite dual-functional scaffold could meet the requirements of bone defect treatment and provide a promising strategy for the repair of large segmental bone defects in clinic.