Melt Electrospinning and Its Technologization in Tissue Engineering

Advances in natural and synthetic macromolecules with stem cells and extracellular vesicles for orthopedic disease treatment

Serious orthopedic disorders resulting from myriad diseases and impairments continue to pose a considerable challenge to contemporary clinical care. Owing to its limited regenerative capacity, achieving complete bone tissue regeneration and complete functional restoration has proven challenging with existing treatments. By virtue of cellular regenerative and paracrine pathways, stem cells are extensively utilized in the restoration and regeneration of bone tissue; however, low survival and retention after transplantation severely limit their therapeutic effect. Meanwhile, biomolecule materials provide a delivery platform that improves stem cell survival, increases retention, and enhances therapeutic efficacy. In this review, we present the basic concepts of stem cells and extracellular vesicles from different sources, emphasizing the importance of using appropriate expansion methods and modification strategies. We then review different types of biomolecule materials, focusing on their design strategies. Moreover, we summarize several forms of biomaterial preparation and application strategies as well as current research on biomacromolecule materials loaded with stem cells and extracellular vesicles. Finally, we present the challenges currently impeding their clinical application for the treatment of orthopedic diseases. The article aims to provide researchers with new insights for subsequent investigations.

Recent advances in additive manufacturing of patient-specific devices for dental and maxillofacial rehabilitation

OBJECTIVES

Customization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties.

METHODS

This paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018-2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages.

RESULTS

The recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported.

SIGNIFICANCE

Additive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry.

Electrospinning technologies for the delivery of Biopharmaceuticals: Current status and future trends

This review provides an in-depth exploration of electrospinning techniques employed to produce micro- or nanofibres of biopharmaceuticals using polymeric solutions or melts with high-voltage electricity. Distinct from prior reviews, the current work narrows its focus on the recent developments and advanced applications in biopharmaceutical formulations. It begins with an overview of electrospinning principles, covering both solution and melt modes. Various methods for incorporating biopharmaceuticals into electrospun fibres, such as surface adsorption, blending, emulsion, co-axial, and high-throughput electrospinning, are elaborated. The review also surveys a wide array of biopharmaceuticals formulated through electrospinning, thereby identifying both opportunities and challenges in this emerging field. Moreover, it outlines the analytical techniques for characterizing electrospun fibres and discusses the legal and regulatory requirements for their production. This work aims to offer valuable insights into the evolving realm of electrospun biopharmaceutical delivery systems.

Facile Adaptation of a Fused Deposition Modeling 3D Printer to Motionless Printing through Programmable Electric Relay: Discretized Modeling and Experiments

In this study, a fused deposition modeling 3D printer is modified into a motionless printer, which has the potential to print patterns in a noiseless manner possibly with improved resolution and in less delay time by eliminating the movement of nozzle or collector. In this motionless 3D printer, both nozzle and collector are fixed, whereas the extruded polymer melt is driven by high-voltage switching points on the collector. By this approach, simple 3D patterns such as multilayer circles, squares, and walls have been printed using two polymer melts with different rheological properties, high-temperature polylactic acid and acrylonitrile butadiene styrene. Furthermore, a discretized, nonisothermal bead and spring model is developed to probe printing patterns. The effect of parameters, such as number of conducting points, switching time, voltage and material properties on the accuracy of the printed simple 3D patterns, are thoroughly studied, and we demonstrated that various fiber collection patterns obtained from the experiments are favorably compared with the simulation results.

Highly compliant biomimetic scaffolds for small diameter tissue-engineered vascular grafts (TEVGs) produced via melt electrowriting (MEW)

Biofabrication approaches toward the development of tissue-engineered vascular grafts (TEVGs) have been widely investigated. However, successful translation has been limited to large diameter applications, with small diameter grafts frequently failing due to poor mechanical performance, in particular mismatched radial compliance. Herein, melt electrowriting (MEW) of poly(ϵ-caprolactone) has enabled the manufacture of highly porous, biocompatible microfibre scaffolds with physiological anisotropic mechanical properties, as substrates for the biofabrication of small diameter TEVGs. Highly reproducible scaffolds with internal diameter of 4.0 mm were designed with 500 and 250µm pore sizes, demonstrating minimal deviation of less than 4% from the intended architecture, with consistent fibre diameter of 15 ± 2µm across groups. Scaffolds were designed with straight or sinusoidal circumferential microfibre architecture respectively, to investigate the influence of biomimetic fibre straightening on radial compliance. The results demonstrate that scaffolds with wave-like circumferential microfibre laydown patterns mimicking the architectural arrangement of collagen fibres in arteries, exhibit physiological compliance (12.9 ± 0.6% per 100 mmHg), while equivalent control geometries with straight fibres exhibit significantly reduced compliance (5.5 ± 0.1% per 100 mmHg). Further mechanical characterisation revealed the sinusoidal scaffolds designed with 250µm pores exhibited physiologically relevant burst pressures of 1078 ± 236 mmHg, compared to 631 ± 105 mmHg for corresponding 500µm controls. Similar trends were observed for strength and failure, indicating enhanced mechanical performance of scaffolds with reduced pore spacing. Preliminaryin vitroculture of human mesenchymal stem cells validated the MEW scaffolds as suitable substrates for cellular growth and proliferation, with high cell viability (>90%) and coverage (>85%), with subsequent seeding of vascular endothelial cells indicating successful attachment and preliminary endothelialisation of tissue-cultured constructs. These findings support further investigation into long-term tissue culture methodologies for enhanced production of vascular extracellular matrix components, toward the development of the next generation of small diameter TEVGs.

Effects of Six Processing Parameters on the Size of PCL Fibers Prepared by Melt Electrospinning Writing

Melt electrospinning writing is a new and promising method for fabricating micro/nanofibers, which has shown great prospects in the biomedical fields such as 3D printing of porous scaffolds. The diameter of the melt electrospinning writing fiber can determine the resolution of the microstructure; thus, the controllability of the fiber diameter is of great significance to the whole fabrication process. In this paper, an orthogonal design experiment (six factors, three levels) was used to explore the impacts of six melt electrospinning parameters (melt temperature, collector speed, tip-to-collector distance, melt flow rate, voltage, and needle gauge) on the fiber diameter. In this experiment, the diameter of fibers obtained with the designed experimental parameters and conditions varied from 10.30 μm to 20.02 μm. The range analysis of orthogonal test results showed that the melt flow rate was the most important factor influencing the diameter of melt electrospinning writing fiber, while the voltage was the least influential factor. The variance analysis of orthogonal test results showed that melt temperature, collector velocity, tip-to-collector distance and melt flow rate had a significant influence on the diameter of melt electrospinning writing fiber. On the basis of the first-order regression equation, the fiber diameter of poly-ε-caprolactone can be accurately controlled, thus improving the engineering applications of poly-ε-caprolactone.

Extracellular Matrix-Based and Electrospun Scaffolding Systems for Vaginal Reconstruction

Congenital vaginal anomalies and pelvic organ prolapse affect different age groups of women and both have significant negative impacts on patients' psychological well-being and quality of life. While surgical and non-surgical treatments are available for vaginal defects, their efficacy is limited, and they often result in long-term complications. Therefore, alternative treatment options are urgently needed. Fortunately, tissue-engineered scaffolds are promising new treatment modalities that provide an extracellular matrix (ECM)-like environment for vaginal cells to adhere, secrete ECM, and be remodeled by host cells. To this end, ECM-based scaffolds or the constructs that resemble ECM, generated by self-assembly, decellularization, or electrospinning techniques, have gained attention from both clinicians and researchers. These biomimetic scaffolds are highly similar to the native vaginal ECM and have great potential for clinical translation. This review article aims to discuss recent applications, challenges, and future perspectives of these scaffolds in vaginal reconstruction or repair strategies.

Electrospun nanofibres in drug delivery: advances in controlled release strategies

Emerging drug-delivery systems demand a controlled or programmable or sustained release of drug molecules to improve therapeutic efficacy and patient compliance. Such systems have been heavily investigated as they offer safe, accurate, and quality treatment for numerous diseases. Amongst newly developed drug-delivery systems, electrospun nanofibres have emerged as promising drug excipients and are coming up as promising biomaterials. The inimitable characteristics of electrospun nanofibres in terms of their high surface-to-volume ratio, high porosity, easy drug encapsulation, and programmable release make them an astounding drug-delivery vehicle.

Antioxidant and Antimicrobial Properties of Hydrolysed Collagen Nanofibers Loaded with Ginger Essential Oil

Hydrolysed collagen obtained from bovine leather by-products were loaded with ginger essential oil and processed by the electrospinning technique for obtaining bioactive nanofibers. Particle size measurements of hydrolysed collagen, GC-MS analysis of ginger essential oil (EO), and structural and SEM examinations of collagen nanofibers loaded with ginger essential oil collected on waxed paper, cotton, and leather supports were performed. Antioxidant and antibacterial activities against Staphylococcus aureus and Escherichia coli and antifungal activity against Candida albicans were also determined. Data show that the hydrolysed collagen nanofibers loaded with ginger EO can be used in the medical, pharmaceutical, cosmetic, or niche fields.

Unveiling the potential of melt electrowriting in regenerative dental medicine

For nearly three decades, tissue engineering strategies have been leveraged to devise effective therapeutics for dental, oral, and craniofacial (DOC) regenerative medicine and treat permanent deformities caused by many debilitating health conditions. In this regard, additive manufacturing (AM) allows the fabrication of personalized scaffolds that have the potential to recapitulate native tissue morphology and biomechanics through the utilization of several 3D printing techniques. Among these, melt electrowriting (MEW) is a versatile direct electrowriting process that permits the development of well-organized fibrous constructs with fiber resolutions ranging from micron to nanoscale. Indeed, MEW offers great prospects for the fabrication of scaffolds mimicking tissue specificity, healthy and pathophysiological microenvironments, personalized multi-scale transitions, and functional interfaces for tissue regeneration in medicine and dentistry. Excitingly, recent work has demonstrated the potential of converging MEW with other AM technologies and/or cell-laden scaffold fabrication (bioprinting) as a favorable route to overcome some of the limitations of MEW for DOC tissue regeneration. In particular, such convergency fabrication strategy has opened great promise in terms of supporting multi-tissue compartmentalization and predetermined cell commitment. In this review, we offer a critical appraisal on the latest advances in MEW and its convergence with other biofabrication technologies for DOC tissue regeneration. We first present the engineering principles of MEW and the most relevant design aspects for transition from flat to more anatomically relevant 3D structures while printing highly-ordered constructs. Secondly, we provide a thorough assessment of contemporary achievements using MEW scaffolds to study and guide soft and hard tissue regeneration, and draw a parallel on how to extrapolate proven concepts for applications in DOC tissue regeneration. Finally, we offer a combined engineering/clinical perspective on the fabrication of hierarchically organized MEW scaffold architectures and the future translational potential of site-specific, single-step scaffold fabrication to address tissue and tissue interfaces in dental, oral, and craniofacial regenerative medicine. STATEMENT OF SIGNIFICANCE: Melt electrowriting (MEW) techniques can further replicate the complexity of native tissues and could be the foundation for novel personalized (defect-specific) and tissue-specific clinical approaches in regenerative dental medicine. This work presents a unique perspective on how MEW has been translated towards the application of highly-ordered personalized multi-scale and functional interfaces for tissue regeneration, targeting the transition from flat to anatomically-relevant three-dimensional structures. Furthermore, we address the value of convergence of biofabrication technologies to overcome the traditional manufacturing limitations provided by multi-tissue complexity. Taken together, this work offers abundant engineering and clinical perspectives on the fabrication of hierarchically MEW architectures aiming towards site-specific implants to address complex tissue damage in regenerative dental medicine.

Establishment of a bi-layered tissue engineered conjunctiva using a 3D-printed melt electrowritten poly-(ε-caprolactone) scaffold

PURPOSE

To utilize melt electrowriting (MEW) technology using poly-(ε-caprolactone) (PCL) coupled with a 2-step co-culturing strategy for the development of a conjunctival bi-layer synthetic construct.

METHODS

Melt electrowritten scaffolds using PCL were fabricated using an in-house-built MEW printer. Human conjunctival stromal cells (CjSCs) and epithelial cells (CjECs) were isolated from donor tissue. A 2-step co-culture method was done by first seeding the CjSCs and culturing for 4 weeks to establish a stromal layer, followed by CjECs and co-culturing for 2 more weeks. Cultured cells were each characterized by morphology and marker expression on immunofluorescence and qPCR. The produced construct was assessed for cellular proliferation using viability assays. The bi-layer morphology was assessed using scanning electron microscopy (SEM), confocal microscopy, and immunofluorescence imaging. The expression of extracellular matrix components and TGF-b was evaluated using qPCR.

RESULTS

CjSCs were spindle-shaped and vimentin + while CjECs were polygonal and CK13 + . CjSCs showed consistent proliferation and optimal adherence with the scaffold at the 4-week culture mark. A 2-layered construct consisting of a CjSC-composed stromal layer and a CjEC-composed epithelial layer was appreciated on confocal microscopy, SEM, and immunofluorescence. CjSCs secreted collagens (types I, V, VI) but at differing amounts from natural tissue while TGF-b production was comparable.

CONCLUSION

The 3D-printed melt electrowritten PCL scaffold paired with the 2-step co-culturing conditions of the scaffold allowed for the first approximation of a bi-layered stromal and epithelial reconstruction of the conjunctiva that can potentially improve the therapeutic arsenal in ocular surface reconstruction.

Electrospinning vs. Electro-Assisted Solution Blow Spinning for Fabrication of Fibrous Scaffolds for Tissue Engineering

Biodegradable polymeric fibrous non-woven materials are widely used type of scaffolds for tissue engineering. Their morphology and properties could be controlled by composition and fabrication technology. This work is aimed at development of fibrous scaffolds from a multicomponent polymeric system containing biodegradable synthetic (polylactide, polycaprolactone) and natural (gelatin, chitosan) components using different methods of non-woven mats fabrication: electrospinning and electro-assisted solution blow spinning. The effect of the fabrication technique of the fibrous materials onto their morphology and properties, including the ability to support adhesion and growth of cells, was evaluated. The mats fabricated using electrospinning technology consist of randomly oriented monofilament fibers, while application of solution blow spinning gave a rise to chaotically arranged multifilament fibers. Cytocompatibility of all fabricated fibrous mats was confirmed using in vitro analysis of metabolic activity, proliferative capacity and morphology of NIH 3T3 cell line. Live/Dead assay revealed the formation of the highest number of cell-cell contacts in the case of multifilament sample formed by electro-assisted solution blow spinning technology.

Design, Fabrication, and Application of Mini-Scaffolds for Cell Components in Tissue Engineering

The concept of "lockyballs" or interlockable mini-scaffolds fabricated by two-photon polymerization from biodegradable polymers for the encagement of tissue spheroids and their delivery into the desired location in the human body has been recently introduced. In order to improve control of delivery, positioning, and assembly of mini-scaffolds with tissue spheroids inside, they must be functionalized. This review describes the design, fabrication, and functionalization of mini-scaffolds as well as perspectives on their application in tissue engineering for precisely controlled cell and mini-tissue delivery and patterning. The development of functionalized mini-scaffolds advances the original concept of "lockyballs" and opens exciting new prospectives for mini-scaffolds' applications in tissue engineering and regenerative medicine and their eventual clinical translation.

Melt Electrospinning Writing of Mesh Implants for Pelvic Organ Prolapse Repair

Over the past decade, melt electrospinning writing has attracted renewed attention. When combined with three-dimensional (3D) printing capabilities, complex 3D structures can be produced, from ultrafine fibers in the absence of toxic solvents, making it particularly attractive to fabricate customized scaffolds and implants for medical applications. This research aimed to develop novel less stiff vaginal mesh implants for pelvic organ prolapse (POP) repair, matching the physiological biomechanics of vaginal tissues. The main objectives, to attain that goal, were: development of a melt electrospinning writing prototype, with additive manufacturing capability, to produce complex structures from micrometer scale fibers, in a direct 3D printing mode; and design and validate new concepts of biodegradable meshes/scaffolds with new geometries, for POP repair. The melt electrospinning writing prototype was built based on different modules. Biodegradable polycaprolactone was used to produce novel implants: three geometries and two fiber configurations were employed. The commercially available Restorelle® (Coloplast) mesh was used as a benchmark. Printed implants were analyzed via scanning electron microscopy (SEM) and uniaxial tensile testing. The SEM images showed that the geometry is generally well produced; however, some minor deviations are visible due to charge interactions. The tensile test results indicated that, regardless of the geometry, the samples showed an elastic behavior for smaller displacements; aplastic behavior dominates later stages. In the physiological range of deformation, the novel meshes (80 μm fiber diameter) matched the tissue properties (p > 0.05). The Restorelle mesh was significantly stiffer than vaginal tissue (p < 0.05) and novel meshes. The precision of the various geometrical patterns and fiber diameters produced highlights the success of the designed and built prototype equipment. Results showed that the biodegradable meshes produced are biomechanically more compatible with native tissue than commercial implants.

Texturing Hierarchical Tissues by Gradient Assembling of Microengineered Platelet-Lysates Activated Fibers

The heterogeneity of hierarchical tissues requires designing multipart engineered constructs as suitable tissue replacements. Herein, the incorporation of platelet lysate (PL) within an electrospun fiber core is proposed aiming for the fabrication of functionally graded 3D scaffolds for heterotypic tissues regeneration, such as tendon-to-bone interfaces. First, anisotropic yarns (A-Yarns) and isotropic threads with nanohydroxyapatite (I-Threads/PL@nHAp) are fabricated to recreate the tendon- and bone-microstructures and both incorporated with PL using emulsion electrospinning for a sustained and local delivery of growth factors, cytokines, and chemokines. Biological performance using human adipose-derived stem cells demonstrates that A-Yarns/PL induce a higher expression of scleraxis, a tenogenic-marker, while in I-Threads/PL@nHAp, higher alkaline phosphatase activity and matrix mineralization suggest an osteogenic commitment without the need for biochemical supplementation compared to controls. As a proof-of-concept, functional 3D gradient scaffolds are fabricated using a weaving technique, resulting in 3D textured hierarchical constructs with gradients in composition and topography. Additionally, the precise delivery of bioactive cues together with in situ biophysical features guide the commitment into a phenotypic gradient exhibiting chondrogenic and osteochondrogenic profiles in the interface of scaffolds. Overall, a promising patch solution for the regeneration of tendon-to-bone tissue interface through the fabrication of PL-functional 3D gradient constructs is demonstrated.

Tunable Spun Fiber Constructs in Biomedicine: Influence of Processing Parameters in the Fibers' Architecture

Electrospinning and wet-spinning have been recognized as two of the most efficient and promising techniques for producing polymeric fibrous constructs for a wide range of applications, including optics, electronics, food industry and biomedical applications. They have gained considerable attention in the past few decades because of their unique features and tunable architectures that can mimic desirable biological features, responding more effectively to local demands. In this review, various fiber architectures and configurations, varying from monolayer and core-shell fibers to tri-axial, porous, multilayer, side-by-side and helical fibers, are discussed, highlighting the influence of processing parameters in the final constructs. Additionally, the envisaged biomedical purposes for the examined fiber architectures, mainly focused on drug delivery and tissue engineering applications, are explored at great length.

Fibrous Scaffolds for Muscle Tissue Engineering Based on Touch-Spun Poly(Ester-Urethane) Elastomer

Development of fiber-spinning technologies and materials with proper mechanical properties is highly important for the manufacturing of aligned fibrous scaffolds mimicking structure of the muscle tissues. Here, the authors report touch spinning of a thermoplastic poly(1,4-butylene adipate)-based polyurethane elastomer, obtained via solvent-free polymerization. This polymer possesses a combination of important advantages such as 1) low elastic modulus in the range of a few MPa, 2) good recovery ratio and 3) resilience, 4) processability, 5) nontoxicity, 6) biocompatibility, and 7) biodegradability that makes it suitable for fabrication of structures mimicking extracellular matrix of muscle tissue. Touch spinning allows fast and precise deposition of highly aligned micro- and nano-fibers without use of high voltage. C2C12 myoblasts readily align along soft polymer fibers and demonstrate high viability as well as proliferation that make proposed combination of polymer and fabrication method highly suitable for engineering skeletal muscles.

Pharmaceutical Aspects of Nanocarriers for Smart Anticancer Therapy

Drug delivery to tumor sites using nanotechnology has been demonstrated to overcome the drawbacks of conventional anticancer drugs. Altering the surface shape and geometry of nanocomposites alters their chemical properties, which can confer multiple attributes to nanocarriers for the treatment of cancer and their use as imaging agents for cancer diagnosis. However, heterogeneity and blood flow in human cancer limit the distribution of nanoparticles at the site of tumor tisues. For targeted delivery and controlled release of drug molecules in harsh tumor microenvironments, smart nanocarriers combined with various stimuli-responsive materials have been developed. In this review, we describe nanomaterials for smart anticancer therapy as well as their pharmaceutical aspects including pharmaceutical process, formulation, controlled drug release, drug targetability, and pharmacokinetic or pharmacodynamic profiles of smart nanocarriers. Inorganic or organic-inorganic hybrid nanoplatforms and the electrospinning process have also been briefly described here.

Controlling Topography and Crystallinity of Melt Electrowritten Poly(ɛ-Caprolactone) Fibers

Melt electrowriting (MEW) is an aspiring 3D printing technology with an unprecedented resolution among fiber-based printing technologies. It offers the ability to direct-write predefined designs utilizing a jet of molten polymer to fabricate constructs composed of fibers with diameters of only a few micrometers. These dimensions enable unique construct properties. Poly(ɛ-caprolactone) (PCL), a semicrystalline polymer mainly used for biomedical and life science applications, is the most prominent material for MEW and exhibits excellent printing properties. Despite the wealth of melt electrowritten constructs that have been fabricated by MEW, a detailed investigation, especially regarding fiber analysis on a macro- and microlevel is still lacking. Hence, this study systematically examines the influence of process parameters such as spinneret diameter, feeding pressure, and collector velocity on the diameter and particularly the topography of PCL fibers and sheds light on how these parameters affect the mechanical properties and crystallinity. A correlation between the mechanical properties, crystallite size, and roughness of the deposited fiber, depending on the collector velocity and applied feeding pressure, is revealed. These findings are used to print constructs composed of fibers with different microtopography without affecting the fiber diameter and thus the macroscopic assembly of the printed constructs.

Engineering a 3D bone marrow adipose composite tissue loading model suitable for studying mechanobiological questions

Tissue engineering strategies are widely used to model and study the bone marrow microenvironment in healthy and pathological conditions. Yet, while bone function highly depends on mechanical stimulation, the effects of biomechanical stimuli on the bone marrow niche, specifically on bone marrow adipose tissue (BMAT) is poorly understood due to a lack of representative in vitro loading models. Here, we engineered a BMAT analog made of a GelMA (gelatin methacryloyl) hydrogel/medical-grade polycaprolactone (mPCL) scaffold composite to structurally and biologically mimic key aspects of the bone marrow microenvironment, and exploited an innovative bioreactor to study the effects of mechanical loading. Highly reproducible BMAT analogs facilitated the successful adipogenesis of human mesenchymal bone marrow stem cells. Upon long-term intermittent stimulation (1 Hz, 2 h/day, 3 days/week, 3 weeks) in the novel bioreactor, cellular proliferation and lipid accumulation were similar to unloaded controls, yet there was a significant reduction in the secretion of adipokines including leptin and adiponectin, in line with clinical evidence of reduced adipokine expression following exercise/activity. Ultimately, this innovative loading platform combined with reproducibly engineered BMAT analogs provide opportunities to study marrow physiology in greater complexity as it accounts for the dynamic mechanical microenvironment context.

Genitourinary Tissue Engineering: Reconstruction and Research Models

Tissue engineering is an emerging field of research that initially aimed to produce 3D tissues to bypass the lack of adequate tissues for the repair or replacement of deficient organs. The basis of tissue engineering protocols is to create scaffolds, which can have a synthetic or natural origin, seeded or not with cells. At the same time, more and more studies have indicated the low clinic translation rate of research realised using standard cell culture conditions, i.e., cells on plastic surfaces or using animal models that are too different from humans. New models are needed to mimic the 3D organisation of tissue and the cells themselves and the interaction between cells and the extracellular matrix. In this regard, urology and gynaecology fields are of particular interest. The urethra and vagina can be sites suffering from many pathologies without currently adequate treatment options. Due to the specific organisation of the human urethral/bladder and vaginal epithelium, current research models remain poorly representative. In this review, the anatomy, the current pathologies, and the treatments will be described before focusing on producing tissues and research models using tissue engineering. An emphasis is made on the self-assembly approach, which allows tissue production without the need for biomaterials.

Electrohydrodynamic jet 3D printing in biomedical applications

Electrohydrodynamic Jet 3D Printing (e-jetting) is a promising technique developed from electrospinning, which enables precise fiber deposition in a layer-by-layer fashion with customized designs. Several studies have verified that e-jetted scaffolds were able to support cell attachment, proliferation, and extracellular matrix formation, as well as cell infiltration into the scaffold due to the well-defined pores. Besides, e-jetting has also been combined with other techniques to incorporate biomaterials (e.g., hydrogels and cell spheroids) that could not be e-jetted, to promote the biological performance of the scaffold. In the recent decade, applying e-jetting in the fabrication of tissue-engineered scaffolds has drawn a lot of interest. Moreover, efforts have been put to develop varied scaffolds for some specific biomedical applications such as cartilage, tendon, and blood vessel, which exhibited superior mechanical properties and promoted cell behaviors including cellular alignment and differentiation. This review article also provides the reader with some crucial considerations and major limitations of e-jetting, such as scaffold design, printability of large-scale constructs, applicable biomaterials, and cell behaviors. Overall, this review article expounds on perspectives in the context of development and biomedical applications of this technique. STATEMENT OF SIGNIFICANCE: E-jetting technique is able to produce fibers with diameter in micrometer scale, which has been considered as a promising 3D printing technique. This technique has shown promise for regeneration of tissue engineered scaffolds with well-defined structures, which has been reported to apply in regeneration of different tissue types. The superior controllability of the process endows the feasibility of constructing multi-scale scaffolds with great biological mimicry and cellular infiltration. The incorporation of other biomaterials into the e-jetted networks further reinforces the scope of applications as compared to e-jetted scaffolds only. There is no doubt that e-jetting will be a great tool for tissue engineered scaffolding, and this review article will give overall perspectives in this topic.

Visualization of USPIO-labeled melt-electrowritten scaffolds by non-invasive magnetic resonance imaging

Melt electrowriting (MEW) is a high-resolution fiber-forming technology for the digital fabrication of complex micro-structured scaffolds for tissue engineering, which has convincingly shown its potential in in vitro and in vivo animal studies. The clinical translation of such constructs to the patient requires the capability to visualize them upon implantation with clinically accepted methods such as magnetic resonance imaging (MRI). To this end, this work presents the modification of polycaprolactone (PCL) scaffolds with ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles to render them visualizable by MRI. Composite scaffolds containing up to 0.3 weight % USPIOs were 3D printed by MEW and could be sensitively detected in vitro using T2- and T2*-weighted MRI. At the same time, USPIO incorporation did not affect the usability of PCL for tissue engineering applications as demonstrated by the mechanical and cytocompatibility evaluation. Concentrations up to 0.2% caused small to no decrease in the ultimate tensile strength and Young's modulus. Cytocompatibility tests resulted in excellent cell viability, with proliferating cells adhering to all the scaffolds. This work contributes to the materials library for MEW and opens the possibility of using MRI for longitudinal monitoring of MEW grafts.

Electrospinning of Nanofibrous Membrane and Its Applications in Air Filtration: A Review

Air pollution caused by particulate matter and toxic gases is violating individual’s health and safety. Nanofibrous membrane, being a reliable filter medium for particulate matter, has been extensively studied and applied in the field of air purification. Among the different fabrication approaches of nanofibrous membrane, electrospinning is considered as the most favorable and effective due to its advantages of controllable process, high production efficiency, and low cost. The electrospun membranes, made of different materials and unique structures, exhibit good PM2.5 filtration performance and multi-functions, and are used as masks and filters against PM2.5. This review presents a brief overview of electrospinning techniques, different structures of electrospun nanofibrous membranes, unique characteristics and functions of the fabricated membranes, and summarization of the outdoor and indoor applications in PM filtration.

Biomimetic Tympanic Membrane Replacement Made by Melt Electrowriting

The tympanic membrane (TM) transfers sound waves from the air into mechanical motion for the ossicular chain. This requires a high sensitivity to small dynamic pressure changes and resistance to large quasi-static pressure differences. The TM achieves this by providing a layered structure of about 100µm in thickness, a low flexural stiffness, and a high tensile strength. Chronically infected middle ears require reconstruction of a large area of the TM. However, current clinical treatment can cause a reduction in hearing. With the novel additive manufacturing technique of melt electrowriting (MEW), it is for the first time possible to fabricate highly organized and biodegradable membranes within the dimensions of the TM. Scaffold designs of various fiber composition are analyzed mechanically and acoustically. It can be demonstrated that by customizing fiber orientation, fiber diameter, and number of layers the desired properties of the TM can be met. An applied thin collagen layer seals the micropores of the MEW-printed membrane while keeping the favorable mechanical and acoustical characteristics. The determined properties are beneficial for implantation, closely match those of the human TM, and support the growth of a neo-epithelial layer. This proves the possibilities to create a biomimimetic TM replacement using MEW.

Modeling the printability of photocuring and strength adjustable hydrogel bioink during projection-based 3D bioprinting

As a projection based three-dimensional printing method, digital light processing bioprinting (DLPBP) has higher printing resolution and is suitable for constructing finer structures to mimic tissues when compared to extrusion based bioprinting. However, there is a lack of understanding about printing behavior during DLPBP. Herein, a photo crosslinking theory for ink was established and a specified amount of light absorber was added to control crosslinking depth. Then, a standardized methodology was established to quantitatively evaluate printing resolution using different parameters. Complex biostructures, such as the ear, hand, and heart, were precisely printed after understanding the mechanism. Additionally, the mechanical properties of printed samples were accurately adjusted by changing the hydrogel concentration, as well as the degree of substitution and photocrosslinking time. The tissue types printed were from ultra-soft tissues, such as liver (6-8 kPa) to soft tissue, such as the skin (0.3-0.4 MPa). A branching vessel with cells in a real tensile modulus was printed as a demonstration. After 1 week of culture, proliferation and function of human umbilical vein endothelial cells were characterized. Overall, we made it possible to print a mimic complex tissue with high precision, required physical properties and functionalized living cells.

Reconstruction of Vascular and Urologic Tubular Grafts by Tissue Engineering

Tissue engineering is one of the most promising scientific breakthroughs of the late 20th century. Its objective is to produce in vitro tissues or organs to repair and replace damaged ones using various techniques, biomaterials, and cells. Tissue engineering emerged to substitute the use of native autologous tissues, whose quantities are sometimes insufficient to correct the most severe pathologies. Indeed, the patient’s health status, regulations, or fibrotic scars at the site of the initial biopsy limit their availability, especially to treat recurrence. This new technology relies on the use of biomaterials to create scaffolds on which the patient’s cells can be seeded. This review focuses on the reconstruction, by tissue engineering, of two types of tissue with tubular structures: vascular and urological grafts. The emphasis is on self-assembly methods which allow the production of tissue/organ substitute without the use of exogenous material, with the patient’s cells producing their own scaffold. These continuously improved techniques, which allow rapid graft integration without immune rejection in the treatment of severely burned patients, give hope that similar results will be observed in the vascular and urological fields.

Melt Electrospinning of Polymers: Blends, Nanocomposites, Additives and Applications

Melt electrospinning has been developed in the last decade as an eco-friendly and solvent-free process to fill the gap between the advantages of solution electrospinning and the need of a cost-effective technique for industrial applications. Although the benefits of using melt electrospinning compared to solution electrospinning are impressive, there are still challenges that should be solved. These mainly concern to the improvement of polymer melt processability with reduction of polymer degradation and enhancement of fiber stability; and the achievement of a good control over the fiber size and especially for the production of large scale ultrafine fibers. This review is focused in the last research works discussing the different melt processing techniques, the most significant melt processing parameters, the incorporation of different additives (e.g., viscosity and conductivity modifiers), the development of polymer blends and nanocomposites, the new potential applications and the use of drug-loaded melt electrospun scaffolds for biomedical applications.

Production of Scaffolds Using Melt Electrospinning Writing and Cell Seeding

Melt electrospinning writing (MEW) is a solvent-free fabrication method for making polymer fiber scaffolds with features which include large surface area, high porosity, and controlled deposition of the fibers. These scaffolds are ideal for tissue engineering applications. Here we describe how to produce scaffolds made from poly(ε-caprolactone) using MEW and the seeding of primary human-derived dermal fibroblasts to create cell-scaffold constructs. The same methodology could be used with any number of cell types and MEW scaffold designs.

A multifunctional electrowritten bi-layered scaffold for guided bone regeneration

The guided bone regeneration (GBR) concept has been extensively utilized to treat maxillofacial bone defects in clinical practice. However, the repair efficacy of currently available GBR membranes is often compromised by their limited bone regeneration potential and deficient antibacterial activity. In this study, inspired by the bi-layered structure design of the commonly used Bio-Gide^Ⓡmembrane, we designed and fabricated a new kind of multifunctional bi-layered "GBR scaffold" combining solution electrospinning writing (SEW) and solution electrospinning (SES) techniques using a single SEW printer. Copper-loaded mesoporous silica nanoparticles (Cu@MSNs) were incorporated into the poly(lactic-co-glycolic acid)/gelatin (PLGA/Gel, denoted as PG) fiber matrix to construct a composite PG-Cu@MSNs fibrous scaffold. The obtained GBR scaffold consisted of a loose and porous SEW layer to support and facilitate bone ingrowth, and a dense and compact SES layer to resist non-osteoblast interference. The resulting enhanced mechanical properties, coordinated degradation profile, and facile preparation procedure imparted the composite scaffold with good clinical feasibility. In vitro biological experiments indicate that the PG-Cu@MSNs composite scaffold exhibited favorable osteogenic and antibacterial properties. Furthermore, an in vivo rat periodontal defect model further confirmed the promising bone regeneration efficacy of the PG-Cu@MSNs scaffold. In conclusion, the developed electrowritten Cu@MSNs-incorporated bi-layered scaffold with hierarchical architecture and concurrent osteogenic and antibacterial functions may hold great potential for application in GBR.

Prevascularized Retrievable Hybrid Implant to Enhance Function of Subcutaneous Encapsulated Islets

Replacement of pancreatic β-cells is one of the most promising treatment options for treatment of type 1 diabetes (T1D), even though, toxic immunosuppressive drugs are required. In this study, we aim to deliver allogeneic β-cell therapies without antirejection drugs using a bioengineered hybrid device that contains microencapsulated β-cells inside 3D polycaprolactone (PCL) scaffolds printed using melt electrospin writing (MEW). Mouse β-cell (MIN6) pseudoislets and QS mouse islets are encapsulated in alginate microcapsules, without affecting viability and insulin secretion. Microencapsulated MIN6 cells are then seeded within 3D MEW scaffolds, and these hybrid devices implanted subcutaneously in streptozotocin-treated diabetic NOD/SCID and BALB/c mice. Similar to NOD/SCID mice, blood glucose levels (BGL) are lowered from 30.1 to 4.8 mM in 25-41 days in BALB/c. In contrast, microencapsulated islets placed in prevascularized MEW scaffold 3 weeks after implantation in BALB/c mice normalize BGL (<12 mM) more rapidly, lasting for 60-105 days. The lowering of glucose levels is confirmed by an intraperitoneal glucose tolerance test. Vascularity within the implanted grafts is demonstrated and quantified by 3D-doppler ultrasound, with a linear increase over 4 weeks (r = 0.65). Examination of the device at 5 weeks shows inflammatory infiltrates of neutrophils, macrophages, and B-lymphocytes on the MEW scaffolds, but not on microcapsules, which have infrequent profibrotic walling. In conclusion, we demonstrate the fabrication of an implantable and retrievable hybrid device for vascularization and enhancing the survival of encapsulated islets implanted subcutaneously in an allotransplantation setting without immunosuppression. This study provides proof-of-concept for the application of such devices for human use, but, will require modifications to allow translation to people with T1D. Impact statement The retrievable 3D printed PCL scaffold we have produced promotes vascularization when implanted subcutaneously and allows seeded microencapsulated insulin-producing cells to normalize blood glucose of diabetic mice for at least 2 months, without the need for antirejection drugs to be administered. The scaffold is scalable for possible human use, but will require modification to ensure that normalization of blood glucose levels can be maintained long term.

A Charge-Based Mechanistic Study into the Effects of Process Parameters on Fiber Accumulating Geometry for a Melt Electrohydrodynamic Process

Melt electrohydrodynamic processes, in conjunction with a moveable collector, have promising engineered tissue applications. However, the residual charges within the fibers deteriorate its printing fidelity. To clarify the mechanism through which the residual charges play roles and exclude the confounding effects of collector movement, a stationary printing mode is adopted in which fibers deposit on a stationary collector. Effects of process parameters on generalizable printing outcomes are studied herein. The fiber deposit bears a unique shape signature typified by a central cone surrounded by an outer ring and is characterized by a ratio of its height and base diameter Hdep/Ddep. Results indicate Hdep/Ddep increases with collector temperature and decreases slightly with voltage. Moreover, the steady-state dynamic jet deposition process is recorded and analyzed at different collector temperatures. A charge-based polarization mechanism describing the effect of collector temperature on the fiber accumulating shape is apparent in both initial and steady-state phases of fiber deposition. Therefore, a key outcome of this study is the identification and mechanistic understanding of collector temperature as a tunable process variable that can yield predictable structural outcomes. This may have cross-cutting potential for additive manufacturing process applications such as the melt electrowriting of layered scaffolds.

Melt Electrospinning of Nanofibers from Medical-Grade Poly(ε-Caprolactone) with a Modified Nozzle

Melt electrospun fibers, in general, have larger diameters than normally achieved with solution electrospinning. This study uses a modified nozzle to direct-write melt electrospun medical-grade poly(ε-caprolactone) onto a collector resulting in fibers with the smallest average diameter being 275 ± 86 nm under certain processing conditions. Within a flat-tipped nozzle is a small acupuncture needle positioned so that reduces the flow rate to ≈0.1 µL h^-1 and has the sharp tip protruding beyond the nozzle, into the Taylor cone. The investigations indicate that 1-mm needle protrusion coupled with a heating temperature of 120 °C produce the most consistent, small diameter nanofibers. Using different protrusion distances for the acupuncture needle results in an unstable jet that deposited poor quality fibers that, in turn, affects the next adjacent path. The material quality is notably affected by the direct-writing speed, which became unstable above 10 mm min^-1 . Coupled with a dual head printer, first melt electrospinning, then melt electrowriting could be performed in a single, automated process for the first time. Overall, the approach used here resulted in some of the smallest melt electrospun fibers reported to date and the smallest diameter fibers from a medical-grade degradable polymer using a melt processing technology.

Impact of Apparatus Orientation and Gravity in Electrospinning-A Review of Empirical Evidence

Electrospinning is a versatile fibre fabrication method with applications from textile to tissue engineering. Despite the appearance that the influencing parameters of electrospinning are fully understood, the effect of setup orientation has not been thoroughly investigated. With current burgeoning interest in modified and specialised electrospinning apparatus, it is timely to review the impact of this seldom-considered parameter. Apparatus configuration plays a major role in the morphology of the final product. The primary difference between spinning setups is the degree to which the electrical force and gravitational force contribute. Since gravity is much lower in magnitude when compared with the electrostatic force, it is thought to have no significant effect on the spinning process. But the shape of the Taylor cone, jet trajectory, fibre diameter, fibre diameter distribution, and overall spinning efficiency are all influenced by it. In this review paper, we discuss all these developments and more. Furthermore, because many research groups build their own electrospinning apparatus, it would be prudent to consider this aspect as particular orientations are more suitable for certain applications.

Bioinspired stratified electrowritten fiber-reinforced hydrogel constructs with layer-specific induction capacity for functional osteochondral regeneration

Despite significant advances in osteochondral tissue engineering, it remains challenging to successfully reconstruct native-like complex tissues organized in three-dimension with spatially varying compositional, structural and functional properties. In this contribution, inspired by the gradients in extracellular matrix (ECM) composition and collagen fiber architecture in native osteochondral tissue, we designed and fabricated a tri-layered (superficial cartilage (S), deep cartilage (D) and subchondral bone (B) layer) stratified scaffold in which a mesenchymal stem cell (MSC)-laden gelatin methacrylamide (GelMA) hydrogel with zone-specific growth factor delivery was combined with melt electrowritten triblock polymer of poly(ε-caprolactone) and poly(ethylene glycol) (PCEC) networks with depth-dependent fiber organization. Introducing PCEC fibers into the weak GelMA hydrogel contributed to a significant increase in mechanical strength. In vitro biological experiments indicated that the stratified fiber-reinforced and growth factor-loaded hydrogel construct induced the MSCs to differentiate down both the chondrogenic and osteogenic lineages and that the engineered complex exhibited cellular phenotype and matrix accumulation profiles resembling those of the native tissue. Simultaneous cartilage and subchondral bone regeneration were achieved in vivo by using the tri-layered integrated scaffold. More importantly, the inclusion of the S layer could impart the regenerated cartilage with a more lubricating and wear-resistant surface. These findings suggest that the bioinspired construct mimicking the spatial variations of native osteochondral tissue might serve as a promising candidate to enhance osteochondral regeneration.

An Electroactive Oligo-EDOT Platform for Neural Tissue Engineering

The unique electrochemical properties of the conductive polymer poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) make it an attractive material for use in neural tissue engineering applications. However, inadequate mechanical properties, and difficulties in processing and lack of biodegradability have hindered progress in this field. Here, the functionality of PEDOT:PSS for neural tissue engineering is improved by incorporating 3,4-ethylenedioxythiophene (EDOT) oligomers, synthesized using a novel end-capping strategy, into block co-polymers. By exploiting end-functionalized oligoEDOT constructs as macroinitiators for the polymerization of poly(caprolactone), a block co-polymer is produced that is electroactive, processable, and bio-compatible. By combining these properties, electroactive fibrous mats are produced for neuronal culture via solution electrospinning and melt electrospinning writing. Importantly, it is also shown that neurite length and branching of neural stem cells can be enhanced on the materials under electrical stimulation, demonstrating the promise of these scaffolds for neural tissue engineering.

Human and mouse bones physiologically integrate in a humanized mouse model while maintaining species-specific ultrastructure

Humanized mouse models are increasingly studied to recapitulate human-like bone physiology. While human and mouse bone architectures differ in multiple scales, the extent to which chimeric human-mouse bone physiologically interacts and structurally integrates remains unknown. Here, we identify that humanized bone is formed by a mosaic of human and mouse collagen, structurally integrated within the same bone organ, as shown by immunohistochemistry. Combining this with materials science techniques, we investigate the extracellular matrix of specific human and mouse collagen regions. We show that human-like osteocyte lacunar-canalicular network is retained within human collagen regions and is distinct to that of mouse tissue. This multiscale analysis shows that human and mouse tissues physiologically integrate into a single, functional bone tissue while maintaining their species-specific ultrastructural differences. These results offer an original method to validate and advance tissue-engineered human-like bone in chimeric animal models, which grow to be eloquent tools in biomedical research.

In vivo bone regeneration assessment of offset and gradient melt electrowritten (MEW) PCL scaffolds

BACKGROUND

Biomaterial-based bone tissue engineering represents a promising solution to overcome reduced residual bone volume. It has been previously demonstrated that gradient and offset architectures of three-dimensional melt electrowritten poly-caprolactone (PCL) scaffolds could successfully direct osteoblast cells differentiation toward an osteogenic lineage, resulting in mineralization. The aim of this study was therefore to evaluate the in vivo osteoconductive capacity of PCL scaffolds with these different architectures.

METHODS

Five different calcium phosphate (CaP) coated melt electrowritten PCL pore sized scaffolds: 250 μm and 500 μm, 500 μm with 50% fibre offset (offset.50.50), tri layer gradient 250-500-750 μm (grad.250top) and 750-500-250 μm (grad.750top) were implanted into rodent critical-sized calvarial defects. Empty defects were used as a control. After 4 and 8 weeks of healing, the new bone was assessed by micro-computed tomography and immunohistochemistry.

RESULTS

Significantly more newly formed bone was shown in the grad.250top scaffold 8 weeks post-implantation. Histological investigation also showed that soft tissue was replaced with newly formed bone and fully covered the grad.250top scaffold. While, the bone healing did not happen completely in the 250 μm, offset.50.50 scaffolds and blank calvaria defects following 8 weeks of implantation. Immunohistochemical analysis showed the expression of osteogenic markers was present in all scaffold groups at both time points. The mineralization marker Osteocalcin was detected with the highest intensity in the grad.250top and 500 μm scaffolds. Moreover, the expression of the endothelial markers showed that robust angiogenesis was involved in the repair process.

CONCLUSIONS

These results suggest that the gradient pore size structure provides superior conditions for bone regeneration.

3D Bioprinting in Tissue Engineering for Medical Applications: The Classic and the Hybrid

Three-dimensional (3D) printing, as one of the most popular recent additive manufacturing processes, has shown strong potential for the fabrication of biostructures in the field of tissue engineering, most notably for bones, orthopedic tissues, and associated organs. Desirable biological, structural, and mechanical properties can be achieved for 3D-printed constructs with a proper selection of biomaterials and compatible bioprinting methods, possibly even while combining additive and conventional manufacturing (AM and CM) procedures. However, challenges remain in the need for improved printing resolution (especially at the nanometer level), speed, and biomaterial compatibilities, and a broader range of suitable 3D-printed materials. This review provides an overview of recent advances in the development of 3D bioprinting techniques, particularly new hybrid 3D bioprinting technologies for combining the strengths of both AM and CM, along with a comprehensive set of material selection principles, promising medical applications, and limitations and future prospects.

Melt Electrowriting of Complex 3D Anatomically Relevant Scaffolds

The manufacture of fibrous scaffolds with tailored micrometric features and anatomically relevant three-dimensional (3D) geometries for soft tissue engineering applications remains a great challenge. Melt electrowriting (MEW) is an advanced additive manufacturing technique capable of depositing predefined micrometric fibers. However, it has been so far inherently limited to simple planar and tubular scaffold geometries because of the need to avoid polymer jet instabilities. In this work, we surmount the technical boundaries of MEW to enable the manufacture of complex fibrous scaffolds with simultaneous controlled micrometric and patient-specific anatomic features. As an example of complex geometry, aortic root scaffolds featuring the sinuses of Valsalva were realized. By modeling the electric field strength associated with the MEW process for these constructs, we found that the combination of a conductive core mandrel with a non-conductive 3D printed model reproducing the complex geometry minimized the variability of the electric field thus enabling the accurate deposition of fibers. We validated these findings experimentally and leveraged the micrometric resolution of MEW to fabricate unprecedented fibrous aortic root scaffolds with anatomically relevant shapes and biomimetic microstructures and mechanical properties. Furthermore, we demonstrated the fabrication of patient-specific aortic root constructs from the 3D reconstruction of computed tomography clinical data.

Electrospun nanofibers: A nanotechnological approach for drug delivery and dissolution optimization in poorly water-soluble drugs

Electrospinning is a novel and sophisticated technique for the production of nanofibers with high surface area, extreme porous structure, small pore size, and surface morphologies that make them suitable for biomedical and bioengineering applications, which can provide solutions to current drug delivery issues of poorly water-soluble drugs. Electrospun nanofibers can be obtained through different methods asides from the conventional one, such as coaxial, multi-jet, side by side, emulsion, and melt electrospinning. In general, the application of an electric potential to a polymer solution causes a charged liquid jet that moves downfield to an oppositely charged collector, where the nanofibers are deposited. Plenty of polymers that differ in their origin, degradation character and water affinity are used during the process. Physicochemical properties of the drug, polymer(s), and solvent systems need to be addressed to guarantee successful manufacturing. Therefore, this review summarizes the recent progress in electrospun nanofibers for their use as a nanotechnological tool for dissolution optimization and drug delivery systems for poorly water-soluble drugs.

Advances in Hybrid Fabrication toward Hierarchical Tissue Constructs

The diversity of manufacturing processes used to fabricate 3D implants, scaffolds, and tissue constructs is continuously increasing. This growing number of different applicable fabrication technologies include electrospinning, melt electrowriting, volumetric-, extrusion-, and laser-based bioprinting, the Kenzan method, and magnetic and acoustic levitational bioassembly, to name a few. Each of these fabrication technologies feature specific advantages and limitations, so that a combination of different approaches opens new and otherwise unreachable opportunities for the fabrication of hierarchical cell-material constructs. Ongoing challenges such as vascularization, limited volume, and repeatability of tissue constructs at the resolution required to mimic natural tissue is most likely greater than what one manufacturing technology can overcome. Therefore, the combination of at least two different manufacturing technologies is seen as a clear and necessary emerging trend, especially within biofabrication. This hybrid approach allows more complex mechanics and discrete biomimetic structures to address mechanotransduction and chemotactic/haptotactic cues. Pioneering milestone papers in hybrid fabrication for biomedical purposes are presented and recent trends toward future manufacturing platforms are analyzed.