Shape memory effect in 3D-printed scaffolds for self-fitting implants

Recent advances in implantable sensors and electronics using printable materials for advanced healthcare

This review article focuses on the recent printing technological progress in healthcare, underscoring the significant potential of implantable devices across diverse applications. Printing technologies have widespread use in developing health monitoring devices, diagnostic systems, and surgical devices. Recent years have witnessed remarkable progress in fabricating low-profile implantable devices, driven by advancements in printing technologies and nanomaterials. The importance of implantable biosensors and bioelectronics is highlighted, specifically exploring printing tools using bio-printable inks for practical applications, including a detailed examination of fabrication processes and essential parameters. This review also justifies the need for mechanical and electrical compatibility between bioelectronics and biological tissues. In addition to technological aspects, this article delves into the importance of appropriate packaging methods to enhance implantable devices' performance, compatibility, and longevity, which are made possible by integrating cutting-edge printing technology. Collectively, we aim to shed light on the holistic landscape of implantable biosensors and bioelectronics, showcasing their evolving role in advancing healthcare through innovative printing technologies.

4D Printing for Biomedical Applications

4D (bio-)printing endows 3D printed (bio-)materials with multiple functionalities and dynamic properties. 4D printed materials have been recently used in biomedical engineering for the design and fabrication of biomedical devices, such as stents, occluders, microneedles, smart 3D-cell engineered microenvironments, drug delivery systems, wound closures, and implantable medical devices. However, the success of 4D printing relies on the rational design of 4D printed objects, the selection of smart materials, and the availability of appropriate types of external (multi-)stimuli. Here, this work first highlights the different types of smart materials, external stimuli, and design strategies used in 4D (bio-)printing. Then, it presents a critical review of the biomedical applications of 4D printing and discusses the future directions of biomedical research in this exciting area, including in vivo tissue regeneration studies, the implementation of multiple materials with reversible shape memory behaviors, the creation of fast shape-transformation responses, the ability to operate at the microscale, untethered activation and control, and the application of (machine learning-based) modeling approaches to predict the structure-property and design-shape transformation relationships of 4D (bio)printed constructs.

Application of 3D printing for fabrication of superhydrophobic surfaces with reversible wettability

Control of surface wettability is needed in many applications. The potential use of 3D printing technology to gain control over wettability remains largely unexplored. In this paper, Fused Deposition Molding (FDM) 3D printing technology was utilized to print polylactic acid (PLA) microplate array structures to generate superhydrophobic surfaces with reversable wetting properties. This was achieved by spraying polydimethylsiloxane (PDMS) and silica (SiO2) solutions, over microplate surfaces. Anisotropic wetting properties were also achieved based on the surface structure design. Due to the shape memory properties of PLA, the morphology of the microplate arrays could be switched between the original upright shape and deformed shape. Through alternating pressing and heating treatments, the microplate arrays showed anisotropic wettability switching. The difference between the contact angle (CA) and sliding angle (SA) of water droplets on the original surface parallel to and perpendicular to the microplate array direction were ΔCA = 7° and ΔSA = 3° respectively, and those on the surface of the deformed microplate array were ΔCA = 7° and ΔSA = 21°, respectively. This process enabled reversible alteration in the wetting behavior of water droplets on the original and deformed surfaces between sliding and sticking states. PLA-based shape memory anisotropic superhydrophobic surfaces with tunable adhesion were successfully applied to rewritable platforms, micro droplet reaction platforms, and gas sensing.

Direct inkjet writing of polylactic acid/β-tricalcium phosphate composites for bone tissue regeneration: A proof-of-concept study

There is an ever-evolving need of customized, anatomic-specific grafting materials for bone regeneration. More specifically, biocompatible and osteoconductive materials, that may be configured dynamically to fit and fill defects, through the application of an external stimulus. The objective of this study was to establish a basis for the development of direct inkjet writing (DIW)-based shape memory polymer-ceramic composites for bone tissue regeneration applications and to establish material behavior under thermomechanical loading. Polymer-ceramic (polylactic acid [PLA]/β-tricalcium phosphate [β-TCP]) colloidal gels were prepared of different w/w ratios (90/10, 80/20, 70/30, 60/40, and 50/50) through polymer dissolution in acetone (15% w/v). Cytocompatibility was analyzed through Presto Blue assays. Rheological properties of the colloidal gels were measured to determine shear-thinning capabilities. Gels were then extruded through a custom-built DIW printer. Space filling constructs of the gels were printed and subjected to thermomechanical characterization to measure shape fixity (Rf) and shape recovery (Rr) ratios through five successive shape memory cycles. The polymer-ceramic composite gels exhibited shear-thinning capabilities for extrusion through a nozzle for DIW. A significant increase in cellular viability was observed with the addition of β-TCP particles within the polymer matrix relative to pure PLA. Shape memory effect in the printed constructs was repeatable up to 4 cycles followed by permanent deformation. While further research on scaffold macro-/micro-geometries, and engineered porosities are warranted, this proof-of-concept study suggested suitability of this polymer-ceramic material and the DIW 3D printing workflow for the production of customized, patient specific constructs for bone tissue engineering.

4D printed shape-shifting biomaterials for tissue engineering and regenerative medicine applications

The existing 3D printing methods exhibit certain fabrication-dependent limitations for printing curved constructs that are relevant for many tissues. Four-dimensional (4D) printing is an emerging technology that is expected to revolutionize the field of tissue engineering and regenerative medicine (TERM). 4D printing is based on 3D printing, featuring the introduction of time as the fourth dimension, in which there is a transition from a 3D printed scaffold to a new, distinct, and stable state, upon the application of one or more stimuli. Here, we present an overview of the current developments of the 4D printing technology for TERM, with a focus on approaches to achieve temporal changes of the shape of the printed constructs that would enable biofabrication of highly complex structures. To this aim, the printing methods, types of stimuli, shape-shifting mechanisms, and cell-incorporation strategies are critically reviewed. Furthermore, the challenges of this very recent biofabrication technology as well as the future research directions are discussed. Our findings show that the most common printing methods so far are stereolithography (SLA) and extrusion bioprinting, followed by fused deposition modelling, while the shape-shifting mechanisms used for TERM applications are shape-memory and differential swelling for 4D printing and 4D bioprinting, respectively. For shape-memory mechanism, there is a high prevalence of synthetic materials, such as polylactic acid (PLA), poly(glycerol dodecanoate) acrylate (PGDA), or polyurethanes. On the other hand, different acrylate combinations of alginate, hyaluronan, or gelatin have been used for differential swelling-based 4D transformations. TERM applications include bone, vascular, and cardiac tissues as the main target of the 4D (bio)printing technology. The field has great potential for further development by considering the combination of multiple stimuli, the use of a wider range of 4D techniques, and the implementation of computational-assisted strategies.

4D Printing: The Development of Responsive Materials Using 3D-Printing Technology

Additive manufacturing, widely known as 3D printing, has revolutionized the production of biomaterials. While conventional 3D-printed structures are perceived as static, 4D printing introduces the ability to fabricate materials capable of self-transforming their configuration or function over time in response to external stimuli such as temperature, light, or electric field. This transformative technology has garnered significant attention in the field of biomedical engineering due to its potential to address limitations associated with traditional therapies. Here, we delve into an in-depth review of 4D-printing systems, exploring their diverse biomedical applications and meticulously evaluating their advantages and disadvantages. We emphasize the novelty of this review paper by highlighting the latest advancements and emerging trends in 4D-printing technology, particularly in the context of biomedical applications.

PLA-based nature-inspired architecture for bone scaffolds: A finite element analysis

The implantation of bio-degradable scaffolds is considered as a promising approach to address the repair of bone defects. This article aims to develop a computational approach to study the mechanical behaviour, fluid dynamic, and degradation impact on polylactic acid scaffolds with nature-inspired design structures. Scaffold design is considered to be one of the main factors for the regulation of mechanical characteristics and fluid flow dynamics. In this article, five scaffolds with different nature-inspired architectures have been designed within a specific porosity range. Based on finite element analysis, their mechanical behaviour and computational fluid dynamic study are performed to evaluate the respective properties of different scaffolds. In addition, diffusion-governed degradation analysis of the scaffolds has been performed to compute the total time required for the scaffold to degrade within a given environment. Based on the mechanical behaviour, the Spider-web architecture scaffold was found to have the least deformation, and also the lowest value of equivalent stress and strain. The Nautilus Shell architecture scaffold had the highest value of equivalent stress and strain. The permeability of all the scaffolds was found to meet the requirement of the cancellous bone. All computational fluid dynamics (CFD) results of wall shear stress are in line with the requirement for cell differentiation. It was observed that the Spider-web architecture scaffold had undergone the slowest degradation, and the Giant Water Lily architecture scaffold experienced the fastest degradation.

Three-Dimensional Printing Bioceramic Scaffolds Using Direct-Ink-Writing for Craniomaxillofacial Bone Regeneration

Defects characterized as large osseous voids in bone, in certain circumstances, are difficult to treat, requiring extensive treatments which lead to an increased financial burden, pain, and prolonged hospital stays. Grafts exist to aid in bone tissue regeneration (BTR), among which ceramic-based grafts have become increasingly popular due to their biocompatibility and resorbability. BTR using bioceramic materials such as β-tricalcium phosphate has seen tremendous progress and has been extensively used in the fabrication of biomimetic scaffolds through the three-dimensional printing (3DP) workflow. 3DP has hence revolutionized BTR by offering unparalleled potential for the creation of complex, patient, and anatomic location-specific structures. More importantly, it has enabled the production of biomimetic scaffolds with porous structures that mimic the natural extracellular matrix while allowing for cell growth-a critical factor in determining the overall success of the BTR modality. While the concept of 3DP bioceramic bone tissue scaffolds for human applications is nascent, numerous studies have highlighted its potential in restoring both form and function of critically sized defects in a wide variety of translational models. In this review, we summarize these recent advancements and present a review of the engineering principles and methodologies that are vital for using 3DP technology for craniomaxillofacial reconstructive applications. Moreover, we highlight future advances in the field of dynamic 3D printed constructs via shape-memory effect, and comment on pharmacological manipulation and bioactive molecules required to treat a wider range of boney defects.

A flexible design framework to design graded porous bone scaffolds with adjustable anisotropic properties

Since the success of bone regenerative medicine depends on scaffold morphological and mechanical properties, numerous scaffolds designs have been proposed in the last decade, including graded structures that are suited to enhance tissue ingrowth. Most of these structures are based either on foams with a random pore definition, or on the periodic repetition of a unit cell (UC). These approaches are limited by the range of target porosities and obtained effective mechanical properties, and do not permit to easily generate a pore size gradient from the core to the periphery of the scaffold. In opposition, the objective of the present contribution is to propose a flexible design framework to generate various three-dimensional (3D) scaffolds structures including cylindrical graded scaffolds from the definition of a UC by making use of a non-periodic mapping. Conformal mappings are firstly used to generate graded circular cross-sections, while 3D structures are then obtained by stacking the cross-sections with or without a twist between different scaffold layers. The effective mechanical properties of different scaffold configurations are presented and compared using an energy-based efficient numerical method, pointing out the versatility of the design procedure to separately govern longitudinal and transverse anisotropic scaffold properties. Among these configurations, a helical structure exhibiting couplings between transverse and longitudinal properties is proposed and permits to extend the adaptability of the proposed framework. In order to investigate the capacity of common additive manufacturing techniques to fabricate the proposed structures, a subset of these configurations is elaborated using a standard SLA setup, and subjected to experimental mechanical testing. Despite observed geometric differences between the initial design and the actual obtained structures, the effective properties are satisfyingly predicted by the proposed computational method. Promising perspectives are offered concerning the design of self-fitting scaffolds with on-demand properties depending on the clinical application.

Additive Manufacturing of Bioceramic Implants for Restoration Bone Engineering: Technologies, Advances, and Future Perspectives

Treating bone defects is highly challenging because they do not heal on their own inside the patients, so implants are needed to assist in the reconstruction of the bone. Bioceramic implants based on additive manufacturing (AM) are currently emerging as promising treatment options for restoration bone engineering. On the one hand, additively manufactured bioceramic implants have excellent mechanical properties and biocompatibility, which are suitable for bone regeneration. On the other hand, the designable structure and adjustable pores of additively manufactured bioceramic implants allow them to promote suitable cell growth and tissue climbing. Herein, this review unfolds to introduce several frequently employed AM technologies for bioceramic implants. After that, advances in commonly used additively manufactured bioceramic implants, including bioinert ceramic implants, bioactive ceramic implants, and bioceramic/organic composite implants, are categorized and summarized. Finally, the future perspectives of additively manufactured bioceramic implants, in terms of mechanical performance improvement, innovative structural design, biological property enhancement, and other functionalization approaches, are proposed and forecasted. This review is believed to provide some fundamental understanding and cutting-edge knowledge for the additive manufacturing of bioceramic implants for restoration bone engineering.

Study of Correlation between Structure and Shape-Memory Effect/Drug-Release Profile of Polyurethane/Hydroxyapatite Composites for Antibacterial Implants

The effectiveness of multifunctional composites that combine a shape-memory polyurethane (PU) matrix with hydroxyapatite (HA) as a bioactive agent and antibiotics molecules results from a specific composite structure. In this study, structure-function correlations of PU-based composites consisting of 3, 5, and 10 (wt%) of HA and (5 wt%) of gentamicin sulfate (GeS) as a model drug were investigated. The performed analysis revealed that increasing HA content up to 5 wt% enhanced hydrogen-bonding interaction within the soft segments of the PU. Differential-scanning-calorimetry (DSC) analysis confirmed the semi-crystalline structure of the composites. Hydroxyapatite enhanced thermal stability was confirmed by thermogravimetric analysis (TGA), and the water contact angle evaluated hydrophilicity. The shape-recovery coefficient (R_r) measured in water, decreased from 94% for the PU to 86% for the PU/GeS sample and to 88-91% for the PU/HA/GeS composites. These values were positively correlated with hydrogen-bond interactions evaluated using the Fourier-transform-infrared (FTIR) spectroscopy. Additionally, it was found that the shape-recovery process initiates drug release. After shape recovery, the drug concentration in water was 17 μg/mL for the PU/GeS sample and 33-47 μg/mL for the PU HA GeS composites. Antibacterial properties of developed composites were confirmed by the agar-diffusion test against Escherichia coli and Staphylococcus epidermidis.

Advances in 4D printing: from stimulation to simulation

The advancement of four-dimensional (4D) printing has been fueled by the rise in demand for additive manufacturing and the expansion in shape-memory materials. The printing of smart substances that respond to external stimuli is known as 4D printing. 4D printing allows highly controlled shapes to simulate the physiological milieu by adding time dimensions. The 4D printing is suitable with current progress in smart compounds, printers, and its mechanism of action. The 4D printing paradigm, a revolutionary enhancement of 3D printing, was anticipated by various engineering disciplines. Tissue engineering, medicinal, consumer items, aerospace, and organ engineering use 4D printing technology. The current review mainly focuses on the basics of 4D printing and the methods used therein. It also discusses the time-dependent behavior of stimulus-sensitive compounds, which are widely used in 4D printing. In addition, this review highlights material aspects, specifically related to shape-memory polymers, stimuli-responsive materials (classified as physical, chemical, and biological), and modified materials, the backbone of 4D printing technology. Finally, potential applications of 4D printing in the biomedical sector are also discussed with challenges and future perspectives.

Raw Materials, Technology, Healthcare Applications, Patent Repository and Clinical Trials on 4D Printing Technology: An Updated Review

After the successful commercial exploitation of 3D printing technology, the advanced version of additive manufacturing, i.e., 4D printing, has been a new buzz in the technology-driven industries since 2013. It is a judicious combination of 3D printing technologies and smart materials (stimuli responsive), where time is the fourth dimension. Materials such as liquid crystal elastomer (LCE), shape memory polymers, alloys and composites exhibiting properties such as self-assembling and self-healing are used in the development/manufacturing of these products, which respond to external stimuli such as solvent, temperature, light, etc. The technologies being used are direct ink writing (DIW), fused filament fabrication (FFF), etc. It offers several advantages over 3D printing and has been exploited in different sectors such as healthcare, textiles, etc. Some remarkable applications of 4D printing technology in healthcare are self-adjusting stents, artificial muscle and drug delivery applications. Potential of applications call for further research into more responsive materials and technologies in this field. The given review is an attempt to collate all the information pertaining to techniques employed, raw materials, applications, clinical trials, recent patents and publications specific to healthcare products. The technology has also been evaluated in terms of regulatory perspectives. The data garnered is expected to make a strong contribution to the field of technology for human welfare and healthcare.

Research Progress of Shape Memory Polymer and 4D Printing in Biomedical Application

As a kind of smart material, shape memory polymer (SMP) shows great application potential in the biomedical field. Compared with traditional metal-based medical devices, SMP-based devices have the following characteristics: 1) The adaptive ability allows the biomedical device to better match the surrounding tissue after being implanted into the body by minimally invasive implantation; 2) it has better biocompatibility and adjustable biodegradability; 3) mechanical properties can be regulated in a large range to better match with the surrounding tissue. 4D printing technology is a comprehensive technology based on smart materials and 3D printing, which has great application value in the biomedical field. 4D printing technology breaks through the technical bottleneck of personalized customization and provides a new opportunity for the further development of the biomedical field. This paper summarizes the application of SMP and 4D printing technology in the field of bone tissue scaffolds, tracheal scaffolds, and drug release, etc. Moreover, this paper analyzes the existing problems and prospects, hoping to provide a preliminary discussion and useful reference for the application of SMP in biomedical engineering.

Advances in 3D printing of composite scaffolds for the repairment of bone tissue associated defects

The conventional methods of using autografts and allografts for repairing defects in bone, the osteochondral bone and the cartilage tissue have many disadvantages, like donor site morbidity and shortage of donors. Moreover, only 30% of the implanted grafts are shown to be successful in treating the defects. Hence, exploring alternative techniques such as tissue engineering to treat bone tissue associated defects is promising as it eliminates the above-mentioned limitations. To enhance the mechanical and biological properties of the tissue engineered product, it is essential to fabricate the scaffold used in tissue engineering by the combination of various biomaterials. Three-dimensional (3D) printing, with its ability to print composite materials and with complex geometry seems to have a huge potential in scaffold fabrication technique for engineering bone associated tissues.This review summarizes the recent applications and future perspectives of 3D printing technologies in the fabrication of composite scaffolds used in bone, osteochondral and cartilage tissue engineering. Key developments in the field of 3D printing technologies involves the incorporation of various biomaterials and cells in printing composite scaffolds mimicking physiologically relevant complex geometry & gradient porosity. Much recently, the emerging trend of printing smart scaffolds which can respond to external stimulus such as temperature, pH and magnetic field, known as 4D printing is gaining immense popularity and can be considered as the future of 3D printing applications in the field of tissue engineering. This article is protected by copyright. All rights reserved.

Advanced Infill Designs for 3D Printed Shape-Memory Components

Poly(lactic acid) (PLA) is one of the most often used polymers in 3D printing based on the fused deposition modeling (FDM) method. On the other hand, PLA is also a shape memory polymer (SMP) with a relatively low glass transition temperature of ~60 °C, depending on the exact material composition. This enables, on the one hand, so-called 4D printing, i.e., printing flat objects which are deformed afterwards by heating them above the glass transition temperature, shaping them and cooling them down in the desired shape. On the other hand, objects from PLA which have been erroneously deformed, e.g., bumpers during an accident, can recover their original shape to a certain amount, depending on the applied temperature, the number of deformation cycles, and especially on the number of broken connections inside the object. Here, we report on an extension of a previous study, investigating optimized infill designs which avoid breaking in 3-point bending tests and thus allow for multiple repeated destruction and recovery cycles with only a small loss in maximum force at a certain deflection.

An advanced method to design graded cylindrical scaffolds with versatile effective cross-sectional mechanical properties

The selection of the most-suited bone scaffold for a given clinical application is challenging, and has motivated numerous studies. They are mostly based on the characterization of cellular structures, generated from the three-dimensional repetition of a unit cell. However, the interest of circular graded bone scaffolds has been emphasized since they facilitate nutrient transport from the periphery to the core of the scaffold. In the present contribution, we present an advanced and versatile method to design graded circular porous 2D structures based on the conformal mapping of unit cells. We propose a method to generate 3D porous scaffolds by a multilayer repetition of the circular cross-section, resulting in tunable anisotropy depending on the clinical application. We then analyze the link between the porosities of the obtained structures and their effective elastic mechanical cross-sectional properties, making use of a novel and computationally efficient method allowing exhaustive parametric studies. The comparison of various conformal transformations and unit cell designs emphasizes the extent of mechanical properties and porosities that may be reached for a given constitutive material, including non-standard mechanical properties that open large perspectives towards the development of self-fitting scaffolds.

Polymer Composite Materials Based on Polylactide with a Shape Memory Effect for "Self-Fitting" Bone Implants

The development of adaptive medical structures is one of the promising areas of bioengineering. Polymer composite materials based on polylactide (PLA) are interesting not only for their properties, such as biocompatibility, mechanical properties, biodegradation, and convenience of use, but also for demonstrating shape memory effect (SME). In this study, reducing the activation initiation temperature and the SME activation energy was achieved by forming a composite based on PLA containing 10% poly (ε-caprolactone) (PCL). The effect of the plasticizer on the structure, mechanical properties, and especially SME of the composite, was studied by DSC, SEM, FTIR spectroscopy, compression tests, and DMA. By varying the composition, the beginning of the SME activation was reached at 45 °C, and the apparent activation energy of the process decreased by 85 kJ/mol, ensuring safe and effective use of the material as a precursor for temporary self-fitting scaffolds for reconstructive surgery.

Pressure Orientation-Dependent Recovery of 3D-Printed PLA Objects with Varying Infill Degree

Poly(lactic acid) is not only one of the most often used materials for 3D printing via fused deposition modeling (FDM), but also a shape-memory polymer. This means that objects printed from PLA can, to a certain extent, be deformed and regenerate their original shape automatically when they are heated to a moderate temperature of about 60-100 °C. It is important to note that pure PLA cannot restore broken bonds, so that it is necessary to find structures which can take up large forces by deformation without full breaks. Here we report on the continuation of previous tests on 3D-printed cubes with different infill patterns and degrees, now investigating the influence of the orientation of the applied pressure on the recovery properties. We find that for the applied gyroid pattern, indentation on the front parallel to the layers gives the worst recovery due to nearly full layer separation, while indentation on the front perpendicular to the layers or diagonal gives significantly better results. Pressing from the top, either diagonal or parallel to an edge, interestingly leads to a different residual strain than pressing from front, with indentation on top always firstly leading to an expansion towards the indenter after the first few quasi-static load tests. To quantitatively evaluate these results, new measures are suggested which could be adopted by other groups working on shape-memory polymers.

Mechanical Properties of FDM Printed PLA Parts before and after Thermal Treatment

Fused deposition modeling (FDM) is one of the most often-used technologies in additive manufacturing. Several materials are used with this technology, such as poly(lactic acid) (PLA), which is most commonly applied. The mechanical properties of 3D-printed parts depend on the process parameters. This is why, in this study, three-point bending tests were carried out to characterize the influence of build orientation, layer thickness, printing temperature and printing speed on the mechanical properties of PLA samples. Not only the process parameters may affect the mechanical properties, but heat after-treatment also has an influence on them. For this reason, additional samples were printed with optimal process parameters and characterized after pure heat treatment as well as after deformation at a temperature above the glass transition temperature, cooling with applied deformation, and subsequent recovery under heat treatment. These findings are planned to be used in a future study on finger orthoses that could either be printed according to shape or in a flat shape and afterwards heated and bent around the finger.

Medical application of biomimetic 4D printing

Additive manufacturing has attracted a lot of attention in fabrication of bio medical devices and structures in recent years. 4D printing, a new class of 3D printing where time is considered as a 4th dimension, allows us to build biological structures such as scaffolds, implants, and stents with dynamic performance mimicking the body's natural tissues. In order to properly exploit the capabilities of this fabrication method, understanding and exploiting the shape memory materials is critical. These 'smart' materials are responsive to the external stimuli which eliminates the need for utilizing the sensors, and batteries. These stimuli-triggered 'smart' materials possess a dynamic behavior unlike the static scaffolds based on conventional manufacturing techniques. In this review, recent advances on application of 4D printing for manufacturing of this type of materials and other high-performance biomaterials for medical applications have been discussed.

Extrusion-Based 3D Printing Applications of PLA Composites: A Review

Polylactic acid (PLA) is the most widely used raw material in extrusion-based three-dimensional (3D) printing (fused deposition modeling, FDM approach) in many areas since it is biodegradable and environmentally friendly, however its utilization is limited due to some of its disadvantages such as mechanical weakness, water solubility rate, etc. FDM is a simple and more cost-effective fabrication process compared to other 3D printing techniques. Unfortunately, there are deficiencies of the FDM approach, such as mechanical weakness of the FDM parts compared to the parts produced by the conventional injection and compression molding methods. Preparation of PLA composites with suitable additives is the most useful technique to improve the properties of the 3D-printed PLA parts obtained by the FDM method. In the last decade, newly developed PLA composites find large usage areas both in academic and industrial circles. This review focuses on the chemistry and properties of pure PLA and also the preparation methods of the PLA composites which will be used as a raw material in 3D printers. The main drawbacks of the pure PLA filaments and the necessity for the preparation of PLA composites which will be employed in the FDM-based 3D printing applications is also discussed in the first part. The current methods to obtain PLA composites as raw materials to be used as filaments in the extrusion-based 3D printing are given in the second part. The applications of the novel PLA composites by utilizing the FDM-based 3D printing technology in the fields of biomedical, tissue engineering, human bone repair, antibacterial, bioprinting, electrical conductivity, electromagnetic, sensor, battery, automotive, aviation, four-dimensional (4D) printing, smart textile, environmental, and luminescence applications are presented and critically discussed in the third part of this review.

Porosity and pore design influence on fatigue behavior of 3D printed scaffolds for trabecular bone replacement

Polymeric scaffolds provide several advantages when compared with other bone replacement and regenerating techniques. Namely, when compared with the current gold standard, bone autografts, there is no shortage of supply nor donor site morbidity. Contrarily to metallic implants, their mechanical properties are similar to those of cortical bone and they are biodegradable, therefore stress shielding is not expected to occur, and they will be gradually replaced by new bone tissue. Yet, there are still several challenges to overcome. After implantation scaffolds are subjected to dynamic loads, thus understanding polymeric scaffolds' fatigue behavior plays a major role on the design of better products. In this work PLA scaffolds were manufactured using 3D printing with optimized parameters. A total of six configurations were tested under static and dynamic load conditions. Static compression testing and numerical simulation showed good correlation. Numerical simulation provided a viable resource for scaffold design and innovation. Four different low-cycle fatigue loads were applied, during 3600 cycles with a frequency of 0.25 Hz. While under dynamic conditions, with a maximum stress of 24 MPa and R = 0.1, the apparent compressive modulus reached 973 MPa, due to pore collapse. Even after 3600 cycles no significant fatigue damage mechanisms were found on low porosity scaffolds, rendering them useful for trabecular bone replacement under dynamic conditions.

A Review of Shape Memory Polymers and Composites: Mechanisms, Materials, and Applications

Over the past decades, interest in shape memory polymers (SMPs) has persisted, and immense efforts have been dedicated to developing SMPs and their multifunctional composites. As a class of stimuli-responsive polymers, SMPs can return to their initial shape from a programmed temporary shape under external stimuli, such as light, heat, magnetism, and electricity. The introduction of functional materials and nanostructures results in shape memory polymer composites (SMPCs) with large recoverable deformation, enhanced mechanical properties, and controllable remote actuation. Because of these unique features, SMPCs have a broad application prospect in many fields covering aerospace engineering, biomedical devices, flexible electronics, soft robotics, shape memory arrays, and 4D printing. Herein, a comprehensive analysis of the shape recovery mechanisms, multifunctionality, applications, and recent advances in SMPs and SMPCs is presented. Specifically, the combination of functional, reversible, multiple, and controllable shape recovery processes is discussed. Further, established products from such materials are highlighted. Finally, potential directions for the future advancement of SMPs are proposed.

Investigation of the Shape-Memory Properties of 3D Printed PLA Structures with Different Infills

Polylactic acid (PLA) belongs to the few thermoplastic polymers that are derived from renewable resources such as corn starch or sugar cane. PLA is often used in 3D printing by fused deposition modeling (FDM) as it is relatively easy to print, does not show warping and can be printed without a closed building chamber. On the other hand, PLA has interesting mechanical properties which are influenced by the printing parameters and geometries. Here we present shape-memory properties of PLA cubes with different infill patterns and percentages, extending the research reported before in a conference paper. We investigate the material response under defined quasi-static load as well as the possibility to restore the original 3D printed shape. The quasi-static flexural properties are linked to the porosity and the infill structure of the samples under investigation as well as to the numbers of closed top layers, examined optically and by simulations. Our results underline the importance of designing the infill patterns carefully to develop samples with desired mechanical properties.

4D Printing: Materials, Technologies, and Future Applications in the Biomedical Field

4D printing can be defined as the fabrication of structures using smart materials that allow the final object to change its shape, properties, or function in response to an external stimulus such as light, heat, or moisture. The available technologies, materials, and applications have evolved significantly since their first development in 2013, with prospective applications within the aerospace, manufacturing, and soft robotic industries. This review focuses on the printing technologies and smart materials currently available for fabricating these structures. The applications of 4D printing within biomedicine are explored with a focus on tissue engineering, drug delivery, and artificial organs. Finally, some ideas for potential uses are proposed. 4D printing is making its mark with seemingly unlimited potential applications, however, its use in mainstream medical treatments relies on further developments and extensive research investments.

Morphological and mechanical characterization of 3D printed PLA scaffolds with controlled porosity for trabecular bone tissue replacement

Bone transplant is still the gold standard approach when dealing with orthopedic trauma or disease. When this solution is not possible, scaffolding is a possibility provided by bone tissue engineering. To support the regeneration process, damaged bone tissue is removed and replaced by porous scaffold structures. In recent years, additive manufacturing has shown huge potential to produce scaffold structures with the required performance. In the current work, PLA scaffolds with different designs were 3D printed, using optimal manufacturing parameters. Scaffolds with three different porosity values were obtained by changing the filament offset from 571 to 1333 μm. A total of twelve designs were tested under monotonic and dynamic compression conditions. Numerical analysis showed good correlation with experimental results, allowing for a better assessment of scaffold mechanical behavior. Stress relaxation was measured on four different strain levels, assessing scaffold's behavior after implantation and consequent static response over time. Overall, orthogonal design provided better performance, due to improved material deposition. With lower porosity scaffolds equilibrium stress reached 24 MPa after 300 s relaxation time under 4% deformation, and the obtained equilibrium modulus was 428 MPa. Overall, attained results show that 3D printing with PLA can be applied in the manufacture of scaffolds for trabecular bone replacement.

3D printed biodegradable functional temperature-stimuli shape memory polymer for customized scaffoldings

Shape memory polymers (SMPs) and their composites have become the prominent choice of the various industries owing to the unique inherent characteristics which can be stimulated through the exposure of external stimuli. The use of SMPs in the three-dimensional (3D) technologies has produced enormous advantages. However, the potential of SMPs in 3D printing has limitedly explored. In the present study, an investigation was performed to study the shape memory effect (SME) of the fused filament fabricated (FFF) chitosan (CS) reinforced poly-lactic-acid (PLA) based porous scaffolds. Firstly, the composite filaments, with 1, 1.5, and 2% wt. of CS, were fabricated by using the twin-screw extrusion process, which was later used to print the test specimens at different infill density. The printed samples were selectively pre-elongated to 2.5 mm and then processed through direct heating, at 60-70 °C, for enabling the SME. It has been observed that the CS particles acted as rigid phases and interrupted the re-ordering of PLA chain. However, the scaffoldings showed 18.8% shape recovery at optimized process parametric settings. In addition, wettability and biocompatibility analyses of developed scaffoldings have also been performed to investigate the biological aspects of the developed scaffoldings. The stimulated samples found to be possessed with good wettability and cell proliferation. Overall, the 3D printed PLA/CS porous scaffoldings have shown significant shape recovery characteristics and are biologically active to be used as self-healing implants for acute bone deficiencies.

3D and 4D Printing of Polymers for Tissue Engineering Applications

Three-dimensional (3D) and Four-dimensional (4D) printing emerged as the next generation of fabrication techniques, spanning across various research areas, such as engineering, chemistry, biology, computer science, and materials science. Three-dimensional printing enables the fabrication of complex forms with high precision, through a layer-by-layer addition of different materials. Use of intelligent materials which change shape or color, produce an electrical current, become bioactive, or perform an intended function in response to an external stimulus, paves the way for the production of dynamic 3D structures, which is now called 4D printing. 3D and 4D printing techniques have great potential in the production of scaffolds to be applied in tissue engineering, especially in constructing patient specific scaffolds. Furthermore, physical and chemical guidance cues can be printed with these methods to improve the extent and rate of targeted tissue regeneration. This review presents a comprehensive survey of 3D and 4D printing methods, and the advantage of their use in tissue regeneration over other scaffold production approaches.

A 3D Printable Thermal Energy Storage Crystalline Gel Using Mask-Projection Stereolithography

Most of the phase change materials (PCMs) have been limited to use as functional additions or sealed in containers, and extra auxiliary equipment or supporting matrix is needed. The emergence of 3D printing technique has dramatically advanced the developments of materials and simplified production processes. This study focuses on a novel strategy to model thermal energy storage crystalline gels with three-dimensional architecture directly from liquid resin without supporting materials through light-induced polymerization 3D printing technique. A mask-projection stereolithography printer was used to measure the 3D printing test, and the printable characters of crystalline thermal energy storage P(SA-DMAA) gels with different molar ratios were evaluated. For the P(SA-DMMA) gels with a small fraction of SA, the 3D fabrication was realized with higher printing precision both on milli- and micro- meter scales. As a comparison of 3D printed samples, P(SA-DMAA) gels made by other two methods, post-UV curing treatment after 3D printing and UV curing using conventional mold, were prepared. The 3D printed P(SA-DMAA) gels shown high crystallinity. Post-UV curing treatment was beneficial to full curing of 3D printed gels, but did not lead to the further improvement of the crystal structure to get higher crystallinity. The P(SA-DMAA) crystalline gel having the highest energy storage enthalpy was developed, which reached 69.6 J·g-1. Its good thermoregulation property in the temperature range from 25 to 40 °C was proved. The P(SA-DMAA) gels are feasible for practical applications as one kind of 3D printing material with thermal energy storage and thermoregulation functionality.

Three-Dimensional (3D) Printing of Polymer-Metal Hybrid Materials by Fused Deposition Modeling

Fused deposition modeling (FDM) is a three-dimensional (3D) printing technology that is usually performed with polymers that are molten in a printer nozzle and placed line by line on the printing bed or the previous layer, respectively. Nowadays, hybrid materials combining polymers with functional materials are also commercially available. Especially combinations of polymers with metal particles result in printed objects with interesting optical and mechanical properties. The mechanical properties of objects printed with two of these metal-polymer blends were compared to common poly (lactide acid) (PLA) printed objects. Tensile tests and bending tests show that hybrid materials mostly containing bronze have significantly reduced mechanical properties. Tensile strengths of the 3D-printed objects were unexpectedly nearly identical with those of the original filaments, indicating sufficient quality of the printing process. Our investigations show that while FDM printing allows for producing objects with mechanical properties similar to the original materials, metal-polymer blends cannot be used for the rapid manufacturing of objects necessitating mechanical strength.