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Bernadi-Forteza A, Mallon M, Velasco-Gallego C, Cubo-Mateo N. A Systematic Review on the Generation of Organic Structures through Additive Manufacturing Techniques. Polymers (Basel) 2024; 16:2027. [PMID: 39065345 PMCID: PMC11280941 DOI: 10.3390/polym16142027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Additive manufacturing (AM) has emerged as a transformative technology in the fabrication of intricate structures, offering unparalleled adaptability in crafting complex geometries. Particularly noteworthy is its burgeoning significance within the realm of medical prosthetics, owing to its capacity to seamlessly replicate anatomical forms utilizing biocompatible materials. Notably, the fabrication of porous architectures stands as a cornerstone in orthopaedic prosthetic development and bone tissue engineering. Porous constructs crafted via AM exhibit meticulously adjustable pore dimensions, shapes, and porosity levels, thus rendering AM indispensable in their production. This systematic review ventures to furnish a comprehensive examination of extant research endeavours centred on the generation of porous scaffolds through additive manufacturing modalities. Its primary aim is to delineate variances among distinct techniques, materials, and structural typologies employed, with the overarching objective of scrutinizing the cutting-edge methodologies in engineering self-supported stochastic printable porous frameworks via AM, specifically for bone scaffold fabrication. Findings show that most of the structures analysed correspond to lattice structures. However, there is a strong tendency to use organic structures generated by mathematical models and printed using powder bed fusion techniques. However, no work has been found that proposes a self-supporting design for organic structures.
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Affiliation(s)
- Alex Bernadi-Forteza
- Research Group ARIES, Higher Polytechnic School, Nebrija University, 28040 Madrid, Spain; (C.V.-G.); (N.C.-M.)
| | - Michael Mallon
- European Space Research and Technology Centre, European Space Agency, 2201 AZ Noordwijk, The Netherlands;
| | - Christian Velasco-Gallego
- Research Group ARIES, Higher Polytechnic School, Nebrija University, 28040 Madrid, Spain; (C.V.-G.); (N.C.-M.)
| | - Nieves Cubo-Mateo
- Research Group ARIES, Higher Polytechnic School, Nebrija University, 28040 Madrid, Spain; (C.V.-G.); (N.C.-M.)
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Matschke J, Farahzadi S, Sembdner P, Holtzhausen S, Kroschwald L, Korn P, Schröder TA, Keil C, Paetzold-Byhain K, Lauer G, Franke A. A cross-sectional study of the anatomy of the jaws of a central-European caucasian population using cone beam computer tomography as a prerequisite for designing pre-formed calcium phosphate cement scaffolds. Ann Anat 2024; 254:152270. [PMID: 38679148 DOI: 10.1016/j.aanat.2024.152270] [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: 02/20/2024] [Revised: 04/04/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE This study aims to measure the cortical and cancellous bone thickness in the upper and lower jaws, serving as a data template for developing pre-defined calcium phosphate cement primary implant forms. These measurements are crucial for creating a biphasic scaffold. METHODS Forty complete jaws were assessed for cortical bone shape and thickness using statistical analysis and specific software tools. Sex and age were considered, and four groups were created. RESULTS The cumulative thickness of the cortical layer varied from region to region. In both the upper and lower jaws, the cortical layer in the molar region was significantly thicker than in the frontal region. Within the alveolar process, cortical thickness increases with distance from the alveolar crest on both sides. The oral side of the lower jaw is significantly thicker than the vestibular side. For the upper jaw, no significant differences between the oral and vestibular sides were found in this study. Additionally, it is noteworthy that men have a significantly thicker cortical layer than women. Regarding age, no significant overall differences were found. CONCLUSION Mathematical analysis of anatomical forms using polynomial functions improves understanding of jaw anatomy. This approach facilitates the design of patient-specific scaffold structures, minimizing the need for costly and time-consuming planning and enabling more efficient implementation of optimal therapy.
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Affiliation(s)
- Jan Matschke
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany.
| | - Samaneh Farahzadi
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, Dresden 01062, Germany
| | - Stefan Holtzhausen
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, Dresden 01062, Germany
| | - Lysann Kroschwald
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Paula Korn
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Tom Alexander Schröder
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Christiane Keil
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany; Department of Orthodontics, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Kristin Paetzold-Byhain
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, Dresden 01062, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
| | - Adrian Franke
- Department of Oral and Maxillofacial Surgery, University Hospital "Carl Gustav Carus" Dresden, Technische Universität Dresden, Dresden 01307, Germany
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Huang X, Lou Y, Duan Y, Liu H, Tian J, Shen Y, Wei X. Biomaterial scaffolds in maxillofacial bone tissue engineering: A review of recent advances. Bioact Mater 2024; 33:129-156. [PMID: 38024227 PMCID: PMC10665588 DOI: 10.1016/j.bioactmat.2023.10.031] [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: 08/28/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Maxillofacial bone defects caused by congenital malformations, trauma, tumors, and inflammation can severely affect functions and aesthetics of maxillofacial region. Despite certain successful clinical applications of biomaterial scaffolds, ideal bone regeneration remains a challenge in maxillofacial region due to its irregular shape, complex structure, and unique biological functions. Scaffolds that address multiple needs of maxillofacial bone regeneration are under development to optimize bone regeneration capacity, costs, operational convenience. etc. In this review, we first highlight the special considerations of bone regeneration in maxillofacial region and provide an overview of the biomaterial scaffolds for maxillofacial bone regeneration under clinical examination and their efficacy, which provide basis and directions for future scaffold design. Latest advances of these scaffolds are then discussed, as well as future perspectives and challenges. Deepening our understanding of these scaffolds will help foster better innovations to improve the outcome of maxillofacial bone tissue engineering.
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Affiliation(s)
- Xiangya Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yaxin Lou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yihong Duan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jun Tian
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Elrawdy AM, Amer ME, Algariah AK, Eid MH, Abu-Elsaoud AM, Ghoneim MM. Appraisal of the Accuracy and Reliability of Cone-Beam Computed Tomography and Three-Dimensional Printing for Volumetric Mandibular Condyle Measurements of a Human Condyle. Cureus 2023; 15:e46746. [PMID: 38022326 PMCID: PMC10631571 DOI: 10.7759/cureus.46746] [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] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study aims to evaluate the accuracy of volumetric measurements of three-dimensional (3D)-printed human condyles from cone-beam computed tomography (CBCT) in comparison to physical condyles using a water displacement test. Methodology A sample of 22 dry condyles was separated from the mandibular body by disc, mounted on a base made of casting wax, and scanned using the SCANORA (Scanora 3DX, Soredex, Finland) CBCT scanner. Subsequently, the projection data were reconstructed with the machine-dedicated OnDemand 3D (Cybermed Co., Seoul, Korea). The Standard Tessellation Language file was prepared for 3D printing using chitubox slicing software v1.9.1. Frozen water-washable gray resin was used for 3D printing. All condyles were printed using the same parameters and the same resin. The volumetric measurements were then performed using a customized modified pycnometer based on water volume and weight displacement. Volumetric measures were performed for both the physical human condyles and the 3D-printed replicas and the measurements were then compared. Results The volume of dry condyles using the water displacement method showed an average (±SD) of 1.925 ± 0.40 cm3. However, the volume of 3D-printed replicas using the water displacement method showed an average (±SD) of 2.109 ± 0.40 cm3. The differences in measurements were insignificant (p > 0.05), as revealed by an independent t-test. Conclusions Highly precise, accurate, and reliable CBCT for volumetric mandibular condyle was applied for measurements of a human condyle and 3D-printed replica. The modified pycnometer for volumetric measurements presented an excellent volumetric measure based on a simple water displacement device. The tested modified pycnometer can be applied in volumetric measurements in both 3D-printed and mandibular condyle. For best accuracy, the highest scanning resolution possible should be used. As it directly handles irregularly shaped solid objects in a non-destructive manner with a high level of precision and reliability, this 3D scanning approach may be seen as a superior alternative to the current measurement methods.
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Affiliation(s)
- Ahmed M Elrawdy
- Department of Oral Radiology, Suez Canal University, Faculty of Dentistry, Ismailia, EGY
| | - Mohamed E Amer
- Department of Orthodontics, Zagazig University, Faculty of Dentistry, Zagazig, EGY
| | - Ahmed K Algariah
- Department of Orthodontics, Sinai University, Faculty of Dentistry, Ismailia, EGY
| | - Mohamed H Eid
- Department of Oral and Maxillofacial Surgery, Suez Canal University, Faculty of Dentistry, Ismailia, EGY
| | - Abdelghafar M Abu-Elsaoud
- Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
- Faculty of Science, Suez Canal University, Ismailia, EGY
| | - Mohamed M Ghoneim
- Department of Oral and Maxillofacial Surgery, Sinai University, Faculty of Dentistry, El-Arish, EGY
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Schulz MC, Holtzhausen S, Nies B, Heinemann S, Muallah D, Kroschwald L, Paetzold-Byhain K, Lauer G, Sembdner P. Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation—A New Method for Regeneration. J Pers Med 2023; 13:jpm13030464. [PMID: 36983646 PMCID: PMC10058839 DOI: 10.3390/jpm13030464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
For sinus grafting, different methods and materials are available. One possible shortcoming of particulate bone grafts is either overfilling or augmenting the planned implant area insufficiently. To overcome this risk and to determine the implant position prior augmentation, we present an approach using three-dimensional printed scaffolds. A patient with a remaining anterior dentition and bilateral severely atrophied posterior maxilla was seeking oral rehabilitation. The cone beam computed tomography (CBCT) showed residual bone heights between one and two millimeters. Following the three-dimensional reconstruction of the CBCT data, the positions of the implants were determined in areas 16 and 26. Three-dimensional scaffolds adapted to the topography of the sinus were virtually designed and printed using a calcium phosphate cement paste. Bilateral sinus floor augmentation applying the printed scaffolds with an interconnecting porosity followed. After nine months, a satisfying integration of the scaffolds was obvious. At the re-entry, vital bone with sufficient blood supply was found. One implant could be placed in positions 16 and 26, respectively. After five months, the implants could be uncovered and were provided with a temporary denture. The application of three-dimensionally printed scaffolds from calcium phosphate cement paste seems to be a promising technique to graft the severely atrophied posterior maxilla for the placement of dental implants.
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Affiliation(s)
- Matthias C. Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Correspondence: ; Tel.: +49-7071-2986-174
| | - Stefan Holtzhausen
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Berthold Nies
- INNOTERE GmbH, Meissner Str. 191, 01445 Radebeul, Germany
| | | | - David Muallah
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Lysann Kroschwald
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Kristin Paetzold-Byhain
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Chair of Virtual Product Development, Technische Universität Dresden, 01062 Dresden, Germany
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Kilian D, Holtzhausen S, Groh W, Sembdner P, Czichy C, Lode A, Stelzer R, Gelinsky M. 3D extrusion printing of density gradients by variation of sinusoidal printing paths for tissue engineering and beyond. Acta Biomater 2023; 158:308-323. [PMID: 36563775 DOI: 10.1016/j.actbio.2022.12.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022]
Abstract
During extrusion printing of pasty biomaterials, internal geometries are mainly adjusted by positioning of straightly deposited strands which does not allow realization of spatially adaptable density gradients in x-, y- and z-direction for anisotropic scaffolds or anatomically shaped constructs. Herein, an alternative concept for printing patterns based on sinusoidal curves was evaluated using a clinically approved calcium phosphate cement (CPC). Infill density in scaffolds was adjusted by varying wavelength and amplitude of a sinus curve. Both wavelength and amplitude factors were defined by multitudes of the applied nozzle diameter. For CPC as a biomaterial ink in bone application, porosity, mechanical stiffness and biological response by seeded immortalized human mesenchymal stem cells - adhesion and pore bridging behavior - were investigated. The internal structure of a xyz-gradient scaffold was proven via X-ray based micro computed tomography (µCT). Silicone was used as a model material to investigate the impact of printing velocity and strand distance on the shape fidelity of the sinus pattern for soft matter printing. The impact of different sinus patterns on mechanical properties was assessed. Density and mechanical properties of CPC scaffolds were successfully adjusted without an adverse effect on adhesion and cell number development. In a proof-of-concept experiment, a sinus-adjusted density gradient in an anatomically shaped construct (human vertebral body) defined via clinical computed tomography (CT) data was demonstrated. This fills a technological gap for extrusion-based printing of freely adjustable, continuously guidable infill density gradients in all spatial directions. STATEMENT OF SIGNIFICANCE: 3D extrusion printing of biomaterials allows the generation of anatomically shaped, patient-specific implants or tissue engineering scaffolds. The density of such a structure is typically adjusted by the strand-to-strand distance of parallel, straight-meandered strands in each deposited layer. By printing in a sinusoidal pattern, design of density gradients is possible with a free, spatial resolution in x-, y- and z-direction. We demonstrated that porosity and mechanical properties can be freely adapted in this way without an adverse effect on cell adhesion. With the example of a CT dataset of a human spine, the anisotropic pattern of a vertebral body was resembled by this printing technique that can be translated to various patterns, materials and application.
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Affiliation(s)
- David Kilian
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Holtzhausen
- Institute of Machine Elements and Machine Design, Faculty of Mechanical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Wolfram Groh
- Institute of Machine Elements and Machine Design, Faculty of Mechanical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Philipp Sembdner
- Institute of Machine Elements and Machine Design, Faculty of Mechanical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Charis Czichy
- Chair of Magnetofluiddynamics, Measuring and Automation Technology, Technische Universität Dresden, Dresden, Germany
| | - Anja Lode
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ralph Stelzer
- Institute of Machine Elements and Machine Design, Faculty of Mechanical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Michael Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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Dairaghi J, Benito Alston C, Cadle R, Rogozea D, Solorio L, Barco CT, Moldovan NI. A dual osteoconductive-osteoprotective implantable device for vertical alveolar ridge augmentation. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2022.1066501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Repair of large oral bone defects such as vertical alveolar ridge augmentation could benefit from the rapidly developing additive manufacturing technology used to create personalized osteoconductive devices made from porous tricalcium phosphate/hydroxyapatite (TCP/HA)-based bioceramics. These devices can be also used as hydrogel carriers to improve their osteogenic potential. However, the TCP/HA constructs are prone to brittle fracture, therefore their use in clinical situations is difficult. As a solution, we propose the protection of this osteoconductive multi-material (herein called “core”) with a shape-matched “cover” made from biocompatible poly-ɛ-caprolactone (PCL), which is a ductile, and thus more resistant polymeric material. In this report, we present a workflow starting from patient-specific medical scan in Digital Imaging and Communications in Medicine (DICOM) format files, up to the design and 3D printing of a hydrogel-loaded porous TCP/HA core and of its corresponding PCL cover. This cover could also facilitate the anchoring of the device to the patient's defect site via fixing screws. The large, linearly aligned pores in the TCP/HA bioceramic core, their sizes, and their filling with an alginate hydrogel were analyzed by micro-CT. Moreover, we created a finite element analysis (FEA) model of this dual-function device, which permits the simulation of its mechanical behavior in various anticipated clinical situations, as well as optimization before surgery. In conclusion, we designed and 3D-printed a novel, structurally complex multi-material osteoconductive-osteoprotective device with anticipated mechanical properties suitable for large-defect oral bone regeneration.
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Alternative Geometries for 3D Bioprinting of Calcium Phosphate Cement as Bone Substitute. Biomedicines 2022; 10:biomedicines10123242. [PMID: 36551998 PMCID: PMC9775344 DOI: 10.3390/biomedicines10123242] [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: 09/20/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
In the literature, many studies have described the 3D printing of ceramic-based scaffolds (e.g., printing with calcium phosphate cement) in the form of linear structures with layer rotations of 90°, although no right angles can be found in the human body. Therefore, this work focuses on the adaptation of biological shapes, including a layer rotation of only 1°. Sample shapes were printed with calcium phosphate cement using a 3D Bioplotter from EnvisionTec. Both straight and wavy spokes were printed in a round structure with 12 layers. Depending on the strand diameter (200 and 250 µm needle inner diameter) and strand arrangement, maximum failure loads of 444.86 ± 169.39 N for samples without subsequent setting in PBS up to 1280.88 ± 538.66 N after setting in PBS could be achieved.
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Yuan Y, Shen L, Liu T, He L, Meng D, Jiang Q. Physicochemical properties of bone marrow mesenchymal stem cells encapsulated in microcapsules combined with calcium phosphate cement and their ectopic bone formation. Front Bioeng Biotechnol 2022; 10:1005954. [PMID: 36277380 PMCID: PMC9582332 DOI: 10.3389/fbioe.2022.1005954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Calcium phosphate bone cement (CPC) serves as an excellent scaffold material for bone tissue engineering owing to its good biocompatibility, injectability, self-setting property and three-dimensional porous structure. However, its clinical use is limited due to the cytotoxic effect of its setting reaction on cells and difficulties in degradation into bone. In this study, bone marrow mesenchymal stem cells (BMSCs) were encapsulated in alginate chitosan alginate (ACA) microcapsules and compounded with calcium phosphate bone cement. Changes in the compressive strength, porosity, injectability and collapsibility of CPC at different volume ratios of microcapsules were evaluated. At a 40% volume ratio of microcapsules, the composite scaffold displayed high porosity and injectability with good collapsibility and compressive strength. Cell live/dead double staining, Cell Counting Kit-8 (CCK-8) assays and scanning electron microscopy were used to detect the viability, proliferation and adhesion of cells after cell microcapsules were combined with CPC. The results revealed that cells protected by microcapsules proliferated and adhered better than those that were directly combined with CPC paste, and cell microcapsules could effectively form macropores in scaffold material. The composite was subsequently implanted subcutaneously on the backs of nude mice, and ectopic osteogenesis of the scaffold was detected via haematoxylin-eosin (H&E), Masson’s trichrome and Goldner’s trichrome staining. CPC clearly displayed better new bone formation function and degradability after addition of pure microcapsules and cell microcapsules. Furthermore, the cell microcapsule treatment group showed greater osteogenesis than the pure microcapsule group. Collectively, these results indicate that BMSCs encapsulated in ACA microcapsules combined with CPC composite scaffolds have good application prospects as bone tissue engineering materials.
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Affiliation(s)
- Yafei Yuan
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Lipei Shen
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Tiankun Liu
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing, China
| | - Lin He
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Dan Meng
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Qingsong Jiang
- Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
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Shaikh MQ, Nath SD, Akilan AA, Khanjar S, Balla VK, Grant GT, Atre SV. Investigation of Patient-Specific Maxillofacial Implant Prototype Development by Metal Fused Filament Fabrication (MF 3) of Ti-6Al-4V. Dent J (Basel) 2021; 9:dj9100109. [PMID: 34677171 PMCID: PMC8534331 DOI: 10.3390/dj9100109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
Additive manufacturing (AM) and related digital technologies have enabled several advanced solutions in medicine and dentistry, in particular, the design and fabrication of patient-specific implants. In this study, the feasibility of metal fused filament fabrication (MF3) to manufacture patient-specific maxillofacial implants is investigated. Here, the design and fabrication of a maxillofacial implant prototype in Ti-6Al-4V using MF3 is reported for the first time. The cone-beam computed tomography (CBCT) image data of the patient’s oral anatomy was digitally processed to design a 3D CAD model of the hard tissue and fabricate a physical model by stereolithography (SLA). Using the digital and physical models, bone loss condition was analyzed, and a maxillofacial implant initial design was identified. Three-dimensional (3D) CAD models of the implant prototypes were designed that match the patient’s anatomy and dental implant requirement. In this preliminary stage, the CAD models of the prototypes were designed in a simplified form. MF3 printing of the prototypes was simulated to investigate potential deformation and residual stresses. The patient-specific implant prototypes were fabricated by MF3 printing followed by debinding and sintering using a support structure for the first time. MF3 printed green part dimensions fairly matched with simulation prediction. Sintered parts were characterized for surface integrity after cutting the support structures off. An overall 18 ± 2% shrinkage was observed in the sintered parts relative to the green parts. A relative density of 81 ± 4% indicated 19% total porosity including 11% open interconnected porosity in the sintered parts, which would favor bone healing and high osteointegration in the metallic implants. The surface roughness of Ra: 18 ± 5 µm and a Rockwell hardness of 6.5 ± 0.8 HRC were observed. The outcome of the work can be leveraged to further investigate the potential of MF3 to manufacture patient-specific custom implants out of Ti-6Al-4V.
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Affiliation(s)
- Mohammad Qasim Shaikh
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Subrata Deb Nath
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Arulselvan Arumugam Akilan
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Saleh Khanjar
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Vamsi Krishna Balla
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, 196 Raja S.C. Mullick Road, Kolkata 700 032, India
| | | | - Sundar Vedanarayanan Atre
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Correspondence:
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