Three-Dimensional Fiber Deposition of Cell-Laden, Viable, Patterned Constructs for Bone Tissue Printing

4D bioprinting of programmed dynamic tissues

Setting time as the fourth dimension, 4D printing allows us to construct dynamic structures that can change their shape, property, or functionality over time under stimuli, leading to a wave of innovations in various fields. Recently, 4D printing of smart biomaterials, biological components, and living cells into dynamic living 3D constructs with 4D effects has led to an exciting field of 4D bioprinting. 4D bioprinting has gained increasing attention and is being applied to create programmed and dynamic cell-laden constructs such as bone, cartilage, and vasculature. This review presents an overview on 4D bioprinting for engineering dynamic tissues and organs, followed by a discussion on the approaches, bioprinting technologies, smart biomaterials and smart design, bioink requirements, and applications. While much progress has been achieved, 4D bioprinting as a complex process is facing challenges that need to be addressed by transdisciplinary strategies to unleash the full potential of this advanced biofabrication technology. Finally, we present future perspectives on the rapidly evolving field of 4D bioprinting, in view of its potential, increasingly important roles in the development of advanced dynamic tissues for basic research, pharmaceutics, and regenerative medicine.

Tribocorrosion of 3D printed dental implants: An overview

With the advancements in dental science and the growing need for improved dental health, it has become imperative to develop new implant materials which possess better geometrical, mechanical, and physical properties. The oral environment is a corrosive environment and the relative motion between the teeth also makes the environment more hostile. Therefore, the combined corrosion and tribology commonly known as tribocorrosion of implants needs to be studied. The complex shapes of the dental implants and the high-performance requirements of these implants make manufacturing difficult by conventional manufacturing processes. With the advent of additive manufacturing or 3D-printing, the development of implants has become easy. However, the various requirements such as surface roughness, mechanical strength, and corrosion resistance further make the manufacturing of implants difficult. The current paper reviews the various studies related to3D-printed implants. Also, the paper tries to highlight the role of 3D-Printing can play in the area of dental implants. Further studies both experimental and numerical are needed to devise optimized conditions for 3D-printing implants to develop implants with improved mechanical, corrosion, and biological properties.

Application of 3D Bioprinting in Liver Diseases

Liver diseases are the primary reason for morbidity and mortality in the world. Owing to a shortage of organ donors and postoperative immune rejection, patients routinely suffer from liver failure. Unlike 2D cell models, animal models, and organoids, 3D bioprinting can be successfully employed to print living tissues and organs that contain blood vessels, bone, and kidney, heart, and liver tissues and so on. 3D bioprinting is mainly classified into four types: inkjet 3D bioprinting, extrusion-based 3D bioprinting, laser-assisted bioprinting (LAB), and vat photopolymerization. Bioinks for 3D bioprinting are composed of hydrogels and cells. For liver 3D bioprinting, hepatic parenchymal cells (hepatocytes) and liver nonparenchymal cells (hepatic stellate cells, hepatic sinusoidal endothelial cells, and Kupffer cells) are commonly used. Compared to conventional scaffold-based approaches, marked by limited functionality and complexity, 3D bioprinting can achieve accurate cell settlement, a high resolution, and more efficient usage of biomaterials, better mimicking the complex microstructures of native tissues. This method will make contributions to disease modeling, drug discovery, and even regenerative medicine. However, the limitations and challenges of this method cannot be ignored. Limitation include the requirement of diverse fabrication technologies, observation of drug dynamic response under perfusion culture, the resolution to reproduce complex hepatic microenvironment, and so on. Despite this, 3D bioprinting is still a promising and innovative biofabrication strategy for the creation of artificial multi-cellular tissues/organs.

Multifunctional GelMA platforms with nanomaterials for advanced tissue therapeutics

Polymeric hydrogels are fascinating platforms as 3D scaffolds for tissue repair and delivery systems of therapeutic molecules and cells. Among others, methacrylated gelatin (GelMA) has become a representative hydrogel formulation, finding various biomedical applications. Recent efforts on GelMA-based hydrogels have been devoted to combining them with bioactive and functional nanomaterials, aiming to provide enhanced physicochemical and biological properties to GelMA. The benefits of this approach are multiple: i) reinforcing mechanical properties, ii) modulating viscoelastic property to allow 3D printability of bio-inks, iii) rendering electrical/magnetic property to produce electro-/magneto-active hydrogels for the repair of specific tissues (e.g., muscle, nerve), iv) providing stimuli-responsiveness to actively deliver therapeutic molecules, and v) endowing therapeutic capacity in tissue repair process (e.g., antioxidant effects). The nanomaterial-combined GelMA systems have shown significantly enhanced and extraordinary behaviors in various tissues (bone, skin, cardiac, and nerve) that are rarely observable with GelMA. Here we systematically review these recent efforts in nanomaterials-combined GelMA hydrogels that are considered as next-generation multifunctional platforms for tissue therapeutics. The approaches used in GelMA can also apply to other existing polymeric hydrogel systems.

Biomaterials in bone and mineralized tissue engineering using 3D printing and bioprinting technologies

This review focuses on recently developed printable biomaterials for bone and mineralized tissue engineering. 3D printing or bioprinting is an advanced technology to design and fabricate complex functional 3D scaffolds, mimicking native tissue forin vivoapplications. We categorized the biomaterials into two main classes: 3D printing and bioprinting. Various biomaterials, including natural, synthetic biopolymers and their composites, have been studied. Biomaterial inks or bioinks used for bone and mineralized tissue regeneration include hydrogels loaded with minerals or bioceramics, cells, and growth factors. In 3D printing, the scaffold is created by acellular biomaterials (biomaterial inks), while in 3D bioprinting, cell-laden hydrogels (bioinks) are used. Two main classes of bioceramics, including bioactive and bioinert ceramics, are reviewed. Bioceramics incorporation provides osteoconductive properties and induces bone formation. Each biopolymer and mineral have its advantages and limitations. Each component of these composite biomaterials provides specific properties, and their combination can ameliorate the mechanical properties, bioactivity, or biological integration of the 3D printed scaffold. Present challenges and future approaches to address them are also discussed.

Investigation of the mechanical properties of a bony scaffold for comminuted distal radial fractures: Addition of akermanite nanoparticles and using a freeze-drying technique

One of the methods of repairing the damaged bone is the fabrication of porous scaffold using synergic methods like three-dimensional (3D) printing and freeze-drying technology. These techniques improve the damaged and fracture parts rapidly for better healing bone lesions using bioactive ceramic and polymer. This research, due to the need to increase the mechanical strength of 3D bone scaffolds for better mechanical performance. Akermanite bioceramic as a bioactive and calcium silicate bioceramic has been used besides the polymeric component. In this study, the porous scaffolds were designed using solid work with an appropriate porosity with a Gyroid shape. The prepared Gyroid scaffold was printed using a 3D printing machine with Electroconductive Polylactic Acid (EC-PLA) and then coated with a polymeric solution containing various amounts of akermanite bioceramic as reinforcement. The mechanical and biological properties were investigated according to the standard test. The mechanical properties of the porous-coated scaffold showed stress tolerance up to 30 MPa. The maximum strain obtained was 0.0008, the maximum stress was 32 MPa and the maximum displacement was 0.006 mm. Another problem of bone implants is the impossibility of controlling bone cancer and tumor size. To solve this problem, an electroconductive filament containing Magnetic Nanoparticles (MNPs) is used to release heat and control cancer cells. The mechanical feature of the porous scaffold containing 10 wt% akermanite was obtained as the highest stress tolerance of about 32 MPa with 46% porosity. Regarding the components and prepare the bony scaffold, the MNPs release heat when insert into the magnetic field and control the tumor size which helps the treatment of cancer. In general, it can be concluded that the produced porous scaffold using 3D printing and freeze-drying technology can be used to replace broken bones with the 3D printed EC-PLA coated with 10 wt% akermanite bioceramic with sufficient mechanical and biological behavior for the orthopedic application.

Bioinks and bioprinting technologies to make heterogeneous and biomimetic tissue constructs

The native tissues are complex structures consisting of different cell types, extracellular matrix materials, and biomolecules. Traditional tissue engineering strategies have not been able to fully reproduce biomimetic and heterogeneous tissue constructs because of the lack of appropriate biomaterials and technologies. However, recently developed three-dimensional bioprinting techniques can be leveraged to produce biomimetic and complex tissue structures. To achieve this, multicomponent bioinks composed of multiple biomaterials (natural, synthetic, or hybrid natural-synthetic biomaterials), different types of cells, and soluble factors have been developed. In addition, advanced bioprinting technologies have enabled us to print multimaterial bioinks with spatial and microscale resolution in a rapid and continuous manner, aiming to reproduce the complex architecture of the native tissues. This review highlights important advances in heterogeneous bioinks and bioprinting technologies to fabricate biomimetic tissue constructs. Opportunities and challenges to further accelerate this research area are also described.

Self-Supporting Nanoclay as Internal Scaffold Material for Direct Printing of Soft Hydrogel Composite Structures in Air

Three dimensional (3D) bioprinting technology enables the freeform fabrication of complex constructs from various hydrogels and is receiving increasing attention in tissue engineering. The objective of this study is to develop a novel self-supporting direct hydrogel printing approach to extrude complex 3D hydrogel composite structures in air without the help of a support bath. Laponite, a member of the smectite mineral family, is investigated to serve as an internal scaffold material for the direct printing of hydrogel composite structures in air. In the proposed printing approach, due to its yield-stress property, Laponite nanoclay can be easily extruded through a nozzle as a liquid and self-supported after extrusion as a solid. Its unique crystal structure with positive and negative charges enables it to be mixed with many chemically and physically cross-linked hydrogels, which makes it an ideal internal scaffold material for the fabrication of various hydrogel structures. By mixing Laponite nanoclay with various hydrogel precursors, the hydrogel composites retain their self-supporting capacity and can be printed into 3D structures directly in air and retain their shapes before cross-linking. Then, the whole structures are solidified in situ by applying suitable cross-linking stimuli. The addition of Laponite nanoclay can effectively improve the mechanical and biological properties of hydrogel composites. Specifically, the addition of Laponite nanoclay results in a significant increase in the Young's modulus of each hydrogel-Laponite composite: 1.9-fold increase for the poly(ethylene glycol) diacrylate (PEGDA)-Laponite composite, 7.4-fold increase for the alginate-Laponite composite, and 3.3-fold increase for the gelatin-Laponite composite.

Advancing the field of 3D biomaterial printing

3D biomaterial printing has emerged as a potentially revolutionary technology, promising to transform both research and medical therapeutics. Although there has been recent progress in the field, on-demand fabrication of functional and transplantable tissues and organs is still a distant reality. To advance to this point, there are two major technical challenges that must be overcome. The first is expanding upon the limited variety of available 3D printable biomaterials (biomaterial inks), which currently do not adequately represent the physical, chemical, and biological complexity and diversity of tissues and organs within the human body. Newly developed biomaterial inks and the resulting 3D printed constructs must meet numerous interdependent requirements, including those that lead to optimal printing, structural, and biological outcomes. The second challenge is developing and implementing comprehensive biomaterial ink and printed structure characterization combined with in vitro and in vivo tissue- and organ-specific evaluation. This perspective outlines considerations for addressing these technical hurdles that, once overcome, will facilitate rapid advancement of 3D biomaterial printing as an indispensable tool for both investigating complex tissue and organ morphogenesis and for developing functional devices for a variety of diagnostic and regenerative medicine applications.

Additive manufacturing of cell-loaded alginate enriched with alkaline phosphatase for bone tissue engineering application

Hydrogels are gaining interest as scaffolds for bone tissue regeneration due to ease of incorporation of cells and biological molecules such as enzymes. Mineralization of hydrogels, desirable for bone tissue regeneration applications, may be achieved enzymatically by incorporation of alkaline phosphatase (ALP). Additive manufacturing techniques such as bioplotting enable the layer-by-layer creation of three-dimensional hydrogel scaffolds with highly defined geometry and internal architecture. In this study, we present a novel method to produce macroporous hydrogel scaffolds in combination with cell-loaded capsule-containing struts by 3D bioplotting. This approach enables loading of the capsules and strut phases with different cells and/or bioactive substances and hence makes compartmentalization within a scaffold possible. 3D porous alginate scaffolds enriched with ALP and MG-63 osteoblast-like cells were produced by bioplotting struts of alginate which were loaded with pre-fabricated alginate capsules. Two combinations were compared, namely ALP in the struts and cells in the capsules and vice-versa. Both combinations were cytocompatible for cells and mineralization of scaffolds could be detected in both cases, according to an OsteoImage staining. ALP had no adverse effect on cytocompatibility and enhanced mitochondrial activity.

Taking a deep look: modern microscopy technologies to optimize the design and functionality of biocompatible scaffolds for tissue engineering in regenerative medicine

This review focuses on modern nonlinear optical microscopy (NLOM) methods that are increasingly being used in the field of tissue engineering (TE) to image tissue non-invasively and without labelling in depths unreached by conventional microscopy techniques. With NLOM techniques, biomaterial matrices, cultured cells and their produced extracellular matrix may be visualized with high resolution. After introducing classical imaging methodologies such as µCT, MRI, optical coherence tomography, electron microscopy and conventional microscopy two-photon fluorescence (2-PF) and second harmonic generation (SHG) imaging are described in detail (principle, power, limitations) together with their most widely used TE applications. Besides our own cell encapsulation, cell printing and collagen scaffolding systems and their NLOM imaging the most current research articles will be reviewed. These cover imaging of autofluorescence and fluorescence-labelled tissue and biomaterial structures, SHG-based quantitative morphometry of collagen I and other proteins, imaging of vascularization and online monitoring techniques in TE. Finally, some insight is given into state-of-the-art three-photon-based imaging methods (e.g. coherent anti-Stokes Raman scattering, third harmonic generation). This review provides an overview of the powerful and constantly evolving field of multiphoton microscopy, which is a powerful and indispensable tool for the development of artificial tissues in regenerative medicine and which is likely to gain importance also as a means for general diagnostic medical imaging.

Bioprinting toward organ fabrication: challenges and future trends

Tissue engineering has been a promising field of research, offering hope for bridging the gap between organ shortage and transplantation needs. However, building three-dimensional (3-D) vascularized organs remains the main technological barrier to be overcome. Organ printing, which is defined as computer-aided additive biofabrication of 3-D cellular tissue constructs, has shed light on advancing this field into a new era. Organ printing takes advantage of rapid prototyping (RP) technology to print cells, biomaterials, and cell-laden biomaterials individually or in tandem, layer by layer, directly creating 3-D tissue-like structures. Here, we overview RP-based bioprinting approaches and discuss the current challenges and trends toward fabricating living organs for transplant in the near future.

Extrusion printed polymer structures: a facile and versatile approach to tailored drug delivery platforms

A novel extrusion printing system was used to create drug delivery structures wherein dexamethasone-21-phosphate disodium salt (Dex21P) was encapsulated within a biodegradable polymer (PLGA) and water soluble poly(vinyl alcohol) (PVA) configurations. The ability to control the drug release profile through the spatial distribution of drug within the printed 3-dimensional structures is demonstrated. The fabricated configurations were characterised by optical microscopy and SEM to evaluate surface morphology. The results clearly demonstrate the successful encapsulation of dexamethasone within a laminated PLGA:PVA structure. The resulting drug release profiles from the structures show a two stage release profile with distinctly different release rates and minimal initial burst release observed. Dexamethasone release was monitored over a 4-month period. This approach clearly demonstrates that the extrusion printing technique provides a facile and versatile approach to fabrication of novel drug delivery platforms.

Aqueous biphasic microprinting approach to tissue engineering

We summarize a recently developed microtechnology for printing biomaterials on biological surfaces. The technique is based on the use of immiscible aqueous solutions of two biopolymers and allows spatially defined placement of cells and biomolecules suspended in the denser aqueous phase on existing cell layers and extracellular matrix hydrogel surfaces maintained in the second phase. Printing takes place due to an extremely small interfacial tension and density difference between the two aqueous phases. The contact-free printing process ensures that both printed cells and the underlying cell monolayer maintain full viability and functionality. The technique accommodates both arbitrarily shaped patterns and microarrays of cells and bioreagents. The capability to print cells and small molecules on existing cell layers enables unique interrogations of the effects of cell-cell and cell-material interaction on cell fate and function. Furthermore, the very gentle conditions and the ability to directly pattern nongel embedded cells over cells make this technology appealing to tissue engineering applications where patterned multicellar organization with minimal scaffolding materials is needed, such as in dense tissues of the skeletal muscle and liver.

Biomatrices and biomaterials for future developments of bioprinting and biofabrication

The next step beyond conventional scaffold-based tissue engineering is cell-based direct biofabrication techniques. In industrial processes, various three-dimensional (3D) prototype models have been fabricated using several different rapid prototyping methods, such as stereo-lithography, 3D printing and laser sintering, as well as others, in which a variety of chemical materials are utilized. However, with direct cell-based biofabrication, only biocompatible materials can be used, and the manufacturing process must be performed under biocompatible and physiological conditions. We have developed a direct 3D cell printing system using inkjet and gelation techniques with inkjet droplets, and found that it had good potential to construct 3D structures with multiple types of cells. With this system, we have used alginate and fibrin hydrogel materials, each of which has advantages and disadvantages. Herein, we discuss the roles of hydrogel for biofabrication and show that further developments in biofabrication technology with biomatrices will play a major part, as will developments in manufacturing technology. It is important to explore suitable biomatrices as the next key step in biofabrication techniques.