1
|
Kirmanidou Y, Chatzinikolaidou M, Michalakis K, Tsouknidas A. Clinical translation of polycaprolactone-based tissue engineering scaffolds, fabricated via additive manufacturing: A review of their craniofacial applications. BIOMATERIALS ADVANCES 2024; 162:213902. [PMID: 38823255 DOI: 10.1016/j.bioadv.2024.213902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 06/03/2024]
Abstract
The craniofacial region is characterized by its intricate bony anatomy and exposure to heightened functional forces presenting a unique challenge for reconstruction. Additive manufacturing has revolutionized the creation of customized scaffolds with interconnected pores and biomimetic microarchitecture, offering precise adaptation to various craniofacial defects. Within this domain, medical-grade poly(ε-caprolactone) (PCL) has been extensively used for the fabrication of 3D printed scaffolds, specifically tailored for bone regeneration. Its adoption for load-bearing applications was driven mainly by its mechanical properties, adjustable biodegradation rates, and high biocompatibility. The present review aims to consolidating current insights into the clinical translation of PCL-based constructs designed for bone regeneration. It encompasses recent advances in enhancing the mechanical properties and augmenting biodegradation rates of PCL and PCL-based composite scaffolds. Moreover, it delves into various strategies improving cell proliferation and the osteogenic potential of PCL-based materials. These strategies provide insight into the refinement of scaffold microarchitecture, composition, and surface treatments or coatings, that include certain bioactive molecules such as growth factors, proteins, and ceramic nanoparticles. The review critically examines published data on the clinical applications of PCL scaffolds in both extraoral and intraoral craniofacial reconstructions. These applications include cranioplasty, nasal and orbital floor reconstruction, maxillofacial reconstruction, and intraoral bone regeneration. Patient demographics, surgical procedures, follow-up periods, complications and failures are thoroughly discussed. Although results from extraoral applications in the craniofacial region are encouraging, intraoral applications present a high frequency of complications and related failures. Moving forward, future studies should prioritize refining the clinical performance, particularly in the domain of intraoral applications, and providing comprehensive data on the long-term outcomes of PCL-based scaffolds in bone regeneration. Future perspective and limitations regarding the transition of such constructs from bench to bedside are also discussed.
Collapse
Affiliation(s)
- Y Kirmanidou
- Laboratory for Biomaterials and Computational Mechanics, Department of Mechanical Engineering, University of Western Macedonia, University Campus ZEP, 50100 Kozani, Greece
| | - M Chatzinikolaidou
- Department of Materials Science and Engineering, University of Crete, 70013 Heraklion, Greece; Foundation for Research and Technology Hellas (FO.R.T.H), Institute of Electronic Structure and Laser (IESL), 70013 Heraklion, Greece
| | - K Michalakis
- Laboratory of Biomechanics, Department of Restorative Sciences & Biomaterials, Henry M. Goldman School of Dental Medicine, Boston University, Boston MA-02111, USA; Center for Multiscale and Translational Mechanobiology, Boston University, Boston, MA, USA
| | - A Tsouknidas
- Laboratory for Biomaterials and Computational Mechanics, Department of Mechanical Engineering, University of Western Macedonia, University Campus ZEP, 50100 Kozani, Greece; Laboratory of Biomechanics, Department of Restorative Sciences & Biomaterials, Henry M. Goldman School of Dental Medicine, Boston University, Boston MA-02111, USA.
| |
Collapse
|
2
|
Akbarian M, Kianpour M, Tayebi L. Fabricating Multiphasic Angiogenic Scaffolds Using Amyloid/Roxadustat-Assisted High-Temperature Protein Printing. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 38953207 DOI: 10.1021/acsami.4c06207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
Repairing multiphasic defects is cumbersome. This study presents new soft and hard scaffold designs aimed at facilitating the regeneration of multiphasic defects by enhancing angiogenesis and improving cell attachment. Here, the nonimmunogenic, nontoxic, and cost-effective human serum albumin (HSA) fibril (HSA-F) was used to fabricate thermostable (up to 90 °C) and hard printable polymers. Additionally, using a 10.0 mg/mL HSA-F, an innovative hydrogel was synthesized in a mixture with 2.0% chitosan-conjugated arginine, which can gel in a cell-friendly and pH physiological environment (pH 7.4). The presence of HSA-F in both hard and soft scaffolds led to an increase in significant attachment of the scaffolds to the human periodontal ligament fibroblast (PDLF), human umbilical vein endothelial cell (HUVEC), and human osteoblast. Further studies showed that migration (up to 157%), proliferation (up to 400%), and metabolism (up to 210%) of these cells have also improved in the direction of tissue repair. By examining different in vitro and ex ovo experiments, we observed that the final multiphasic scaffold can increase blood vessel density in the process of per-vascularization as well as angiogenesis. By providing a coculture environment including PDLF and HUVEC, important cross-talk between these two cells prevails in the presence of roxadustat drug, a proangiogenic in this study. In vitro and ex ovo results demonstrated significant enhancements in the angiogenic response and cell attachment, indicating the effectiveness of the proposed design. This approach holds promise for the regeneration of complex tissue defects by providing a conducive environment for vascularization and cellular integration, thus promoting tissue healing.
Collapse
Affiliation(s)
- Mohsen Akbarian
- Marquette University School of Dentistry, Milwaukee, Wisconsin 53233, United States
| | - Maryam Kianpour
- Marquette University School of Dentistry, Milwaukee, Wisconsin 53233, United States
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, Wisconsin 53233, United States
| |
Collapse
|
3
|
Tamo AK, Djouonkep LDW, Selabi NBS. 3D Printing of Polysaccharide-Based Hydrogel Scaffolds for Tissue Engineering Applications: A Review. Int J Biol Macromol 2024; 270:132123. [PMID: 38761909 DOI: 10.1016/j.ijbiomac.2024.132123] [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: 12/05/2023] [Revised: 05/02/2024] [Accepted: 05/04/2024] [Indexed: 05/20/2024]
Abstract
In tissue engineering, 3D printing represents a versatile technology employing inks to construct three-dimensional living structures, mimicking natural biological systems. This technology efficiently translates digital blueprints into highly reproducible 3D objects. Recent advances have expanded 3D printing applications, allowing for the fabrication of diverse anatomical components, including engineered functional tissues and organs. The development of printable inks, which incorporate macromolecules, enzymes, cells, and growth factors, is advancing with the aim of restoring damaged tissues and organs. Polysaccharides, recognized for their intrinsic resemblance to components of the extracellular matrix have garnered significant attention in the field of tissue engineering. This review explores diverse 3D printing techniques, outlining distinctive features that should characterize scaffolds used as ideal matrices in tissue engineering. A detailed investigation into the properties and roles of polysaccharides in tissue engineering is highlighted. The review also culminates in a profound exploration of 3D polysaccharide-based hydrogel applications, focusing on recent breakthroughs in regenerating different tissues such as skin, bone, cartilage, heart, nerve, vasculature, and skeletal muscle. It further addresses challenges and prospective directions in 3D printing hydrogels based on polysaccharides, paving the way for innovative research to fabricate functional tissues, enhancing patient care, and improving quality of life.
Collapse
Affiliation(s)
- Arnaud Kamdem Tamo
- Institute of Microsystems Engineering IMTEK, University of Freiburg, 79110 Freiburg, Germany; Freiburg Center for Interactive Materials and Bioinspired Technologies FIT, University of Freiburg, 79110 Freiburg, Germany; Freiburg Materials Research Center FMF, University of Freiburg, 79104 Freiburg, Germany; Ingénierie des Matériaux Polymères (IMP), Université Claude Bernard Lyon 1, INSA de Lyon, Université Jean Monnet, CNRS, UMR 5223, 69622 Villeurbanne CEDEX, France.
| | - Lesly Dasilva Wandji Djouonkep
- College of Petroleum Engineering, Yangtze University, Wuhan 430100, China; Key Laboratory of Drilling and Production Engineering for Oil and Gas, Wuhan 430100, China
| | - Naomie Beolle Songwe Selabi
- Institute of Advanced Materials and Nanotechnology, Wuhan University of Science and Technology, Wuhan 430081, China
| |
Collapse
|
4
|
Theodosaki AM, Tzemi M, Galanis N, Bakopoulou A, Kotsiomiti E, Aggelidou E, Kritis A. Bone Regeneration with Mesenchymal Stem Cells in Scaffolds: Systematic Review of Human Clinical Trials. Stem Cell Rev Rep 2024; 20:938-966. [PMID: 38407793 PMCID: PMC11087324 DOI: 10.1007/s12015-024-10696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
The aim of the study is to determine the effectiveness of stem cells in scaffolds in the treatment of bone deficits, in regard of bone regeneration, safety, rehabilitation and quality of life in humans. The systematic review was conducted in accordance with PRISMA 2020. A systematic search was conducted in three search engines and two registries lastly in 29-9-2022.for studies of the last 15 years. The risk of bias was assessed with RoB-2, ROBINS- I and NIH Quality of Before-After (Pre-Post) Studies with no Control group. The certainty of the results was assessed with the GRADE assessment tool. Due to heterogeneity, the results were reported in tables, graphs and narratively. The study protocol was published in PROSPERO with registration number CRD42022359049. Of the 10,091 studies retrieved, 14 were meeting the inclusion criteria, and were qualitatively analyzed. 138 patients were treated with mesenchymal stem cells in scaffolds, showing bone healing in all cases, and even with better results than the standard care. The adverse events were mild in most cases and in accordance with the surgery received. When assessed, there was a rehabilitation of the deficit and a gain in quality of life was detected. Although the heterogeneity between the studies and the small number of patients, the administration of mesenchymal stem cells in scaffolds seems safe and effective in the regeneration of bone defects. These results pave the way for the conduction of more clinical trials, with greater number of participants, with more standardized procedures.
Collapse
Affiliation(s)
- Astero Maria Theodosaki
- Research Methodology in Medicine and Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Regenerative Medicine Center, Basic and Translational Research Unit (BTRU) of Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece.
- Postgraduate program of Research Methodology in Medicine and Health Sciences, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- , Thessaloniki, Greece.
| | - Maria Tzemi
- Research Methodology in Medicine and Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Postgraduate program of Research Methodology in Medicine and Health Sciences, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikiforos Galanis
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 1st Orthopaedic Department, George Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, University Campus, Dentistry Building, 54124, Thessaloniki, Greece
- Regenerative Medicine Center, Basic and Translational Research Unit (BTRU) of Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Eleni Kotsiomiti
- Department of Prosthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, University Campus, Dentistry Building, 54124, Thessaloniki, Greece
| | - Eleni Aggelidou
- Department of Physiology and Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, 54006, Thessaloniki, Greece
- Regenerative Medicine Center, Basic and Translational Research Unit (BTRU) of Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Aristeidis Kritis
- Department of Physiology and Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, 54006, Thessaloniki, Greece
- Regenerative Medicine Center, Basic and Translational Research Unit (BTRU) of Special Unit for Biomedical Research and Education (BRESU), Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| |
Collapse
|
5
|
Menarbazari AA, Mansoori-Kermani A, Mashayekhan S, Soleimani A. 3D-printed polycaprolactone/tricalcium silicate scaffolds modified with decellularized bone ECM-oxidized alginate for bone tissue engineering. Int J Biol Macromol 2024; 265:130827. [PMID: 38484823 DOI: 10.1016/j.ijbiomac.2024.130827] [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: 07/16/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
The treatment of large craniofacial bone defects requires more advanced and effective strategies than bone grafts since such defects are challenging and cannot heal without intervention. In this regard, 3D printing offers promising solutions through the fabrication of scaffolds with the required shape, porosity, and various biomaterials suitable for specific tissues. In this study, 3D-printed polycaprolactone (PCL)-based scaffolds containing up to 30 % tricalcium silicate (TCS) were fabricated and then modified by incorporation of decellularized bone matrix- oxidized sodium alginate (DBM-OA). The results showed that the addition of 20 % TCS increased compressive modulus by 4.5-fold, yield strength by 12-fold, and toughness by 15-fold compared to pure PCL. In addition, the samples containing TCS revealed the formation of crystalline phases with a Ca/P ratio near that of hydroxyapatite (1.67). Cellular experiment results demonstrated that TCS have improved the biocompatibility of PCL-based scaffolds. On day 7, the scaffolds modified with DBM and 20 % TCS exhibited 8-fold enhancement of ALP activity of placenta-derived mesenchymal stem/stromal cells (P-MSCs) compared to pure PCL scaffolds. The present study's results suggest that the incorporation of TCS and DBM-OA into the PCL-based scaffold improves its mechanical behavior, bioactivity, biocompatibility, and promotes mineralization and early osteogenic activity.
Collapse
Affiliation(s)
| | | | - Shohreh Mashayekhan
- Department of Chemical and Petroleum Engineering, Sharif University of Technology, Tehran, Iran.
| | - Afsane Soleimani
- Tarbiat Modares University, Faculty of Medical Sciences, Department of Clinical Biochemistry, Tehran, Iran
| |
Collapse
|
6
|
Kim NH, Yang BE, On SW, Kwon IJ, Ahn KM, Lee JH, Byun SH. Customized three-dimensional printed ceramic bone grafts for osseous defects: a prospective randomized study. Sci Rep 2024; 14:3397. [PMID: 38336901 PMCID: PMC10858220 DOI: 10.1038/s41598-024-53686-w] [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: 11/24/2023] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
Ridge resorption can result in insufficient bone volume for implant surgery, necessitating bone substitutes to restore the resorption area. Recent advances in computer-aided design and manufacturing enable the use of alloplastic bone graft materials with customizable compositions or shapes. This randomized study evaluated the clinical effectiveness of a customized three-dimensional (3D) printed alloplastic bone material. Sixty patients requiring guided bone regeneration for implant installation following tooth extraction due to alveolar bone resorption were recruited at two institutions. The participants were randomly allocated to either a group that received 3D-printed patient-customized bone graft material or a group that received conventional block bone graft material. Implant installation with bone harvesting was performed approximately 5 months after bone grafting. Histological and radiological assessments of the harvested bone area were performed. The experimental group had a significantly higher percent bone volume and a smaller tissue surface than the control group. Bone volume, bone surface, bone surface/volume ratio, bone surface density (bone surface/total volume), and bone mineral density did not differ significantly between groups. Patient-customized bone graft materials offer convenience and reduce patient discomfort. The findings suggest 3D-printed patient-customized bone graft materials could be used as an alternative for simpler bone grafting procedures.
Collapse
Affiliation(s)
- Na-Hyun Kim
- Department of Conservative Dentistry, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea
| | - Byoung-Eun Yang
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Gwanpyung-ro 170, Anyang, 14066, Republic of Korea
- Dental AI-Robotics Center, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea
- Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea
| | - Sung-Woon On
- Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, 18450, Republic of Korea
| | - Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Kang-Min Ahn
- Department of Oral and Maxillofacial Surgery, Seoul Asan Medical Center, Seoul, 05505, Republic of Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
- Department of Oral and Maxillofacial Surgery, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Gwanpyung-ro 170, Anyang, 14066, Republic of Korea.
- Dental AI-Robotics Center, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea.
- Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea.
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea.
| |
Collapse
|
7
|
Dong M, Gao Y, Fan H, Wang Y, Lv J, Bai J, Shao P, Gao Y, Lv Z, Feng Y. Comparison of clinical efficacy of 3D-printed artificial vertebral body and conventional titanium mesh cage in spinal reconstruction after total en bloc spondylectomy for spinal tumors: a systematic review and meta-analysis. Front Oncol 2024; 14:1327319. [PMID: 38380368 PMCID: PMC10878420 DOI: 10.3389/fonc.2024.1327319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Propose This meta-analysis aimed to determine whether 3D-printed artificial vertebral bodies (AVBs) have superior clinical efficacy compared to conventional titanium mesh cages (TMCs) for spinal reconstruction after total en bloc spondylectomy (TES) for spinal tumors. Methods Electronic databases, including PubMed, OVID, ScienceDirect, Embase, CINAHL, Web of Science, Cochrane Library, WANFANG, and CNKI, were searched to identify clinical trials investigating 3D-printed AVB versus conventional TMC from inception to August 2023. Data on the operation time, intraoperative blood loss, preoperative and postoperative visual analogue scale (VAS) scores, preoperative and postoperative Frankel classification of spinal cord injury, vertebral body subsidence, and early complications were collected from eligible studies for a meta-analysis. Data were analyzed using Review Manager 5.4 and Stata 14.0. Results Nine studies assessing 374 patients were included. The results revealed significant differences between the 3D-printed AVB and conventional TMC groups with regard to operation time (P = 0.04), intraoperative blood loss (P = 0.004), postoperative VAS score (P = 0.02), vertebral body subsidence (P < 0.0001), and early complications (P = 0.02). Conversely, the remaining preoperative VAS score and Frankel classifications (pre-and postoperative) did not differ significantly between the groups. Conclusion The 3D-printed AVB in spinal reconstruction after TES for spinal tumors has the advantages of a short operative time, little intraoperative blood loss, weak postoperative pain, low occurrence of vertebral body subsidence and early complications, and a significant curative effect. This could provide a strong basis for physicians to make clinical decisions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441521, identifier CRD42023441521.
Collapse
Affiliation(s)
- Mingjie Dong
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Yingjie Gao
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Hao Fan
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yushan Wang
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Jia Lv
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Junjun Bai
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Pengfei Shao
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yu Gao
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhi Lv
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yi Feng
- Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| |
Collapse
|
8
|
Shah KN, Kamal RN. Bone Graft Substitutes-What Are My Options? Hand Clin 2024; 40:13-23. [PMID: 37979985 DOI: 10.1016/j.hcl.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2023]
Abstract
We examine the range of available bone graft substitutes often used in nonunion and malunion surgery of the upper extremity. Synthetic materials such as calcium sulfate, beta-calcium phosphate ceramics, hydroxyapatite, bioactive glass, and 3D printed materials are discussed. We delve into the advantages, disadvantages, and clinical applications for each, considering factors such as biocompatibility, osteoconductivity, mechanical strength, and resorption rates. This review provides upper extremity surgeons with insights into the available array of bone graft substitutes. We hope that the reviews helps in the decision-making process to achieve optimal outcomes when treating nonunion and malunion of the upper extremity.
Collapse
Affiliation(s)
- Kalpit N Shah
- Department of Orthopedic Surgery, Scripps Clinic, San Diego, CA, USA.
| | - Robin N Kamal
- Department of Orthopedic Surgery, Stanford University, Palo Alto, CA, USA
| |
Collapse
|
9
|
Slavin BV, Nayak VV, Boczar D, Bergamo ET, Slavin BR, Yarholar LM, Torroni A, Coelho PG, Witek L. Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part II: Translational Potential of 3D-Printed Scaffolds for Defect Repair. J Craniofac Surg 2024; 35:261-267. [PMID: 37622526 PMCID: PMC10836599 DOI: 10.1097/scs.0000000000009635] [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: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 08/26/2023] Open
Abstract
Computer-aided design/computer-aided manufacturing and 3-dimensional (3D) printing techniques have revolutionized the approach to bone tissue engineering for the repair of craniomaxillofacial skeletal defects. Ample research has been performed to gain a fundamental understanding of the optimal 3D-printed scaffold design and composition to facilitate appropriate bone formation and healing. Benchtop and preclinical, small animal model testing of 3D-printed bioactive ceramic scaffolds augmented with pharmacological/biological agents have yielded promising results given their potential combined osteogenic and osteoinductive capacity. However, other factors must be evaluated before newly developed constructs may be considered analogous alternatives to the "gold standard" autologous graft for defect repair. More specifically, the 3D-printed bioactive ceramic scaffold's long-term safety profile, biocompatibility, and resorption kinetics must be studied. The ultimate goal is to successfully regenerate bone that is comparable in volume, density, histologic composition, and mechanical strength to that of native bone. In vivo studies of these newly developed bone tissue engineering in translational animal models continue to make strides toward addressing regulatory and clinically relevant topics. These include the use of skeletally immature animal models to address the challenges posed by craniomaxillofacial defect repair in pediatric patients. This manuscript reviews the most recent preclinical animal studies seeking to assess 3D-printed ceramic scaffolds for improved repair of critical-sized craniofacial bony defects.
Collapse
Affiliation(s)
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, WA
| | - Edmara Tp Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
- Biomaterials Division, NYU College of Dentistry, New York, NY
| | - Benjamin R Slavin
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Lauren M Yarholar
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Lukasz Witek
- Biomaterials Division, NYU College of Dentistry, New York, NY
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY
| |
Collapse
|
10
|
Boroojeni HSH, Mohaghegh S, Khojasteh A. Application of CAD-CAM Technologies for Maxillofacial Bone Regeneration: A Narrative Review of the Clinical Studies. Curr Stem Cell Res Ther 2024; 19:461-472. [PMID: 36372914 DOI: 10.2174/1574888x18666221111154057] [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: 03/15/2022] [Revised: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
The application of regenerative methods in treating maxillofacial defects can be categorized as functional bone regeneration in which scaffolds without protection are used and in-situ bone regeneration in which a protected healing space is created to induce bone formation. It has been shown that functional bone regeneration can reduce surgical time and obviate the necessity of autogenous bone grafting. However, studies mainly focused on applying this method to reconstruct minor bone effects, and more investigation concerning the large defects is required. In terms of in situ maxillofacial bone regeneration with the help of CAD-CAM technologies, the present data have suggested feasible mesh rigidity, perseverance of the underlying space, and apt augmentative results with CAD-CAM-based individualized Ti meshes. However, complications, including dehiscence and mesh exposure, coupled with consequent graft loss, infection and impeded regenerative rates have also been reported.
Collapse
Affiliation(s)
- Helia Sadat Haeri Boroojeni
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
11
|
Liu H, Chen H, Han Q, Sun B, Liu Y, Zhang A, Fan D, Xia P, Wang J. Recent advancement in vascularized tissue-engineered bone based on materials design and modification. Mater Today Bio 2023; 23:100858. [PMID: 38024843 PMCID: PMC10679779 DOI: 10.1016/j.mtbio.2023.100858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/03/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Bone is one of the most vascular network-rich tissues in the body and the vascular system is essential for the development, homeostasis, and regeneration of bone. When segmental irreversible damage occurs to the bone, restoring its vascular system by means other than autogenous bone grafts with vascular pedicles is a therapeutic challenge. By pre-generating the vascular network of the scaffold in vivo or in vitro, the pre-vascularization technique enables an abundant blood supply in the scaffold after implantation. However, pre-vascularization techniques are time-consuming, and in vivo pre-vascularization techniques can be damaging to the body. Critical bone deficiencies may be filled quickly with immediate implantation of a supporting bone tissue engineered scaffold. However, bone tissue engineered scaffolds generally lack vascularization, which requires modification of the scaffold to aid in enhancing internal vascularization. In this review, we summarize the relationship between the vascular system and osteogenesis and use it as a basis to further discuss surgical and cytotechnology-based pre-vascularization strategies and to describe the preparation of vascularized bone tissue engineered scaffolds that can be implanted immediately. We anticipate that this study will serve as inspiration for future vascularized bone tissue engineered scaffold construction and will aid in the achievement of clinical vascularized bone.
Collapse
Affiliation(s)
- Hao Liu
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Hao Chen
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Qin Han
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Bin Sun
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Yang Liu
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Aobo Zhang
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Danyang Fan
- Department of Dermatology, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Peng Xia
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| | - Jincheng Wang
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, China
| |
Collapse
|
12
|
Liu G, Ma M, Yang H, He W, Xie Y, Li J, Li J, Zhao F, Zheng Y. Chitosan/polydopamine/octacalcium phosphate composite microcarrier simulates natural bone components to induce osteogenic differentiation of stem cells. BIOMATERIALS ADVANCES 2023; 154:213642. [PMID: 37776571 DOI: 10.1016/j.bioadv.2023.213642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Natural polymers and minerals can be combined to simulate natural bone for repairing bone defects. However, bone defects are often irregular and pose challenges for their repair. To overcome these challenges, we prepared Chitosan/Polydopamine/Octacalcium phosphate (CS/PDA/OCP) microcarriers that mimic bone composition and micro-size to adapt to different bone defect defects. CS/PDA microspheres were prepared by emulsion phase separation method and PDA in-situ polymerization. Finally, it was used to adsorb and immobilize OCP particles, resulting in the preparation of CS/PDA/OCP composite microcarriers. The microcarriers maintain an interconnected porous structure and appropriate porosity, which promotes cell adhesion, proliferation, and nutrient exchange. Subsequently, the protein adsorption capacity, simulated degradation, cell adhesion and proliferation capacity of the composite microcarriers were investigated. Additionally, their ability to simulate mineralization and induce osteogenic differentiation of BMSCs was characterized. The results demonstrated that the composite microcarrier had good biocompatibility and was conducive to cell adhesion and proliferation. Moreover, ALP and ARS staining revealed that the addition of OCP significantly enhanced the osteogenic differentiation of BMSCs. These results indicate that the composite microcarrier has promising prospects for bone repair applications.
Collapse
Affiliation(s)
- Guodong Liu
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Mengjiao Ma
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China; Beijing Wanjie Medical Device CO., LTD, China
| | - Huiyi Yang
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Wei He
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yajie Xie
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Junfei Li
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Jiaping Li
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, the Netherlands
| | - Feilong Zhao
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yudong Zheng
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China.
| |
Collapse
|
13
|
Mohaghegh S, Sadat Haeri Boroojeni H, Nokhbatolfoghahaei H, Khojasteh A. Application of biodegradable Patient-specific scaffolds for maxillofacial bone regeneration: a scoping review of clinical studies. Br J Oral Maxillofac Surg 2023; 61:587-597. [PMID: 37845099 DOI: 10.1016/j.bjoms.2023.08.215] [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: 05/14/2023] [Revised: 07/28/2023] [Accepted: 08/20/2023] [Indexed: 10/18/2023]
Abstract
This study aimed to systematically review clinical studies in which biodegradable patient-specific scaffolds were used for bone regeneration. Studies in which biodegradable scaffolds were fabricated through computer-assisted design and computer-assisted manufacturing (CAD-CAM) procedures were included. Those that applied non-biodegradable materials or used biodegradable materials in a condensable powder or block form were excluded. Among a total of 26 included studies, 11 used customised allogeneic bone blocks, five used polycaprolactone (PCL)-containing scaffolds, four used hydroxyapatite (HA) scaffolds, and four biphasic calcium phosphate (BCP). The majority of the studies applied scaffolds for minor intraoral defects. All the large defects were reconstructed with polymer-containing scaffolds. Results of the included studies showed partial to complete filling of the defect following the application of biodegradable scaffolds. However, limited graft exposure was reported when using PCL, BCP, and HA scaffolds. Tissue engineering can be considered a potential method for the treatment of maxillofacial bone defects. However, more evidence is required, especially for the application of biodegradable scaffolds in large defects.
Collapse
Affiliation(s)
- Sadra Mohaghegh
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Helia Sadat Haeri Boroojeni
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran.
| |
Collapse
|
14
|
Lin H, Zhang L, Zhang Q, Wang Q, Wang X, Yan G. Mechanism and application of 3D-printed degradable bioceramic scaffolds for bone repair. Biomater Sci 2023; 11:7034-7050. [PMID: 37782081 DOI: 10.1039/d3bm01214j] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Bioceramics have attracted considerable attention in the field of bone repair because of their excellent osteogenic properties, degradability, and biocompatibility. To resolve issues regarding limited formability, recent studies have introduced 3D printing technology for the fabrication of bioceramic bone repair scaffolds. Nevertheless, the mechanisms by which bioceramics promote bone repair and clinical applications of 3D-printed bioceramic scaffolds remain elusive. This review provides an account of the fabrication methods of 3D-printed degradable bioceramic scaffolds. In addition, the types and characteristics of degradable bioceramics used in clinical and preclinical applications are summarized. We have also highlighted the osteogenic molecular mechanisms in biomaterials with the aim of providing a basis and support for future research on the clinical applications of degradable bioceramic scaffolds. Finally, new developments and potential applications of 3D-printed degradable bioceramic scaffolds are discussed with reference to experimental and theoretical studies.
Collapse
Affiliation(s)
- Hui Lin
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Liyun Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Qiyue Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Xue Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
| | - Guangqi Yan
- School and Hospital of Stomatology, China Medical University, Shenyang, China.
| |
Collapse
|
15
|
Nayak VV, Slavin B, Bergamo ETP, Boczar D, Slavin BR, Runyan C, Tovar N, Witek L, Coelho PG. Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part I: Evolution and Optimization of 3D-Printed Scaffolds for Repair of Defects. J Craniofac Surg 2023; 34:2016-2025. [PMID: 37639650 PMCID: PMC10592373 DOI: 10.1097/scs.0000000000009593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/25/2023] [Indexed: 08/31/2023] Open
Abstract
Bone tissue regeneration is a complex process that proceeds along the well-established wound healing pathway of hemostasis, inflammation, proliferation, and remodeling. Recently, tissue engineering efforts have focused on the application of biological and technological principles for the development of soft and hard tissue substitutes. Aim is directed towards boosting pathways of the healing process to restore form and function of tissue deficits. Continued development of synthetic scaffolds, cell therapies, and signaling biomolecules seeks to minimize the need for autografting. Despite being the current gold standard treatment, it is limited by donor sites' size and shape, as well as donor site morbidity. Since the advent of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing (AM) techniques (3D printing), bioengineering has expanded markedly while continuing to present innovative approaches to oral and craniofacial skeletal reconstruction. Prime examples include customizable, high-strength, load bearing, bioactive ceramic scaffolds. Porous macro- and micro-architecture along with the surface topography of 3D printed scaffolds favors osteoconduction and vascular in-growth, as well as the incorporation of stem and/or other osteoprogenitor cells and growth factors. This includes platelet concentrates (PCs), bone morphogenetic proteins (BMPs), and some pharmacological agents, such as dipyridamole (DIPY), an adenosine A 2A receptor indirect agonist that enhances osteogenic and osteoinductive capacity, thus improving bone formation. This two-part review commences by presenting current biological and engineering principles of bone regeneration utilized to produce 3D-printed ceramic scaffolds with the goal to create a viable alternative to autografts for craniofacial skeleton reconstruction. Part II comprehensively examines recent preclinical data to elucidate the potential clinical translation of such 3D-printed ceramic scaffolds.
Collapse
Affiliation(s)
- Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Blaire Slavin
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Edmara TP Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, WA USA
| | - Benjamin R. Slavin
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christopher Runyan
- Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine; Winston-Salem, NC, USA
| | - Nick Tovar
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
- Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY, USA
| | - Lukasz Witek
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Paulo G. Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
16
|
Nayak VV, Slavin BV, Bergamo ET, Torroni A, Runyan CM, Flores RL, Kasper FK, Young S, Coelho PG, Witek L. Three-Dimensional Printing Bioceramic Scaffolds Using Direct-Ink-Writing for Craniomaxillofacial Bone Regeneration. Tissue Eng Part C Methods 2023; 29:332-345. [PMID: 37463403 PMCID: PMC10495199 DOI: 10.1089/ten.tec.2023.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Blaire V. Slavin
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Edmara T.P. Bergamo
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - Christopher M. Runyan
- Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Roberto L. Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - F. Kurtis Kasper
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Simon Young
- Bernard and Gloria Pepper Katz Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Paulo G. Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, New York University College of Dentistry, New York, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York University, New York, New York, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
| |
Collapse
|
17
|
Thijssen Q, Quaak A, Toombs J, De Vlieghere E, Parmentier L, Taylor H, Van Vlierberghe S. Volumetric Printing of Thiol-Ene Photo-Cross-Linkable Poly(ε-caprolactone): A Tunable Material Platform Serving Biomedical Applications. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2210136. [PMID: 36827642 DOI: 10.1002/adma.202210136] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/10/2023] [Indexed: 05/12/2023]
Abstract
Current thoroughly described biodegradable and cross-linkable polymers mainly rely on acrylate cross-linking. However, despite the swift cross-linking kinetics of acrylates, the concomitant brittleness of the resulting materials limits their applicability. Here, photo-cross-linkable poly(ε-caprolactone) networks through orthogonal thiol-ene chemistry are introduced. The step-growth polymerized networks are tunable, predictable by means of the rubber elasticity theory and it is shown that their mechanical properties are significantly improved over their acrylate cross-linked counterparts. Tunability is introduced to the materials, by altering Mc (or the molar mass between cross-links), and its effect on the thermal properties, mechanical strength and degradability of the materials is evaluated. Moreover, excellent volumetric printability is illustrated and the smallest features obtained via volumetric 3D-printing to date are reported, for thiol-ene systems. Finally, by means of in vitro and in vivo characterization of 3D-printed constructs, it is illustrated that the volumetrically 3D-printed materials are biocompatible. This combination of mechanical stability, tunability, biocompatibility, and rapid fabrication by volumetric 3D-printing charts a new path toward bedside manufacturing of biodegradable patient-specific implants.
Collapse
Affiliation(s)
- Quinten Thijssen
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, Ghent, 9000, Belgium
| | - Astrid Quaak
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, Ghent, 9000, Belgium
| | - Joseph Toombs
- Department of Mechanical Engineering, University of California, Berkeley, 6159 Etcheverry Hall, Berkeley, CA, 94720-1740, USA
| | - Elly De Vlieghere
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, Ghent, 9000, Belgium
| | - Laurens Parmentier
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, Ghent, 9000, Belgium
| | - Hayden Taylor
- Department of Mechanical Engineering, University of California, Berkeley, 6159 Etcheverry Hall, Berkeley, CA, 94720-1740, USA
| | - Sandra Van Vlierberghe
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, Ghent, 9000, Belgium
| |
Collapse
|
18
|
Gao J, Liu X, Cheng J, Deng J, Han Z, Li M, Wang X, Liu J, Zhang L. Application of photocrosslinkable hydrogels based on photolithography 3D bioprinting technology in bone tissue engineering. Regen Biomater 2023; 10:rbad037. [PMID: 37250979 PMCID: PMC10219790 DOI: 10.1093/rb/rbad037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/02/2023] [Accepted: 04/16/2023] [Indexed: 05/31/2023] Open
Abstract
Bone tissue engineering (BTE) has been proven to be an effective method for the treatment of bone defects caused by different musculoskeletal disorders. Photocrosslinkable hydrogels (PCHs) with good biocompatibility and biodegradability can significantly promote the migration, proliferation and differentiation of cells and have been widely used in BTE. Moreover, photolithography 3D bioprinting technology can notably help PCHs-based scaffolds possess a biomimetic structure of natural bone, meeting the structural requirements of bone regeneration. Nanomaterials, cells, drugs and cytokines added into bioinks can enable different functionalization strategies for scaffolds to achieve the desired properties required for BTE. In this review, we demonstrate a brief introduction of the advantages of PCHs and photolithography-based 3D bioprinting technology and summarize their applications in BTE. Finally, the challenges and potential future approaches for bone defects are outlined.
Collapse
Affiliation(s)
| | | | | | - Junhao Deng
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100036, China
| | - Zhenchuan Han
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100036, China
| | - Ming Li
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100036, China
| | - Xiumei Wang
- Correspondence address: E-mail: (X.W); (J.L.); (L.Z.)
| | - Jianheng Liu
- Correspondence address: E-mail: (X.W); (J.L.); (L.Z.)
| | - Licheng Zhang
- Correspondence address: E-mail: (X.W); (J.L.); (L.Z.)
| |
Collapse
|
19
|
Clinical Applications of Three-Dimensional Printing in Upper Extremity Surgery: A Systematic Review. J Pers Med 2023; 13:jpm13020294. [PMID: 36836528 PMCID: PMC9961947 DOI: 10.3390/jpm13020294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Three-dimensional printing for medical applications in surgery of the upper extremity has gained in popularity as reflected by the increasing number of publications. This systematic review aims to provide an overview of the clinical use of 3D printing in upper extremity surgery. METHODS We searched the databases PubMed and Web of Science for clinical studies that described clinical application of 3D printing for upper extremity surgery including trauma and malformations. We evaluated study characteristics, clinical entity, type of clinical application, concerned anatomical structures, reported outcomes, and evidence level. RESULTS We finally included 51 publications with a total of 355 patients, of which 12 were clinical studies (evidence level II/III) and 39 case series (evidence level IV/V). The types of clinical applications were for intraoperative templates (33% of a total of 51 studies), body implants (29%), preoperative planning (27%), prostheses (15%), and orthoses (1%). Over two third of studies were linked to trauma-related injuries (67%). CONCLUSION The clinical application of 3D printing in upper extremity surgery offers great potential for personalized approaches to aid in individualized perioperative management, improvement of function, and ultimately help to benefit certain aspects in the quality of life.
Collapse
|
20
|
Tayanloo-Beik A, Nikkhah A, Roudsari PP, Aghayan H, Rezaei-Tavirani M, Nasli-Esfahani E, Mafi AR, Nikandish M, Shouroki FF, Arjmand B, Larijani B. Application of Biocompatible Scaffolds in Stem-Cell-Based Dental Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1409:83-110. [PMID: 35999347 DOI: 10.1007/5584_2022_734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Tissue engineering as an important field in regenerative medicine is a promising therapeutic approach to replace or regenerate injured tissues. It consists of three vital steps including the selection of suitable cells, formation of 3d scaffolds, and adding growth factors. Mesenchymal stem cells (MSCs) and embryonic stem cells (ESCs) are mentioned as two main sources for this approach that have been used for the treatment of various types of disorders. However, the main focus of literature in the field of dental tissue engineering is on utilizing MSCs. On the other hand, biocompatible scaffolds play a notable role in this regenerative process which is mentioned to be harmless with acceptable osteoinductivity. Their ability in inhibiting inflammatory responses also makes them powerful tools. Indeed, stem cell functions should be supported by biomaterials acting as scaffolds incorporated with biological signals. Naturally derived polymeric scaffolds and synthetically engineered polymeric/ceramic scaffolds are two main types of scaffolds regarding their materials that are defined further in this review. Various strategies of tissue bioengineering can affect the regeneration of dentin-pulp complex, periodontium regeneration, and whole teeth bioengineering. In this regard, in vivo/ex vivo experimental models have been developed recently in order to perform preclinical studies of dental tissue engineering which make it more transferable to be used for clinic uses. This review summarizes dental tissue engineering through its different components. Also, strategies of tissue bioengineering and experimental models are introduced in order to provide a perspective of the potential roles of dental tissue engineering to be used for clinical aims.
Collapse
Affiliation(s)
- Akram Tayanloo-Beik
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirabbas Nikkhah
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyvand Parhizkar Roudsari
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Aghayan
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Rezazadeh Mafi
- Department of Radiation Oncology, Imam Hossein Hospital, Shaheed Beheshti Medical University, Tehran, Iran
| | - Mohsen Nikandish
- AJA Cancer Epidemiology Research and Treatment Center (AJA- CERTC), AJA University of Medical Sciences, Tehran, Iran
| | - Fatemeh Fazeli Shouroki
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
21
|
Charbe NB, Tambuwala M, Palakurthi SS, Warokar A, Hromić‐Jahjefendić A, Bakshi H, Zacconi F, Mishra V, Khadse S, Aljabali AA, El‐Tanani M, Serrano‐Aroca Ã, Palakurthi S. Biomedical applications of three-dimensional bioprinted craniofacial tissue engineering. Bioeng Transl Med 2023; 8:e10333. [PMID: 36684092 PMCID: PMC9842068 DOI: 10.1002/btm2.10333] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023] Open
Abstract
Anatomical complications of the craniofacial regions often present considerable challenges to the surgical repair or replacement of the damaged tissues. Surgical repair has its own set of limitations, including scarcity of the donor tissues, immune rejection, use of immune suppressors followed by the surgery, and restriction in restoring the natural aesthetic appeal. Rapid advancement in the field of biomaterials, cell biology, and engineering has helped scientists to create cellularized skeletal muscle-like structures. However, the existing method still has limitations in building large, highly vascular tissue with clinical application. With the advance in the three-dimensional (3D) bioprinting technique, scientists and clinicians now can produce the functional implants of skeletal muscles and bones that are more patient-specific with the perfect match to the architecture of their craniofacial defects. Craniofacial tissue regeneration using 3D bioprinting can manage and eliminate the restrictions of the surgical transplant from the donor site. The concept of creating the new functional tissue, exactly mimicking the anatomical and physiological function of the damaged tissue, looks highly attractive. This is crucial to reduce the donor site morbidity and retain the esthetics. 3D bioprinting can integrate all three essential components of tissue engineering, that is, rehabilitation, reconstruction, and regeneration of the lost craniofacial tissues. Such integration essentially helps to develop the patient-specific treatment plans and damage site-driven creation of the functional implants for the craniofacial defects. This article is the bird's eye view on the latest development and application of 3D bioprinting in the regeneration of the skeletal muscle tissues and their application in restoring the functional abilities of the damaged craniofacial tissue. We also discussed current challenges in craniofacial bone vascularization and gave our view on the future direction, including establishing the interactions between tissue-engineered skeletal muscle and the peripheral nervous system.
Collapse
Affiliation(s)
- Nitin Bharat Charbe
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| | - Murtaza Tambuwala
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | | | - Amol Warokar
- Department of PharmacyDadasaheb Balpande College of PharmacyNagpurIndia
| | - Altijana Hromić‐Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural SciencesInternational University of SarajevoSarajevoBosnia and Herzegovina
| | - Hamid Bakshi
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | - Flavia Zacconi
- Departamento de Quimica Orgánica, Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Vijay Mishra
- School of Pharmaceutical SciencesLovely Professional UniversityPhagwaraIndia
| | - Saurabh Khadse
- Department of Pharmaceutical ChemistryR.C. Patel Institute of Pharmaceutical Education and ResearchDhuleIndia
| | - Alaa A. Aljabali
- Faculty of Pharmacy, Department of Pharmaceutical SciencesYarmouk UniversityIrbidJordan
| | - Mohamed El‐Tanani
- Pharmacological and Diagnostic Research Centre, Faculty of PharmacyAl‐Ahliyya Amman UniversityAmmanJordan
| | - Ãngel Serrano‐Aroca
- Biomaterials and Bioengineering Lab Translational Research Centre San Alberto MagnoCatholic University of Valencia San Vicente MártirValenciaSpain
| | - Srinath Palakurthi
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| |
Collapse
|
22
|
Mangano C, Luongo G, Luongo F, Lerner H, Margiani B, Admakin O, Mangano F. Custom-made computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) synthetic bone grafts for alveolar ridge augmentation: A retrospective clinical study with 3 years of follow-up. J Dent 2022; 127:104323. [PMID: 36241044 DOI: 10.1016/j.jdent.2022.104323] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To report on the results obtained with computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) custom-made synthetic hydroxyapatite/beta-tricalcium-phosphate (HA/beta-TCP) bone grafts in alveolar ridge augmentation for dental implant placement. METHODS The procedure included: (1) cone-beam computed tomography (CBCT) of the bone defect; (2) virtual design of the custom-made onlay bone grafts; (3) milling of grafts from a pre-formed block of synthetic HA/beta-TCP; and (4) bone reconstructive surgery. Implants were placed 8 months later. The patients were followed for 3 years. The study outcomes were: (1) intra- and immediate post-operative complications; (2) 8-month vertical and horizontal bone gain; (3) implant survival; (4) implant-crown success; and (5) peri-implant marginal bone loss (MBL). RESULTS Twenty-six patients underwent ridge augmentation with custom-made CAD/CAM HA/beta-TCP onlay grafts. Eight months later, these patients were rehabilitated with dental implants. During surgery, 25/26 (96.1%) of the grafts adapted well to the bone defect. Immediate post-operative complications were pain and swelling (2/26 patients: 7.6%), and bone graft exposure (3/26: 11.5%); one exposure led to infection, removal of the graft, and failure of the procedure. Excellent integration of the other grafts was observed 8 months after the regenerative procedure, with mean vertical and horizontal bone gains of 2.10 mm (± 0.35) and 2.96 mm (± 0.45), respectively. Twenty-five implants were placed and restored with single crowns. Three years later, all implants were in function. The 3-year implant crown success rate and peri-implant MBL were 92.0% and 0.7 mm (±0.19), respectively. CONCLUSIONS With custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts reconstruction of small vertical and/or horizontal defects of the alveolar ridge was obtained; this enabled implant placement, with high implant-crown success rate after 3 years. Further studies are needed to validate this technique. STATEMENT OF CLINICAL RELEVANCE Custom-made CAD/CAM synthetic HA/beta-TCP onlay grafts may represent an option for regeneration of small bone defects prior to implant placement.
Collapse
Affiliation(s)
| | | | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany.
| | - Bidzina Margiani
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | - Oleg Admakin
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | - Francesco Mangano
- Department of Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| |
Collapse
|
23
|
Translating Material Science into Bone Regenerative Medicine Applications: State-of-The Art Methods and Protocols. Int J Mol Sci 2022; 23:ijms23169493. [PMID: 36012749 PMCID: PMC9409266 DOI: 10.3390/ijms23169493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
In the last 20 years, bone regenerative research has experienced exponential growth thanks to the discovery of new nanomaterials and improved manufacturing technologies that have emerged in the biomedical field. This revolution demands standardization of methods employed for biomaterials characterization in order to achieve comparable, interoperable, and reproducible results. The exploited methods for characterization span from biophysics and biochemical techniques, including microscopy and spectroscopy, functional assays for biological properties, and molecular profiling. This review aims to provide scholars with a rapid handbook collecting multidisciplinary methods for bone substitute R&D and validation, getting sources from an up-to-date and comprehensive examination of the scientific landscape.
Collapse
|
24
|
Chou PY, Lee D, Chen SH, Liao CT, Lo LJ, Liu SJ. 3D-printed/electrospun bioresorbable nanofibrous drug-eluting cuboid frames for repair of alveolar bone defects. Int J Pharm 2022; 615:121497. [DOI: 10.1016/j.ijpharm.2022.121497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/27/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
|
25
|
Hatt LP, Thompson K, Helms JA, Stoddart MJ, Armiento AR. Clinically relevant preclinical animal models for testing novel cranio-maxillofacial bone 3D-printed biomaterials. Clin Transl Med 2022; 12:e690. [PMID: 35170248 PMCID: PMC8847734 DOI: 10.1002/ctm2.690] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 12/19/2022] Open
Abstract
Bone tissue engineering is a rapidly developing field with potential for the regeneration of craniomaxillofacial (CMF) bones, with 3D printing being a suitable fabrication tool for patient‐specific implants. The CMF region includes a variety of different bones with distinct functions. The clinical implementation of tissue engineering concepts is currently poor, likely due to multiple reasons including the complexity of the CMF anatomy and biology, and the limited relevance of the currently used preclinical models. The ‘recapitulation of a human disease’ is a core requisite of preclinical animal models, but this aspect is often neglected, with a vast majority of studies failing to identify the specific clinical indication they are targeting and/or the rationale for choosing one animal model over another. Currently, there are no suitable guidelines that propose the most appropriate animal model to address a specific CMF pathology and no standards are established to test the efficacy of biomaterials or tissue engineered constructs in the CMF field. This review reports the current clinical scenario of CMF reconstruction, then discusses the numerous limitations of currently used preclinical animal models employed for validating 3D‐printed tissue engineered constructs and the need to reduce animal work that does not address a specific clinical question. We will highlight critical research aspects to consider, to pave a clinically driven path for the development of new tissue engineered materials for CMF reconstruction.
Collapse
Affiliation(s)
- Luan P Hatt
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland.,Department of Health Sciences and Techonology, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Keith Thompson
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford University, Palo Alto, California
| | - Martin J Stoddart
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
| | - Angela R Armiento
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
| |
Collapse
|
26
|
Sliding Flap for the Wide Upper Eyelid Margin Defect After Cancer Removal. J Craniofac Surg 2022; 33:2063-2066. [PMID: 35148531 DOI: 10.1097/scs.0000000000008551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reconstruction of eyelid margin defects following resection of upper-eyelid skin malignancies is typically performed using a lower eyelid switch flap, including eyelash reconstruction. However, a subsequent procedure for flap separation, and prolonged swelling of the flap may occur as a complication. OBJECTIVE The authors performed anterior lamellar reconstruction using a sliding flap with excess upper eyelid skin, a procedure that is a less invasive and simpler. MATERIALS AND METHODS The authors performed anterior lamellar reconstruction using a sliding flap in 7 patients with full-thickness upper eyelid margin defect after skin cancer resection. The mean age of the patients was 76.0 years. The horizontal width of the defect in our cohort ranged from 11 to 25 mm and the vertical width ranged from 5 to 10 mm. RESULTS All the flaps and mucosal grafts were well taken, and none of the patients complained of lack of eyelash reconstruction. However, eyelid margin irregularity, possibly due to flap or mucosal graft contraction, was observed in 2 patients, and 1 patient developed keratoconjunctivitis. CONCLUSIONS The sliding flap technique is a minimally invasive and simple procedure for wide eyelid margin reconstruction. However, 2 patients developed eyelid margin irregularities and 1 patient developed keratoconjunctivitis. Those complications might have occurred owing to the condition of posterior lamellar reconstruction. Therefore, for the successful use of a sliding flap for anterior lamellar reconstruction, the form of the eyelid edge and the choice of posterior lamellar reconstruction are key considerations. In future, we plan to establish a better reconstructive technique by accumulating more evidence.
Collapse
|
27
|
Hegedus T, Kreuter P, Kismarczi-Antalffy AA, Demeter T, Banyai D, Vegh A, Geczi Z, Hermann P, Payer M, Zsembery A, Al-Hassiny A, Mukaddam K, Herber V, Jakse N, Vegh D. User Experience and Sustainability of 3D Printing in Dentistry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041921. [PMID: 35206116 PMCID: PMC8872260 DOI: 10.3390/ijerph19041921] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/30/2022] [Accepted: 02/03/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND 3D printing is a rapidly developing technology in the healthcare industry and in dentistry. Its application clearly shows that this area of digital dentistry has potential for everyday usage across all fields, including prosthodontics, orthodontics, maxillofacial surgery, and oral implantology. However, despite gaining ground, there is a lack of information about how specialists (dentists and dental technicians) use additive technology. Our research group aimed to investigate the impact of social media on additive manufacturing technology among dental specialists and their everyday usage of 3D printing. METHODS This paper investigated specialists' everyday usage of 3D printers via an online survey (Google Forms). The survey questions aimed to discover the number of 3D printers used, the accessibility of the devices, the annual cost, and the design programs. Since specialists tend to build online communities on social media, we circulated our study questionnaire using our profiles on LinkedIn, Facebook, and Instagram platforms during our research. RESULTS A total of 120 responses were received from 20 countries, with the most significant numbers being from Hungary 23.7% (n = 27), the United States 18.4% (n = 21), and the United Kingdom 7.9% (n = 9). Most of the participants were dentists (n = 68) or dental technicians (n = 29), but some CAD/CAM specialists (n = 23) also completed our survey. The participants had an average of 3.8 years (±0.7) of experience in the 3D printing field, and owned a total of 405 printing devices (3.6 on average/person). CONCLUSIONS The impact of social media on this research field is growing increasingly. Hence, we support specialists in joining virtual communities on professional platforms. This article intended to provide a practical overview, feedback, and direction for dentists interested in 3D printing technology. From our survey, we can conclude that additive technology is broadening dental applications and the services that we can provide for our patients.
Collapse
Affiliation(s)
- Tamas Hegedus
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary; (T.H.); (Z.G.); (P.H.)
| | - Patrik Kreuter
- Faculty of Dentistry, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary; (P.K.); (A.A.K.-A.)
| | | | - Tamas Demeter
- Department of General Dental Preclinical Practice, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary;
| | - Dorottya Banyai
- Department of Pediatric Dentistry and Orthodontics, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary;
| | - Adam Vegh
- Department of Maxillofacial Surgery and Dentistry, Semmelweis University, Maria utca 52., 1088 Budapest, Hungary;
| | - Zoltan Geczi
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary; (T.H.); (Z.G.); (P.H.)
| | - Peter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary; (T.H.); (Z.G.); (P.H.)
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Billrothgasse 4, 8010 Graz, Austria; (M.P.); (V.H.); (N.J.)
| | - Akos Zsembery
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., 1089 Budapest, Hungary;
| | - Ahmad Al-Hassiny
- Institute of Digital Dentistry, 9 Hillary Court, Lower Hutt, Wellington 5010, New Zealand;
| | - Khaled Mukaddam
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland;
| | - Valentin Herber
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Billrothgasse 4, 8010 Graz, Austria; (M.P.); (V.H.); (N.J.)
| | - Norbert Jakse
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Billrothgasse 4, 8010 Graz, Austria; (M.P.); (V.H.); (N.J.)
| | - Daniel Vegh
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47., 1088 Budapest, Hungary; (T.H.); (Z.G.); (P.H.)
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, School of Dentistry, Medical University Graz, Billrothgasse 4, 8010 Graz, Austria; (M.P.); (V.H.); (N.J.)
- Correspondence: ; Tel.: +36-30-7405164
| |
Collapse
|
28
|
Bone Morphogenetic Protein-, Antimicrobial Agent-, and Analgesic-Incorporated Nanofibrous Scaffolds for the Therapy of Alveolar Clefts. Pharmaceutics 2022; 14:pharmaceutics14020374. [PMID: 35214106 PMCID: PMC8878068 DOI: 10.3390/pharmaceutics14020374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 11/17/2022] Open
Abstract
An alveolar cleft is a bone defect in the maxillary arch. Although the use of autologous iliac bone grafts to repair alveolar clefts is the preferred treatment method, donor-site morbidity remains a concern. In this study, we incorporated bone morphogenetic protein (BMP), an antimicrobial agent, and an analgesic into nanofibrous scaffolds for alveolar cleft therapy. Three-dimensional (3D) printing and coaxial electrospinning techniques were used to fabricate the scaffolds. BMP-2, ketorolac, and amoxicillin were used as the growth factor, analgesic, and antimicrobial agent, respectively. The in vitro properties of the nanofibrous scaffolds were characterized, and in vivo efficacy was evaluated in a rat alveolar-cleft model. The empirical data indicated that the biomolecule-incorporated scaffolds offered extended discharge of BMP-2, amoxicillin, and ketorolac for >4 weeks. The animal test outcomes also demonstrated favorable bone healing at the cleft site. Biomolecule- and drug-incorporated nanofibrous scaffolds demonstrated their efficacy in alveolar cleft treatment.
Collapse
|
29
|
Xu Y, Zhang F, Zhai W, Cheng S, Li J, Wang Y. Unraveling of Advances in 3D-Printed Polymer-Based Bone Scaffolds. Polymers (Basel) 2022; 14:polym14030566. [PMID: 35160556 PMCID: PMC8840342 DOI: 10.3390/polym14030566] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
The repair of large-area irregular bone defects is one of the complex problems in orthopedic clinical treatment. The bone repair scaffolds currently studied include electrospun membrane, hydrogel, bone cement, 3D printed bone tissue scaffolds, etc., among which 3D printed polymer-based scaffolds Bone scaffolds are the most promising for clinical applications. This is because 3D printing is modeled based on the im-aging results of actual bone defects so that the printed scaffolds can perfectly fit the bone defect, and the printed components can be adjusted to promote Osteogenesis. This review introduces a variety of 3D printing technologies and bone healing processes, reviews previous studies on the characteristics of commonly used natural or synthetic polymers, and clinical applications of 3D printed bone tissue scaffolds, analyzes and elaborates the characteristics of ideal bone tissue scaffolds, from t he progress of 3D printing bone tissue scaffolds were summarized in many aspects. The challenges and potential prospects in this direction were discussed.
Collapse
Affiliation(s)
- Yuanhang Xu
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Feiyang Zhang
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Weijie Zhai
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Shujie Cheng
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Jinghua Li
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
- Correspondence: (J.L.); (Y.W.)
| | - Yi Wang
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
- National United Engineering Laboratory for Advanced Bearing Tribology, Henan University of Science and Technology, Luoyang 471000, China
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Correspondence: (J.L.); (Y.W.)
| |
Collapse
|
30
|
Alvarez Echazú MI, Perna O, Olivetti CE, Antezana PE, Municoy S, Tuttolomondo MV, Galdopórpora JM, Alvarez GS, Olmedo DG, Desimone MF. Recent Advances in Synthetic and Natural Biomaterials-Based Therapy for Bone Defects. Macromol Biosci 2022; 22:e2100383. [PMID: 34984818 DOI: 10.1002/mabi.202100383] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/04/2021] [Indexed: 12/31/2022]
Abstract
Synthetic and natural biomaterials are a promising alternative for the treatment of critical-sized bone defects. Several parameters such as their porosity, surface, and mechanical properties are extensively pointed out as key points to recapitulate the bone microenvironment. Many biomaterials with this pursuit are employed to provide a matrix, which can supply the specific environment and architecture for an adequate bone growth. Nevertheless, some queries remain unanswered. This review discusses the recent advances achieved by some synthetic and natural biomaterials to mimic the native structure of bone and the manufacturing technology applied to obtain biomaterial candidates. The focus of this review is placed in the recent advances in the development of biomaterial-based therapy for bone defects in different types of bone. In this context, this review gives an overview of the potentialities of synthetic and natural biomaterials: polyurethanes, polyesters, hyaluronic acid, collagen, titanium, and silica as successful candidates for the treatment of bone defects.
Collapse
Affiliation(s)
- María I Alvarez Echazú
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina.,Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Marcelo T. de Alvear 2142 (1122), CABA, Argentina
| | - Oriana Perna
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Christian E Olivetti
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Pablo E Antezana
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Sofia Municoy
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - María V Tuttolomondo
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Juan M Galdopórpora
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Gisela S Alvarez
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| | - Daniel G Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Marcelo T. de Alvear 2142 (1122), CABA, Argentina.,CONICET, Consejo Nacional de Investigaciones Científicas y Técnicas, Godoy Cruz 2290, Buenos Aires, 1425, Argentina
| | - Martín F Desimone
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3°, (1113) Buenos Aires, Argentina., Universidad de Buenos Aires, Junín 956, Piso 3°, Buenos Aires, 1113, Argentina
| |
Collapse
|
31
|
Liu G, ZHOU YUAN, Zhang X, Guo S. Advances in Hydrogels for Stem Cell Therapy: Regulation Mechanisms and Tissue Engineering Applications. J Mater Chem B 2022; 10:5520-5536. [DOI: 10.1039/d2tb01044e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Stem cell therapy has shown unparalleled potential in tissue engineering, but it still faces challenges in the regulation of stem cell fate. Inspired by the native stem cell niche, a...
Collapse
|
32
|
Natarajan D, Ye Z, Wang L, Ge L, Pathak JL. Rare earth smart nanomaterials for bone tissue engineering and implantology: Advances, challenges, and prospects. Bioeng Transl Med 2022; 7:e10262. [PMID: 35111954 PMCID: PMC8780931 DOI: 10.1002/btm2.10262] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/09/2021] [Indexed: 12/18/2022] Open
Abstract
Bone grafts or prosthetic implant designing for clinical application is challenging due to the complexity of integrated physiological processes. The revolutionary advances of nanotechnology in the biomaterial field expedite and endorse the current unresolved complexity in functional bone graft and implant design. Rare earth (RE) materials are emerging biomaterials in tissue engineering due to their unique biocompatibility, fluorescence upconversion, antimicrobial, antioxidants, and anti-inflammatory properties. Researchers have developed various RE smart nano-biomaterials for bone tissue engineering and implantology applications in the past two decades. Furthermore, researchers have explored the molecular mechanisms of RE material-mediated tissue regeneration. Recent advances in biomedical applications of micro or nano-scale RE materials have provided a foundation for developing novel, cost-effective bone tissue engineering strategies. This review attempted to provide an overview of RE nanomaterials' technological innovations in bone tissue engineering and implantology and summarized the osteogenic, angiogenic, immunomodulatory, antioxidant, in vivo bone tissue imaging, and antimicrobial properties of various RE nanomaterials, as well as the molecular mechanisms involved in these biological events. Further, we extend to discuss the challenges and prospects of RE smart nano-biomaterials in the field of bone tissue engineering and implantology.
Collapse
Affiliation(s)
- Duraipandy Natarajan
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Zhitong Ye
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Janak Lal Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| |
Collapse
|
33
|
Aristotle S, Patil S, Jayakumar S. Dimensional accuracy of medical models of the skull produced by three-dimensional printing technology by advanced morphometric analysis. J ANAT SOC INDIA 2022. [DOI: 10.4103/jasi.jasi_202_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
34
|
Mueller ML, Ottensmeyer MP, Thamm JR, Schmelzeisen R, Troulis MJ, Guastaldi FPS. Increased Osteogenic Activity of Dynamic Cultured Composite Bone Scaffolds: Characterization and In Vitro Study. J Oral Maxillofac Surg 2021; 80:303-312. [PMID: 34822754 DOI: 10.1016/j.joms.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to develop and characterize beta-tricalcium phosphate (β-TCP)/polycaprolactone (PCL) scaffolds, with 2 different ratios (50/50% and 65/35%), using 3-dimensionally (3D) printed dissolvable molds, and to evaluate cellular growth and osteogenic differentiation of both groups seeded with porcine bone marrow stem cells (pBMSCs) under dynamic culture in vitro. MATERIALS AND METHODS Two different groups of scaffolds were produced: group 1 (n = 40) with a ratio (wt%) of 50/50% and group 2 (n = 40) with 65/35% of β-TCP/PCL. Physicochemical, morphological, and mechanical characterization of the scaffolds were performed. Scaffolds were seeded with pBMSCs and differentiated osteogenically in dynamic culture. Cell density, distribution, and viability were assessed. Osteogenic differentiation was examined through alkaline phosphatase (ALP) staining, immunofluorescence, and photospectrometry. RESULTS Osteogenic differentiated constructs showed homogenous and viable cell distribution. Cell density was significantly higher (P < .05) for 65/35% scaffolds at 10 days postseeding, whereas at 6 weeks, cell number equalized for both groups. ALP activity increased over time and was significantly higher (P < .05) for 65/35% scaffolds at 14 days postseeding. CONCLUSIONS The mechanical properties of the developed 65/35% scaffolds were within the range of natural trabecular bone. Moreover, the 65/35% scaffolds showed biological advantages, such as higher cell growth and higher ALP activity.
Collapse
Affiliation(s)
- Max-Laurin Mueller
- Research Fellow, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Mark P Ottensmeyer
- Senior Engineer, Medical Device & Simulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Janis R Thamm
- Research Fellow, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Rainer Schmelzeisen
- Medical Director, Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Maria J Troulis
- Walter C. Guralnick Distinguished Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA
| | - Fernando P S Guastaldi
- Instructor of Oral and Maxillofacial Surgery, Director, Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA.
| |
Collapse
|
35
|
Mattavelli D, Fiorentino A, Tengattini F, Colpani A, Agnelli S, Buffoli B, Ravanelli M, Ferrari M, Schreiber A, Rampinelli V, Taboni S, Verzeletti V, Deganello A, Rodella LF, Maroldi R, Ceretti E, Sartore L, Piazza C, Fontanella MM, Nicolai P, Doglietto F. Additive Manufacturing for Personalized Skull Base Reconstruction in Endoscopic Transclival Surgery: A Proof-of-Concept Study. World Neurosurg 2021; 155:e439-e452. [PMID: 34450324 DOI: 10.1016/j.wneu.2021.08.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Endoscopic transnasal transclival intradural surgery is limited by a high postoperative cerebrospinal fluid leak rate. The aim of this study was to investigate the role of three-dimensional printing to create a personalized, rigid scaffold for clival reconstruction. METHODS Two different types of clivectomy were performed in 5 specimens with the aid of neuronavigation, and 11 clival reconstructions were simulated. They were repaired with polylactide, three-dimensional-printed scaffolds that were manually designed in a computer-aided environment based either on the real or on the predicted defect. Scaffolds were printed with a fused filament fabrication technique and different offsets. They were positioned and fixed either following the gasket seal technique or with screws. Postdissection radiological evaluation of scaffold position was performed in all cases. In 3 specimens, the cerebrospinal fluid leak pressure point was measured immediately after reconstruction. RESULTS The production process took approximately 30 hours. The designed scaffolds were satisfactory when no offset was added. Wings were added during the design to allow for screw positioning, but broke in 30% of cases. Radiological assessment documented maximal accuracy of scaffold positioning when the scaffold was created on the real defect; accuracy was satisfactory when the predicted clivectomy was performed under neuronavigation guidance. The cerebrospinal fluid leak pressure point was significantly higher when the scaffold was fixed with screws compared with the gasket technique. CONCLUSIONS In this preclinical setting, additive manufacturing allows the creation of customized scaffolds that are effective in reconstructing even large and geometrically complex clival defects.
Collapse
Affiliation(s)
- Davide Mattavelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Antonio Fiorentino
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Francesco Tengattini
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alessandro Colpani
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Silvia Agnelli
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Barbara Buffoli
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marco Ravanelli
- Unit of Radiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Vincenzo Verzeletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Alberto Deganello
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luigi Fabrizio Rodella
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Unit of Radiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elisabetta Ceretti
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Luciana Sartore
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco M Fontanella
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Francesco Doglietto
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| |
Collapse
|
36
|
Mohaghegh S, Hosseini SF, Rad MR, Khojateh A. 3D Printed Composite Scaffolds in Bone Tissue Engineering: A systematic review. Curr Stem Cell Res Ther 2021; 17:648-709. [PMID: 35135465 DOI: 10.2174/1574888x16666210810111754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE This study aimed to analyze the effect of fabrication factors on both biological and physico-chemical features of 3-dimensional (3D) printed composite scaffolds. METHOD Electronic search was done according to the PRISMA guideline in PubMed and Scopus databases limited to English articles published until May 2021.Studies in which composite scaffolds were fabricated through computer-aided design and computer-aided manufacturing (CAD-CAM)-based methods were included.Articles regarding the features of the scaffolds fabricated through indirect techniques were excluded. RESULTS Full text of 121 studies were reviewed, and 69 met the inclusion criteria. According to analyzed studies, PCL and HA were the most commonly used polymer and ceramic,respectively. Besides,the Solvent-based technique was the most commonly used composition technique, which enabled preparing blends with high concentrations of ceramic materials. The most common fabrication method used in the included studies was Fused deposition modeling (FDM).The addition of bio-ceramics enhanced the mechanical features and the biological behaviors of the printed scaffolds in a ratio-dependent manner. However,studies that analyzed the effect of ceramic weight ratio showed that scaffolds with the highest ceramic content did not necessarily possess the optimal biological and non-biological features. CONCLUSION The biological and physico-chemical behaviors of the scaffold can be affected by pre-printing factors, including utilized materials, composition techniques, and fabrication methods. Fabricating scaffolds with high mineral content as of the natural bone may not provide the optimal condition for bone formation. Therefore, it is recommended that future studies compare the efficiency of different kinds of biomaterials rather than different weight ratios of one type.
Collapse
Affiliation(s)
- Sadra Mohaghegh
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences. Iran
| | - Seyedeh Fatemeh Hosseini
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences. Iran
| | - Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences. Iran
| | - Arash Khojateh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences. Iran
| |
Collapse
|
37
|
Fibrin Glue Implants Seeded with Dental Pulp and Periodontal Ligament Stem Cells for the Repair of Periodontal Bone Defects: A Preclinical Study. Bioengineering (Basel) 2021; 8:bioengineering8060075. [PMID: 34206126 PMCID: PMC8226811 DOI: 10.3390/bioengineering8060075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 12/30/2022] Open
Abstract
A technology to create a cell-seeded fibrin-based implant matching the size and shape of bone defect is required to create an anatomical implant. The aim of the study was to develop a technology of cell-seeded fibrin gel implant creation that has the same shape and size as the bone defect at the site of implantation. Using computed tomography (CT) images, molds representing bone defects were created by 3D printing. The form was filled with fibrin glue and human dental pulp stem cells (DPSC). The viability, set of surface markers and osteogenic differentiation of DPSC grown in fibrin gel along with the clot retraction time were evaluated. In mice, an alveolar bone defect was created. The defect was filled with fibrin gel seeded with mouse DPSC. After 28 days, the bone repair was analyzed with cone beam CT and by histological examination. The proliferation rate, set of surface antigens and osteogenic potential of cells grown inside the scaffold and in 2D conditions did not differ. In mice, both cell-free and mouse DPSC-seeded implants increased the bone tissue volume and vascularization. In mice with cell-seeded gel implants, the bone remodeling process was more prominent than in animals with a cell-free implant. The technology of 3D-printed forms for molding implants can be used to prepare implants using components that are not suitable for 3D printing.
Collapse
|
38
|
Xun H, Clarke S, Baker N, Shallal C, Lee E, Fadavi D, Wong A, Brandacher G, Kang SH, Sacks JM. Method, Material, and Machine: A Review for the Surgeon Using Three-Dimensional Printing for Accelerated Device Production. J Am Coll Surg 2021; 232:726-737.e19. [PMID: 33896478 DOI: 10.1016/j.jamcollsurg.2021.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/23/2020] [Accepted: 01/13/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Physicians are at the forefront of identifying innovative targets to address current medical needs. 3D printing technology has emerged as a state-of-the-art method of prototyping medical devices or producing patient-specific models that is more cost-efficient, with faster turnaround time, in comparison to traditional prototype manufacturing. However, initiating 3D printing projects can be daunting due to the engineering learning curve, including the number of methodologies, variables, and techniques for printing from which to choose. To help address these challenges, we sought to create a guide for physicians interested in venturing into 3D printing. STUDY DESIGN All commercially available, plug-and-play, material and stereolithography printers costing less than $15,000 were identified via web search. Companies were contacted to obtain quotes and information sheets for all printer models. The qualifying printers' manufacturer specification sheets were reviewed, and pertinent variables were extracted. RESULTS We reviewed 309 commercially available printers and materials and identified 118 printers appropriate for clinicians desiring plug-and-play models for accelerated device production. We synthesized this information into a decision-making tool to choose the appropriate parameters based on project goals. CONCLUSIONS There is a growing clinical need for medical devices to reduce costs of care and increase access to personalized treatments; however, the learning curve may be daunting for surgeons. In this review paper, we introduce the "3Ms of 3D printing" for medical professionals and provide tools and data sheets for selection of commercially available, affordable, plug-and-play 3D printers appropriate for surgeons interested in innovation.
Collapse
Affiliation(s)
- Helen Xun
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Scott Clarke
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Nusaiba Baker
- Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA
| | - Christopher Shallal
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Erica Lee
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Darya Fadavi
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Alison Wong
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Sung Hoon Kang
- Department of Mechanical Engineering and Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD
| | - Justin M Sacks
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD; Division of Plastic and Reconstructive Surgery, Washington University in St Louis School of Medicine, St Louis, MO.
| |
Collapse
|
39
|
Dziaduszewska M, Zieliński A. Structural and Material Determinants Influencing the Behavior of Porous Ti and Its Alloys Made by Additive Manufacturing Techniques for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2021; 14:712. [PMID: 33546358 PMCID: PMC7913507 DOI: 10.3390/ma14040712] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/20/2022]
Abstract
One of the biggest challenges in tissue engineering is the manufacturing of porous structures that are customized in size and shape and that mimic natural bone structure. Additive manufacturing is known as a sufficient method to produce 3D porous structures used as bone substitutes in large segmental bone defects. The literature indicates that the mechanical and biological properties of scaffolds highly depend on geometrical features of structure (pore size, pore shape, porosity), surface morphology, and chemistry. The objective of this review is to present the latest advances and trends in the development of titanium scaffolds concerning the relationships between applied materials, manufacturing methods, and interior architecture determined by porosity, pore shape, and size, and the mechanical, biological, chemical, and physical properties. Such a review is assumed to show the real achievements and, on the other side, shortages in so far research.
Collapse
Affiliation(s)
- Magda Dziaduszewska
- Biomaterials Technology Division, Institute of Machines Technology and Materials, Faculty of Mechanical Engineering and Ship Building, Gdańsk University of Technology, 80-233 Gdańsk, Poland;
| | | |
Collapse
|
40
|
Garot C, Bettega G, Picart C. Additive Manufacturing of Material Scaffolds for Bone Regeneration: Toward Application in the Clinics. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2006967. [PMID: 33531885 PMCID: PMC7116655 DOI: 10.1002/adfm.202006967] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Indexed: 05/07/2023]
Abstract
Additive manufacturing (AM) allows the fabrication of customized bone scaffolds in terms of shape, pore size, material type and mechanical properties. Combined with the possibility to obtain a precise 3D image of the bone defects using computed tomography or magnetic resonance imaging, it is now possible to manufacture implants for patient-specific bone regeneration. This paper reviews the state-of-the-art of the different materials and AM techniques used for the fabrication of 3D-printed scaffolds in the field of bone tissue engineering. Their advantages and drawbacks are highlighted. For materials, specific criteria, were extracted from a literature study: biomimetism to native bone, mechanical properties, biodegradability, ability to be imaged (implantation and follow-up period), histological performances and sterilization process. AM techniques can be classified in three major categories: extrusion-based, powder-based and liquid-base. Their price, ease of use and space requirement are analyzed. Different combinations of materials/AM techniques appear to be the most relevant depending on the targeted clinical applications (implantation site, presence of mechanical constraints, temporary or permanent implant). Finally, some barriers impeding the translation to human clinics are identified, notably the sterilization process.
Collapse
Affiliation(s)
- Charlotte Garot
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
| | - Georges Bettega
- Service de chirurgie maxillo-faciale, Centre Hospitalier Annecy-Genevois, 1 avenue de l’hôpital, F-74370 Epagny Metz-Tessy, France
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France
| | - Catherine Picart
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
| |
Collapse
|
41
|
Three-Dimensional Technology Applications in Maxillofacial Reconstructive Surgery: Current Surgical Implications. NANOMATERIALS 2020; 10:nano10122523. [PMID: 33339115 PMCID: PMC7765477 DOI: 10.3390/nano10122523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 12/18/2022]
Abstract
Defects in the oral and maxillofacial (OMF) complex may lead to functional and esthetic impairment, aspiration, speech difficulty, and reduced quality of life. Reconstruction of such defects is considered one of the most challenging procedures in head and neck surgery. Transfer of different auto-grafts is still considered as the “gold standard” of regenerative and reconstructive procedures for OMF defects. However, harvesting of these grafts can lead to many complications including donor-site morbidity, extending of surgical time, incomplete healing of the donor site and others. Three-dimensional (3D) printing technology is an innovative technique that allows the fabrication of personalized implants and scaffolds that fit the precise anatomy of an individual’s defect and, therefore, has attracted significant attention during the last few decades, especially among head and neck surgeons. Here we discuss the most relevant applications of the 3D printing technology in the oral and maxillofacial surgery field. We further show different clinical examples of patients who were treated at our institute using the 3D technology and discuss the indications, different technologies, complications, and their clinical outcomes. We demonstrate that 3D technology may provide a powerful tool used for reconstruction of various OMF defects, enabling optimal clinical results in the suitable cases.
Collapse
|
42
|
Abstract
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
Collapse
|
43
|
Robocasting of Single and Multi-Functional Calcium Phosphate Scaffolds and Its Hybridization with Conventional Techniques: Design, Fabrication and Characterization. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In this work, dense, porous, and, for the first time, functionally-graded bi-layer scaffolds with a cylindrical geometry were produced from a commercially available hydroxyapatite powder using the robocasting technique. The bi-layer scaffolds were made of a dense core part attached to a surrounding porous part. Subsequently, these bi-layer robocast scaffolds were joined with an outer shell of an antibacterial porous polymer layer fabricated by solvent casting/salt leaching techniques, leading to hybrid ceramic-polymer scaffolds. The antibacterial functionality was achieved through the addition of silver ions to the polymer layer. All the robocast samples, including the bi-layer ones, were first characterized through scanning electron microscopy observations, mechanical characterization in compression and preliminary bioactivity tests. Then, the hybrid bi-layer ceramic-polymer scaffolds were characterized through antimicrobial tests. After sintering at 1300 °C for 3 h, the compressive strengths of the structures were found to be equal to 29 ± 4 MPa for dense samples and 7 ± 4 MPa for lattice structures with a porosity of 34.1%. Bioactivity tests performed at 37 °C for 4 weeks showed that the precipitated layer on the robocast samples contained octacalcium phosphate. Finally, it was evidenced that the hybrid structure was effective in releasing antibacterial Ag+ ions to the surrounding medium showing its potential efficiency in limiting Staphylococcus aureus proliferation during surgery.
Collapse
|
44
|
Locally Controlled Diffusive Release of Bone Morphogenetic Protein-2 Using Micropatterned Gelatin Methacrylate Hydrogel Carriers. BIOCHIP JOURNAL 2020; 14:405-420. [PMID: 33250969 PMCID: PMC7680086 DOI: 10.1007/s13206-020-4411-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/07/2020] [Indexed: 12/11/2022]
Abstract
In this work, a novel and simple bone morphogenetic protein (BMP)-2 carrier is developed, which enables localized and controlled release of BMP-2 and facilitates bone regeneration. BMP-2 is localized in the gelatin methacrylate (GelMA) micropatterns on hydrophilic semi-permeable membrane (SNM), and its controlled release is regulated by the concentration of GelMA hydrogel and BMP-2. The controlled release of BMP-2 is verified using computational analysis and quantified using fluorescein isothiocyanate-bovine serum albumin (FITC-BSA) diffusion model. The osteogenic differentiation of osteosarcoma MG-63 cells is manipulated by localized and controlled BMP-2 release. The calcium deposits are significantly higher and the actin skeletal networks are denser in MG-63 cells cultured in the BMP-2-immobilized GelMA micropattern than in the absence of BMP-2. The proposed BMP-2 carrier is expected to not only act as a barrier membrane that can prevent invasion of connective tissue during bone regeneration, but also as a carrier capable of localizing and controlling the release of BMP-2 due to GelMA micropatterning on SNM. This approach can be extensively applied to tissue engineering, including the localization and encapsulation of cells or drugs.
Collapse
|
45
|
Jensen MB, Slots C, Ditzel N, Kolstrup S, Kassem M, Thygesen T, Andersen MØ. Treating mouse skull defects with 3D-printed fatty acid and tricalcium phosphate implants. J Tissue Eng Regen Med 2020; 14:1858-1868. [PMID: 33098263 DOI: 10.1002/term.3146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 09/17/2020] [Accepted: 09/28/2020] [Indexed: 11/09/2022]
Abstract
Skull surgery, also known as craniectomy, is done to treat trauma or brain diseases and may require the use of an implant to reestablish skull integrity. This study investigates the performance of 3D printed bone implants in a mouse model of craniectomy with the aim of making biodegradable porous implants that can ultimately be fitted to a patient's anatomy. A nonpolymeric thermoplastic bioink composed of fatty acids and β-tricalcium phosphate was used to 3D print the skull implants. Some of these were sintered to yield pure β-tricalcium phosphate implants. The performance of nonsintered and sintered implants was then compared in two semi-quantitative murine calvarial defect models using computed tomography, histology, and luciferase activity. Both types of implants were biocompatible, but only sintered implants promoted defect healing, with osseointegration to adjacent bone and the formation of new bone and bone marrow tissue in the implant pores. Luciferase scanning and histology showed that mesenchymal stem cells seeded onto the implants engraft and proliferate on the implants after implantation and contribute to forming bone. The experiments indicate that fatty acid-based 3D printing enables the creation of biocompatible and bone-forming β-tricalcium phosphate implants.
Collapse
Affiliation(s)
- Martin Bonde Jensen
- Section for Biotechnology (SDU Biotechnology), Department of Green Technology, Faculty of Engineering, University of Southern Denmark, Odense, Denmark.,Particle3D ApS, Odense, Denmark
| | - Casper Slots
- Section for Biotechnology (SDU Biotechnology), Department of Green Technology, Faculty of Engineering, University of Southern Denmark, Odense, Denmark.,Particle3D ApS, Odense, Denmark
| | - Nicholas Ditzel
- Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Stefanie Kolstrup
- The Biomedical Laboratory, University of Southern Denmark, Odense, Denmark
| | - Moustapha Kassem
- Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Torben Thygesen
- Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark
| | - Morten Østergaard Andersen
- Section for Biotechnology (SDU Biotechnology), Department of Green Technology, Faculty of Engineering, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
46
|
Picciolo G, Peditto M, Irrera N, Pallio G, Altavilla D, Vaccaro M, Picciolo G, Scarfone A, Squadrito F, Oteri G. Preclinical and Clinical Applications of Biomaterials in the Enhancement of Wound Healing in Oral Surgery: An Overview of the Available Reviews. Pharmaceutics 2020; 12:E1018. [PMID: 33114407 PMCID: PMC7692581 DOI: 10.3390/pharmaceutics12111018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative wound healing. A search in Medline was performed, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The literature was searched for reviews published up to July 2020. Reviews evaluating the clinical and histological effects of biomaterials on post-operative wound healing in oral surgical procedures were included. Review selection was performed by two independent reviewers. Disagreements were resolved by a third reviewer, and 41 reviews were included in the final selection. The selected papers covered a wide range of biomaterials such as stem cells, bone grafts, and growth factors. Bioengineering and biomaterials development represent one of the most promising perspectives for the future of oral surgery. In particular, stem cells and growth factors are polarizing the focus of this ever-evolving field, continuously improving standard surgical techniques, and granting access to new approaches.
Collapse
Affiliation(s)
- Giacomo Picciolo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Giuseppe Picciolo
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Alessandro Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| |
Collapse
|
47
|
Tissue Integration and Biological Cellular Response of SLM-Manufactured Titanium Scaffolds. METALS 2020. [DOI: 10.3390/met10091192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: SLM (Selective Laser Melting)–manufactured Titanium (Ti) scaffolds have a significant value for bone reconstructions in the oral and maxillofacial surgery field. While their mechanical properties and biocompatibility have been analysed, there is still no adequate information regarding tissue integration. Therefore, the aim of this study is a comprehensive systematic assessment of the essential parameters (porosity, pore dimension, surface treatment, shape) required to provide the long-term performance of Ti SLM medical implants. Materials and methods: A systematic literature search was conducted via electronic databases PubMed, Medline and Cochrane, using a selection of relevant search MeSH terms. The literature review was conducted using the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Results: Within the total of 11 in vitro design studies, 9 in vivo studies, and 4 that had both in vitro and in vivo designs, the results indicated that SLM-generated Ti scaffolds presented no cytotoxicity, their tissue integration being assured by pore dimensions of 400 to 600 µm, high porosity (75–88%), hydroxyapatite or SiO2–TiO2 coating, and bioactive treatment. The shape of the scaffold did not seem to have significant importance. Conclusions: The SLM technique used to fabricate the implants offers exceptional control over the structure of the base. It is anticipated that with this technique, and a better understanding of the physical interaction between the scaffold and bone tissue, porous bases can be tailored to optimize the graft’s integrative and mechanical properties in order to obtain structures able to sustain osseous tissue on Ti.
Collapse
|
48
|
Jeyachandran P, Bontha S, Bodhak S, Balla VK, Kundu B, Doddamani M. Mechanical behaviour of additively manufactured bioactive glass/high density polyethylene composites. J Mech Behav Biomed Mater 2020; 108:103830. [DOI: 10.1016/j.jmbbm.2020.103830] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
|
49
|
Design and Fabrication of Implants for Mandibular and Craniofacial Defects Using Different Medical-Additive Manufacturing Technologies: A Review. Ann Biomed Eng 2020; 48:2285-2300. [PMID: 32691264 DOI: 10.1007/s10439-020-02567-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
Mandibular and craniofacial bone defects can be caused by trauma, inflammatory disease, and benign or malignant tumors. Patients with bone defects suffer from problems with aesthetics, speech, and mastication, resulting in the need for implants. Conventional methods do not always provide satisfactory results. Most of the techniques proposed by researchers in the field of biomedical engineering use reverse engineering, computer-aided design (CAD), and additive manufacturing (AM), whose implementation can improve the outcomes of reconstructive surgeries. Several literature reviews on this particular topic have been conducted. However, they provide mostly overviews of AM technologies for general biomedical devices. This paper summarizes the use of existing medical AM techniques for the design and fabrication of mandibular and craniofacial implants, and then discusses their advantages and disadvantages in terms of accuracy, costs, energy consumption, and production rate. The aim of this study is to present a comparative review of the most commonly used AM technologies to aid researchers in selecting the best possible AM technologies for medical use. Studies included in this review contain CAD designs of mandibular or cranial implants, as well as their fabrication using AM technologies. Special attention is paid to PolyJet technology, because of its high accuracy, and economical efficiency.
Collapse
|
50
|
Zhang W, Shi W, Wu S, Kuss M, Jiang X, Untrauer JB, Reid SP, Duan B. 3D printed composite scaffolds with dual small molecule delivery for mandibular bone regeneration. Biofabrication 2020; 12:035020. [PMID: 32369796 PMCID: PMC8059098 DOI: 10.1088/1758-5090/ab906e] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Functional reconstruction of craniomaxillofacial defects is challenging, especially for the patients who suffer from traumatic injury, cranioplasty, and oncologic surgery. Three-dimensional (3D) printing/bioprinting technologies provide a promising tool to fabricate bone tissue engineering constructs with complex architectures and bioactive components. In this study, we implemented multi-material 3D printing to fabricate 3D printed PCL/hydrogel composite scaffolds loaded with dual bioactive small molecules (i.e. resveratrol and strontium ranelate). The incorporated small molecules are expected to target several types of bone cells. We systematically studied the scaffold morphologies and small molecule release profiles. We then investigated the effects of the released small molecules from the drug loaded scaffolds on the behavior and differentiation of mesenchymal stem cells (MSCs), monocyte-derived osteoclasts, and endothelial cells. The 3D printed scaffolds, with and without small molecules, were further implanted into a rat model with a critical-sized mandibular bone defect. We found that the bone scaffolds containing the dual small molecules had combinational advantages in enhancing angiogenesis and inhibiting osteoclast activities, and they synergistically promoted MSC osteogenic differentiation. The dual drug loaded scaffolds also significantly promoted in vivo mandibular bone formation after 8 week implantation. This work presents a 3D printing strategy to fabricate engineered bone constructs, which can likely be used as off-the-shelf products to promote craniomaxillofacial regeneration.
Collapse
Affiliation(s)
- Wenhai Zhang
- First Hip Department of Orthopedics, Tianjin Hospital, Tianjin, 300211, China
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Wen Shi
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shaohua Wu
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- College of Textiles & Clothing; Collaborative Innovation Center of Marine Biomass Fibers, Qingdao University, Qingdao, China
| | - Mitchell Kuss
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Xiping Jiang
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- College of Medicine, Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jason B Untrauer
- Division of Oral & Maxillofacial Surgery, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - St Patrick Reid
- College of Medicine, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Mechanical and Materials Engineering, University of Nebraska- Lincoln, Lincoln, NE, USA
| |
Collapse
|