Review of Polymeric Materials in 4D Printing Biomedical Applications

Innovating chitosan-based bioinks for dermal wound healing: Current progress and future prospects

The field of three-dimensional (3D) bio/printing, known as additive manufacturing (AM), heavily relies on bioinks possessing suitable mechanical properties and compatibility with living cells. Among the array of potential hydrogel precursor materials, chitosan (CS) has garnered significant attention due to its remarkable physicochemical and biological attributes. These attributes include biodegradability, nontoxicity, antimicrobial properties, wound healing promotion, and immune system activation, making CS a highly appealing hydrogel-based bioink candidate. This review explores the transformative potential of CS-based bioink for enhancing dermal wound healing therapies. We highlight CS's unique qualities that make it an optimal choice for bioink development. Advancements in 3D bio/printing technology for tissue engineering (TE) are discussed, followed by an examination of strategies for CS-based bioink formulation and their impacts on wound healing. To address the progress in translating advanced wound healing from lab to clinic, we highlight the current and ongoing research in CS-based bioink for 3D bio/printing in skin wound healing applications. Finally, we explore current evidence, commercialization prospects, emerging innovations like 4D printing, and the challenges and future directions in this promising field.

Functional Scaffolds for Bone Tissue Regeneration: A Comprehensive Review of Materials, Methods, and Future Directions

Bone tissue regeneration is a rapidly evolving field aimed at the development of biocompatible materials and devices, such as scaffolds, to treat diseased and damaged osseous tissue. Functional scaffolds maintain structural integrity and provide mechanical support at the defect site during the healing process, while simultaneously enabling or improving regeneration through amplified cellular cues between the scaffold and native tissues. Ample research on functionalization has been conducted to improve scaffold-host tissue interaction, including fabrication techniques, biomaterial selection, scaffold surface modifications, integration of bioactive molecular additives, and post-processing modifications. Each of these methods plays a crucial role in enabling scaffolds to not only support but actively participate in the healing and regeneration process in bone and joint surgery. This review provides a state-of-the-art, comprehensive overview of the functionalization of scaffold-based strategies used in tissue engineering, specifically for bone regeneration. Critical issues and obstacles are highlighted, applications and advances are described, and future directions are identified.

Integrative Modeling and Experimental Insights into 3D and 4D Printing Technologies

This review focuses on advancements in polymer science as it relates to three-dimensional (3D) and four-dimensional (4D) printing technologies, with a specific emphasis on applications in the biomedical field. While acknowledging the breadth of 3D and 4D printing applications, this paper concentrates on the use of polymers in creating biomedical devices and the challenges associated with their implementation. It explores integrative modeling and experimental insights driving innovations in these fields, focusing on sustainable manufacturing with biodegradable polymers, a comparative analysis of 3D and 4D printing techniques, and applications in biomedical devices. Additionally, the review examines the materials used in both 3D and 4D printing, offering a detailed comparison of their properties and applications. By highlighting the transformative potential of these technologies in various industrial and medical applications, the paper underscores the importance of continued research and development. The scope of this review also includes an overview of future research directions to address current challenges, enhance material capabilities, and explore practical applications.

Tuning the Topography of Dynamic 3D Scaffolds through Functional Protein Wrinkled Coatings

Surface wrinkling provides an approach to fabricate micron and sub-micron-level biomaterial topographies that can mimic features of the dynamic, in vivo cell environment and guide cell adhesion, alignment, and differentiation. Most wrinkling research to date has used planar, two-dimensional (2D) substrates, and wrinkling work on three-dimensional (3D) structures has been limited. To enable wrinkle formation on architecturally complex, biomimetic 3D structures, here, we report a simple, low-cost experimental wrinkling approach that combines natural silk fibroin films with a recently developed advanced manufacturing technique for programming strain in complex 3D shape-memory polymer (SMP) scaffolds. By systematically investigating the influence of SMP programmed strain magnitude, silk film thickness, and aqueous media on wrinkle morphology and stability, we reveal how to generate and tune silk wrinkles on the micron and sub-micron scale. We find that increasing SMP programmed strain magnitude increases wavelength and decreases amplitudes of silk wrinkled topographies, while increasing silk film thickness increases wavelength and amplitude. Silk wrinkles persist after 24 h in cell culture medium. Wrinkled topographies demonstrate high cell viability and attachment. These findings suggest the potential for fabricating biomimetic cellular microenvironments that can advance understanding and control of cell-material interactions in engineering tissue constructs.

The application of a 4D-printed chitosan-based stem cell carrier for the repair of corneal alkali burns

BACKGROUND

Corneal alkali burns can lead to ulceration, perforation, and even corneal blindness due to epithelial defects and extensive cell necrosis, resulting in poor healing outcomes. Previous studies have found that chitosan-based in situ hydrogel loaded with limbal epithelium stem cells (LESCs) has a certain reparative effect on corneal alkali burns. However, the inconsistent pore sizes of the carriers and low cell loading rates have resulted in suboptimal repair outcomes. In this study, 4D bioprinting technology was used to prepare a chitosan-based thermosensitive gel carrier (4D-CTH) with uniform pore size and adjustable shape to improve the transfer capacity of LESCs.

METHODS

Prepare solutions of chitosan acetate, carboxymethyl chitosan, and β-glycerophosphate sodium at specific concentrations, and mix them in certain proportions to create a pore-size uniform scaffold using 4D bioprinting technology. Extract and culture rat LESCs (rLESCs) in vitro, perform immunofluorescence experiments to observe the positivity rate of deltaNp63 cells for cell identification. Conduct a series of experiments to validate the cell compatibility of 4D-CTH, including CCK-8 assay to assess cell toxicity, scratch assay to evaluate the effect of 4D-CTH on rLESCs migration, and Calcein-AM/PI cell staining experiment to examine the impact of 4D-CTH on rLESCs proliferation and morphology. Establish a severe alkali burn model in rat corneas, transplant rLESCs onto the injured cornea using 4D-CTH, periodically observe corneal opacity and neovascularization using a slit lamp, and evaluate epithelial healing by fluorescein sodium staining. Assess the therapeutic effect 4D-CTH-loaded rLESCs on corneal alkali burn through histological evaluation of corneal tissue paraffin sections stained with hematoxylin and eosin, as well as immunofluorescence staining of frozen sections.

RESULTS

Using the 4D-CTH, rLESCs were transferred to the alkali burn wounds of rats. Compared with the traditional treatment group (chitosan in situ hydrogel encapsulating rLESCs), the 4D-CTH-rLESC group had significantly higher repair efficiency of corneal injury, such as lower corneal opacity score (1.2 ± 0.4472 vs 0.4 ± 0.5477, p < 0.05) and neovascularization score (5.5 ± 1.118 vs 2.6 ± 0.9618, p < 0.01), and significantly higher corneal epithelial wound healing rate (72.09 ± 3.568% vs 86.60 ± 5.004%, p < 0.01).

CONCLUSION

In summary, the corneas of the 4D-CTH-rLESC treatment group were similar to the normal corneas and had a complete corneal structure. These findings suggested that LESCs encapsulated by 4D-CTH significantly accelerated corneal wound healing after alkali burn and can be considered as a rapid and effective method for treating epithelial defects.

Shape Memory Effect of Four-Dimensional Printed Polylactic Acid-Based Scaffold with Nature-Inspired Structure

The four-dimensional (4D) printing is an evolving technology that has immense scope in various fields of science and technology owing to ever-challenging needs of human. It is an innovative upgradation of 3D printing procedure, which instills smart capabilities into materials such that they respond to external stimulus. This article aims to investigate the feasibility of 4D printing of polylactic acid (PLA)-based composite scaffolds fabricated by incorporating four different nature-inspired architectures (honeycomb, giant water lily, spiderweb, and nautilus shell). The composites were developed by adding 1, 3, and 5 wt.% of Calcium Phosphate (CaP) into PLA. Various thermomechanical tests were accomplished to evaluate the properties of developed material. Furthermore, the shape memory characteristics of these scaffolds were examined using thermally controlled conditions. The characterization tests displayed favorable outcomes in terms of thermal stability and hydrophilic nature of the PLA and PLA/CaP composite materials. It was found that the honeycomb structure showed the best shape memory and mechanical behavior among the four designs. Furthermore, the introduction of CaP was found to enhance mechanical strength and shape memory property, whereas the surface integrity was adversely affected. This study can play a vital role in developing self-fitting high-shape recovery biomedical scaffolds for bone-repair applications.

From Static to Dynamic: Smart Materials Pioneering Additive Manufacturing in Regenerative Medicine

The emerging field of regenerative medicine holds immense promise for addressing complex tissue and organ regeneration challenges. Central to its advancement is the evolution of additive manufacturing techniques, which have transcended static constructs to embrace dynamic, biomimetic solutions. This manuscript explores the pivotal role of smart materials in this transformative journey, where materials are endowed with dynamic responsiveness to biological cues and environmental changes. By delving into the innovative integration of smart materials, such as shape memory polymers and stimulus-responsive hydrogels, into additive manufacturing processes, this research illuminates the potential to engineer tissue constructs with unparalleled biomimicry. From dynamically adapting scaffolds that mimic the mechanical behavior of native tissues to drug delivery systems that respond to physiological cues, the convergence of smart materials and additive manufacturing heralds a new era in regenerative medicine. This manuscript presents an insightful overview of recent advancements, challenges, and future prospects, underscoring the pivotal role of smart materials as pioneers in shaping the dynamic landscape of regenerative medicine and heralding a future where tissue engineering is propelled beyond static constructs towards biomimetic, responsive, and regenerative solutions.

In Situ Observation of Micro-Patterned Elastomeric Surfaces: The Formation of the Area of Real Contact and the Influence on Its Friction and Deformation Behaviour

Structured surfaces, which are the basis of the lotus blossom effect, have great potential to serve/operate as functionalised surfaces, i.e., surfaces with specific and/or adjustable properties. In the present study, the aim is to use micro-structured elastomeric surfaces to specifically influence the friction and deformation behaviours on the basis of the shape and arrangement of the structures. Thiol-acrylate-based photopolymers patterned via nanoimprint lithography were investigated by using an in situ tribological measurement set-up. A clear influence of the different structures on the surface's friction behaviour could be shown, and, furthermore, this could be brought into relation with the real area of contact. This finding provides an important contribution to further development steps, namely, to give the structures switchable properties in order to enable the control of friction properties in a targeted manner.

Recent Advances in Magnetic Polymer Composites for BioMEMS: A Review

The objective of this review is to investigate the potential of functionalized magnetic polymer composites for use in electromagnetic micro-electro-mechanical systems (MEMS) for biomedical applications. The properties that make magnetic polymer composites particularly interesting for application in the biomedical field are their biocompatibility, their adjustable mechanical, chemical, and magnetic properties, as well as their manufacturing versatility, e.g., by 3D printing or by integration in cleanroom microfabrication processes, which makes them accessible for large-scale production to reach the general public. The review first examines recent advancements in magnetic polymer composites that possess unique features such as self-healing capabilities, shape-memory, and biodegradability. This analysis includes an exploration of the materials and fabrication processes involved in the production of these composites, as well as their potential applications. Subsequently, the review focuses on electromagnetic MEMS for biomedical applications (bioMEMS), including microactuators, micropumps, miniaturized drug delivery systems, microvalves, micromixers, and sensors. The analysis encompasses an examination of the materials and manufacturing processes involved and the specific fields of application for each of these biomedical MEMS devices. Finally, the review discusses missed opportunities and possible synergies in the development of next-generation composite materials and bioMEMS sensors and actuators based on magnetic polymer composites.

Meta-analyzing the efficacy of 3D printed models in anatomy education

Three-dimensional printing models (3DPs) have been widely used in medical anatomy training. However, the 3DPs evaluation results differ depending on such factors as the training objects, experimental design, organ parts, and test content. Thus, this systematic evaluation was carried out to better understand the role of 3DPs in different populations and different experimental designs. Controlled (CON) studies of 3DPs were retrieved from PubMed and Web of Science databases, where the participants were medical students or residents. The teaching content is the anatomical knowledge of human organs. One evaluation indicator is the mastery of anatomical knowledge after training, and the other is the satisfaction of participants with 3DPs. On the whole, the performance of the 3DPs group was higher than that of the CON group; however, there was no statistical difference in the resident subgroup, and there was no statistical difference for 3DPs vs. 3D visual imaging (3DI). In terms of satisfaction rate, the summary data showed that the difference between the 3DPs group (83.6%) vs. the CON group (69.6%) (binary variable) was not statistically significant, with p > 0.05. 3DPs has a positive effect on anatomy teaching, although there are no statistical differences in the performance tests of individual subgroups; participants generally had good evaluations and satisfaction with 3DPs. 3DPs still faces challenges in production cost, raw material source, authenticity, durability, etc. The future of 3D-printing-model-assisted anatomy teaching is worthy of expectation.

Advances in 4D printing: from stimulation to simulation

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

Antibacterial smart hydrogels: New hope for infectious wound management

Millions of people die annually due to uncured wound infections. Healthcare systems incur high costs to treat wound infections. Tt is predicted to become more challenging due to the rise of multidrug-resistant conditions. During the last decades, smart antibacterial hydrogels could attract attention as a promising solution, especially for skin wound infections. These antibacterial hydrogels are termed 'smart' due to their response to specific physical and chemical environmental stimuli. To deliver different drugs to particular sites in a controlled manner, various types of crosslinking strategies are used in the manufacturing process. Smart hydrogels are designed to provide antimicrobial agents to the infected sites or are built from polymers with inherent disinfectant properties. This paper aims to critically review recent pre-clinical and clinical advances in using smart hydrogels against skin wound infections and propose the next best thing for future trends. For this purpose, an introduction to skin wound healing and disease is presented and intelligent hydrogels responding to different stimuli are introduced. Finally, the most promising investigations are discussed in their related sections. These studies can pave the way for producing new biomaterials with clinical applications.

Thiol-Based Three-Dimensional Printing of Fully Degradable Poly(propylene fumarate) Star Polymers

Poly(propylene fumarate) star polymers photochemically 3D printed with degradable thiol cross-linkers yielded highly tunable biodegradable polymeric materials. Tailoring the alkene:thiol ratio (5:1, 10:1, 20:1 and 30:1) and thus the cross-link density within the PPF star systems yielded a wide variation of both the mechanical and degradation properties of the printed materials. Fundamental trends were established between the polymer network cross-link density, glass transition temperature, and tensile and thermomechanical properties of the materials. The tensile properties of the PPF star-based systems were compared to commercial state-of-the-art non-degradable polymer resins. The thiolene-cross-linked materials are fully degradable and possess properties over a wide range of mechanical properties relevant to regenerative medicine applications.

A new trend of using poly(vinyl alcohol) in 3D and 4D printing technologies: Process and applications

Recently, 3D/4D printing technologies have been the researchers' interest, and they are getting improved more important. They are applicable in various fields like medical fields, pharmaceutics, construction, tissue engineering, dentistry, water treatment, etc. These technologies overcame the difficulty of the conventional methods in producing complicated structures. They can be fed by different materials such as nanomaterials, smart polymers, responsive polymers, metamaterials, synthetic polymers, natural polymers, and so forth. One of the smart and stimuli-responsive polymers is poly(vinyl alcohol) (PVA). In addition to numerous applications of PVA like medicine, environmental fields, etc., researchers are showing a tendency to use PVA in 3D/4D printing technologies. The main reasons for PVA's increased interest in 3D/4D printing technologies are suitable flowability, stimuli-responsivity, extrudability, biocompatibility, biodegradability, cost-effectiveness, and other features. This review aims to introduce the 3D/4D printing technologies' knowledge and then the applications of PVA as a feed in these novel technologies.

Bone Regeneration and Oxidative Stress: An Updated Overview

Bone tissue engineering is a complex domain that requires further investigation and benefits from data obtained over past decades. The models are increasing in complexity as they reveal new data from co-culturing and microfluidics applications. The in vitro models now focus on the 3D medium co-culturing of osteoblasts, osteoclasts, and osteocytes utilizing collagen for separation; this type of research allows for controlled medium and in-depth data analysis. Oxidative stress takes a toll on the domain, being beneficial as well as destructive. Reactive oxygen species (ROS) are molecules that influence the differentiation of osteoclasts, but over time their increasing presence can affect patients and aid the appearance of diseases such as osteoporosis. Oxidative stress can be limited by using antioxidants such as vitamin K and N-acetyl cysteine (NAC). Scaffolds and biocompatible coatings such as hydroxyapatite and bioactive glass are required to isolate the implant, protect the zone from the metallic, ionic exchange, and enhance the bone regeneration by mimicking the composition and structure of the body, thus enhancing cell proliferation. The materials can be further functionalized with growth factors that create a better response and higher chances of success for clinical use. This review highlights the vast majority of newly obtained information regarding bone tissue engineering, such as new co-culturing models, implant coatings, scaffolds, biomolecules, and the techniques utilized to obtain them.

Smart Additive Manufacturing: The Path to the Digital Value Chain

The aim of this article is to characterize the impacts of Smart Additive Manufacturing (SAM) on industrial production, digital supply chains (DSCs) and corresponding digital value chains (DVCs), logistics and inventory management. The method used consists of a critical review of the literature, enriched by the authors’ field experience. The results show that digital transformation of manufacturing is affecting business models, from resource acquisition to the end user. Smart manufacturing is considered a successful improvement introduced by Industry 4.0. Additive Manufacturing (AM) plays a crucial role in this digital transformation, changing the way manufacturers think about the entire lifecycle of a product. SAM combines AM in a smart factory environment. SAM reduces the complexity of DSCs and contributes to a more flexible approach to logistics and inventory management. It has also spurred the growth and popularization of customized mass production as well as decentralized manufacturing, rapid prototyping, unprecedented flexibility in product design, production and delivery, and resource efficiency and sustainability. SAM technology impacts all five Fletcher’s stages in DVCs. However, the need for clear definitions and regulations on 3D printing of digital files and their reproduction, as well as product health, safety, and integrity issues, cannot be ignored. Furthermore, investment in this technology is still expensive and can be prohibitive for many companies, namely SMEs.

3D Printing-Enabled Nanoparticle Alignment: A Review of Mechanisms and Applications

3D printing (additive manufacturing (AM)) has enormous potential for rapid tooling and mass production due to its design flexibility and significant reduction of the timeline from design to manufacturing. The current state-of-the-art in 3D printing focuses on material manufacturability and engineering applications. However, there still exists the bottleneck of low printing resolution and processing rates, especially when nanomaterials need tailorable orders at different scales. An interesting phenomenon is the preferential alignment of nanoparticles that enhance material properties. Therefore, this review emphasizes the landscape of nanoparticle alignment in the context of 3D printing. Herein, a brief overview of 3D printing is provided, followed by a comprehensive summary of the 3D printing-enabled nanoparticle alignment in well-established and in-house customized 3D printing mechanisms that can lead to selective deposition and preferential orientation of nanoparticles. Subsequently, it is listed that typical applications that utilized the properties of ordered nanoparticles (e.g., structural composites, heat conductors, chemo-resistive sensors, engineered surfaces, tissue scaffolds, and actuators based on structural and functional property improvement). This review's emphasis is on the particle alignment methodology and the performance of composites incorporating aligned nanoparticles. In the end, significant limitations of current 3D printing techniques are identified together with future perspectives.

Stereotactic technology for 3D bioprinting: from the perspective of robot mechanism

Three-dimensional (3D) bioprinting has been widely applied in the field of biomedical engineering because of its rapidly individualized fabrication and precisely geometric designability. The emerging demand for bioprinted tissues/organs with bio-inspired anisotropic property is stimulating new bioprinting strategies. Stereotactic bioprinting is regarded as a preferable strategy for this purpose, which can perform bioprinting at the target position from any desired orientation in 3D space. In this work, based on the motion characteristics analysis of the stacked bioprinting technologies, mechanism configurations and path planning methods for robotic stereotactic bioprinting were investigated and a prototype system based on the double parallelogram mechanism was introduced in detail. Moreover, the influence of the time dimension on stereotactic bioprinting was discussed. Finally, technical challenges and future trends of stereotactic bioprinting within the field of biomedical engineering were summarized.

Three-Dimensional Printing Using a Maize Protein: Zein-Based Inks in Biomedical Applications

The use of three-dimensional (3D) printing for biomedical applications has expanded exponentially in recent years. However, the current portfolio of 3D printable inks is still limited. For instance, only few protein matrices have been explored as printing/bioprinting materials. Here, we introduce the use of zein, the primary constitutive protein in maize seeds, as a 3D printable material. Zein-based inks were prepared by dissolving commercial zein powder in ethanol with or without polyethylene glycol (PEG400) as a plasticizer. The rheological characteristics of our materials, studied during 21 days of aging/maturation, showed an increase in the apparent viscosity as a function of time in all formulations. The addition of PEG400 decreased the apparent viscosity. Inks with and without PEG400 and at different maturation times were tested for printability in a BioX bioprinter. We optimized the 3D printing parameters for each ink formulation in terms of extrusion pressure and linear printing velocity. Higher fidelity structures were obtained with inks that had maturation times of 10 to 14 days. We present different proof-of-concept experiments to demonstrate the versatility of the engineered zein inks for diverse biomedical applications. These include printing of complex and/or free-standing 3D structures, tablets for controlled drug release, and scaffolds for cell culture.

Digital Light Processing Bioprinted Human Chondrocyte-Laden Poly (γ-Glutamic Acid)/Hyaluronic Acid Bio-Ink towards Cartilage Tissue Engineering

Cartilage injury is the main cause of disability in the United States, and it has been projected that cartilage injury caused by osteoarthritis will affect 30% of the entire United States population by the year 2030. In this study, we modified hyaluronic acid (HA) with γ-poly(glutamic) acid (γ-PGA), both of which are common biomaterials used in cartilage engineering, in an attempt to evaluate them for their potential in promoting cartilage regeneration. As seen from the results, γ-PGA-GMA and HA, with glycidyl methacrylate (GMA) as the photo-crosslinker, could be successfully fabricated while retaining the structural characteristics of γ-PGA and HA. In addition, the storage moduli and loss moduli of the hydrogels were consistent throughout the curing durations. However, it was noted that the modification enhanced the mechanical properties, the swelling equilibrium rate, and cellular proliferation, and significantly improved secretion of cartilage regeneration-related proteins such as glycosaminoglycan (GAG) and type II collagen (Col II). The cartilage tissue proof with Alcian blue further demonstrated that the modification of γ-PGA with HA exhibited suitability for cartilage tissue regeneration and displayed potential for future cartilage tissue engineering applications. This study built on the previous works involving HA and further showed that there are unlimited ways to modify various biomaterials in order to further bring cartilage tissue engineering to the next level.

Cardiovascular Stents: A Review of Past, Current, and Emerging Devices

One of the leading causes of morbidity and mortality worldwide is coronary artery disease, a condition characterized by the narrowing of the artery due to plaque deposits. The standard of care for treating this disease is the introduction of a stent at the lesion site. This life-saving tubular device ensures vessel support, keeping the blood-flow path open so that the cardiac muscle receives its vital nutrients and oxygen supply. Several generations of stents have been iteratively developed towards improving patient outcomes and diminishing adverse side effects following the implanting procedure. Moving from bare-metal stents to drug-eluting stents, and recently reaching bioresorbable stents, this research field is under continuous development. To keep up with how stent technology has advanced in the past few decades, this paper reviews the evolution of these devices, focusing on how they can be further optimized towards creating an ideal vascular scaffold.

Fabrication of Microfluidic Devices for Emulsion Formation by Microstereolithography

Droplet microfluidics—the art and science of forming droplets—has been revolutionary for high-throughput screening, directed evolution, single-cell sequencing, and material design. However, traditional fabrication techniques for microfluidic devices suffer from several disadvantages, including multistep processing, expensive facilities, and limited three-dimensional (3D) design flexibility. High-resolution additive manufacturing—and in particular, projection micro-stereolithography (PµSL)—provides a promising path for overcoming these drawbacks. Similar to polydimethylsiloxane-based microfluidics 20 years ago, 3D printing methods, such as PµSL, have provided a path toward a new era of microfluidic device design. PµSL greatly simplifies the device fabrication process, especially the access to truly 3D geometries, is cost-effective, and it enables multimaterial processing. In this review, we discuss both the basics and recent innovations in PµSL; the material basis with emphasis on custom-made photopolymer formulations; multimaterial 3D printing; and, 3D-printed microfluidic devices for emulsion formation as our focus application. Our goal is to support researchers in setting up their own PµSL system to fabricate tailor-made microfluidics.

Fabrication of Biomedical Scaffolds Using Biodegradable Polymers

Degradable polymers are used widely in tissue engineering and regenerative medicine. Maturing capabilities in additive manufacturing coupled with advances in orthogonal chemical functionalization methodologies have enabled a rapid evolution of defect-specific form factors and strategies for designing and creating bioactive scaffolds. However, these defect-specific scaffolds, especially when utilizing degradable polymers as the base material, present processing challenges that are distinct and unique from other classes of materials. The goal of this review is to provide a guide for the fabrication of biodegradable polymer-based scaffolds that includes the complete pathway starting from selecting materials, choosing the correct fabrication method, and considering the requirements for tissue specific applications of the scaffold.

Stay smart: it's all about the materials for 4D printing in biomedicine

Where 3D printing was characterized by the new technologies and machinery, 4D printing is defined by the smart materials making waves in drug development and regenerative medicine.

Bioresorbable Polymers: Advanced Materials and 4D Printing for Tissue Engineering

Three-dimensional (3D) printing is a valuable tool in the production of complexes structures with specific shapes for tissue engineering. Differently from native tissues, the printed structures are static and do not transform their shape in response to different environment changes. Stimuli-responsive biocompatible materials have emerged in the biomedical field due to the ability of responding to other stimuli (physical, chemical, and/or biological), resulting in microstructures modifications. Four-dimensional (4D) printing arises as a new technology that implements dynamic improvements in printed structures using smart materials (stimuli-responsive materials) and/or cells. These dynamic scaffolds enable engineered tissues to undergo morphological changes in a pre-planned way. Stimuli-responsive polymeric hydrogels are the most promising material for 4D bio-fabrication because they produce a biocompatible and bioresorbable 3D shape environment similar to the extracellular matrix and allow deposition of cells on the scaffold surface as well as in the inside. Subsequently, this review presents different bioresorbable advanced polymers and discusses its use in 4D printing for tissue engineering applications.

Programmable Stimuli-Responsive Actuators for Complex Motions in Soft Robotics: Concept, Design and Challenges

During the last years, great progress was made in material science in terms of concept, design and fabrication of new composite materials with conferred properties and desired functionalities. The scientific community paid particular interest to active soft materials, such as soft actuators, for their potential as transducers responding to various stimuli aiming to produce mechanical work. Inspired by this, materials engineers today are developing multidisciplinary approaches to produce new active matters, focusing on the kinematics allowed by the material itself more than on the possibilities offered by its design. Traditionally, more complex motions beyond pure elongation and bending are addressed by the robotics community. The present review targets encompassing and rationalizing a framework which will help a wider scientific audience to understand, sort and design future soft actuators and methods enabling complex motions. Special attention is devoted to recent progress in developing innovative stimulus-responsive materials and approaches for complex motion programming for soft robotics. In this context, a challenging overview of the new materials as well as their classification and comparison (performances and characteristics) are proposed. In addition, the great potential of soft transducers are outlined in terms of kinematic capabilities, illustrated by the related application. Guidelines are provided to design actuators and to integrate asymmetry enabling motions along any of the six basic degrees of freedom (translations and rotations), and strategies towards the programming of more complex motions are discussed. As a final note, a series of manufacturing methods are described and compared, from molding to 3D and 4D printing. The review ends with a Perspectives section, from material science and microrobotic points of view, on the soft materials’ future and close future challenges to be overcome.

Exploring Smart Material Applications for COVID-19 Pandemic Using 4D Printing Technology

Today, in the medical field, innovative technological advancements support healthcare systems and improve patients’ lives. 4D printing is one of the innovative technologies that creates notable innovations in the medical field. For the COVID-19 pandemic, this technology proves to be useful in the manufacturing of smart medical parts, which helps treat infected patients. As compared to 3D printing, 4D printing adds time as an additional element in the manufactured part. 4D printing uses smart materials with the same printing processes as being used in 3D printing technology, but here the part printed with smart materials change their shape with time or by the change of environmental temperature, which further creates innovation for patient treatments. 4D printing manufactures a given part, layer by layer, by taking input of a virtual (CAD) model and uses smart material. This paper studies the capability of smart materials and their advancements when used in 4D printing. We have diagrammatically presented the significant parts of 4D printing technology. This paper identifies 11 significant applications of 4D printing and then studies which one provides innovative solutions during the COVID-19 pandemic.

Assessment of the Release Profile of Fibroblast Growth Factor-2-Load Mesoporous Calcium Silicate/Poly-ε-caprolactone 3D Scaffold for Regulate Bone Regeneration

Recent advances in three-dimensional printing technology enable facile and on-demand fabrication of patient-specific bone scaffolds. However, there is still an urgent need for printable biomaterials with osteoinductivity. In the present study, we propose an approach to synthesize fibroblast growth factor-2 loaded-mesoporous calcium silicate nanoparticles. The growth factor loaded-nanoparticles served as fillers of polycaprolactone and then the composite scaffolds with a controlled pore structure were obtained through a fused deposition modeling technique. To evaluate the feasibility of the composite scaffolds in bone tissue engineering, drug release kinetic, bioactivity, cell proliferation, differentiation, and animal study were conducted. Our findings illustrate that utilization of mesoporous calcium silicate allowed the introduction of fibroblast growth factor-2 into the composite scaffolds through a simple soaking process and then gradually released from the scaffold to facilitate proliferation and osteogenesis differentiation of human Wharton’s jelly mesenchymal stem cells. Additionally, the in vivo femur defect experiments also indicate that the co-existence of calcium silicate and fibrous growth factor-2 synergistically accelerated new bone formation. These results demonstrate that the fibroblast growth factor-2-loaded mesoporous calcium silicate nanoparticles/polycaprolactone composite scaffolds may serve as potential bone grafts for facilitating repair of defected bone tissues.

Polymer-Based Scaffolds for Soft-Tissue Engineering

Biomaterials have been used since ancient times. However, it was not until the late 1960s when their development prospered, increasing the research on them. In recent years, the study of biomaterials has focused mainly on tissue regeneration, requiring a biomaterial that can support cells during their growth and fulfill the function of the replaced tissue until its regeneration. These materials, called scaffolds, have been developed with a wide variety of materials and processes, with the polymer ones being the most advanced. For this reason, the need arises for a review that compiles the techniques most used in the development of polymer-based scaffolds. This review has focused on three of the most used techniques: freeze-drying, electrospinning and 3D printing, focusing on current and future trends. In addition, the advantages and disadvantages of each of them have been compared.

Significant advancements of 4D printing in the field of orthopaedics

Researchers, engineers and doctors are continuously focusing on the development of orthopaedics parts characterised by the required responses. So, advanced manufacturing technologies are introduced to fulfil various previously faced challenges. 4D printing provides rapid development with its capability of customization of smart orthopaedics implants and appropriate surgical procedure. This technology opens up the making of innovative, adaptable internal splints, stents, replacement of tissues and organs. Thus, to write this review based article, relevant papers on 4D printing in medical/orthopaedics and smart materials are identified and studied. 4D printed parts show the capability of shape-changing and self-assembly to perform the required functions, which otherwise manufactured parts are not providing. Smart orthopaedics implants are used for spinal deformities, fracture fixation, joint, knee replacement and other related orthopaedics applications. This paper briefs about the 4D printing technology with its major benefits for orthopaedics applications. Today various smart materials are available, which could be used as raw material in 4D printing, and we have discussed capabilities of some of them. Due to the ability of shape-changing, smart implants can change their shape after being implanted in the patient body. Finally, twelve significant advancements of 4D printing in the field of orthopaedics are identified and briefly provided. Thus, 4D printing help to provide a significant effect on personalised treatments.

Assessment of the Release of Vascular Endothelial Growth Factor from 3D-Printed Poly-ε-Caprolactone/Hydroxyapatite/Calcium Sulfate Scaffold with Enhanced Osteogenic Capacity

Vascular endothelial growth factor (VEGF) is one of the most crucial growth factors and an assistant for the adjustment of bone regeneration. In this study, a 3D scaffold is fabricated using the method of fused deposition modeling. Such a fabricated method allows us to fabricate scaffolds with consistent pore sizes, which could promote cellular ingrowth into scaffolds. Therefore, we drafted a plan to accelerate bone regeneration via VEGF released from the hydroxyapatite/calcium sulfate (HACS) scaffold. Herein, HACS will gradually degrade and provide a suitable environment for cell growth and differentiation. In addition, HACS scaffolds have higher mechanical properties and drug release compared with HA scaffolds. The drug release profile of the VEGF-loaded scaffolds showed that VEGF could be loaded and released in a stable manner. Furthermore, initial results showed that VEGF-loaded scaffolds could significantly enhance the proliferation of human mesenchymal stem cells (hMSCs) and human umbilical vein endothelial cells (HUVEC). In addition, angiogenic- and osteogenic-related proteins were substantially increased in the HACS/VEGF group. Moreover, in vivo results revealed that HACS/VEGF improved the regeneration of the rabbit’s femur bone defect, and VEGF loading improved bone tissue regeneration and remineralization after implantation for 8 weeks. All these results strongly imply that the strategy of VEGF loading onto scaffolds could be a potential candidate for future bone tissue engineering.

Control-Based 4D Printing: Adaptive 4D-Printed Systems

Building on the recent progress of four-dimensional (4D) printing to produce dynamic structures, this study aimed to bring this technology to the next level by introducing control-based 4D printing to develop adaptive 4D-printed systems with highly versatile multi-disciplinary applications, including medicine, in the form of assisted soft robots, smart textiles as wearable electronics and other industries such as agriculture and microfluidics. This study introduced and analysed adaptive 4D-printed systems with an advanced manufacturing approach for developing stimuli-responsive constructs that organically adapted to environmental dynamic situations and uncertainties as nature does. The adaptive 4D-printed systems incorporated synergic integration of three-dimensional (3D)-printed sensors into 4D-printing and control units, which could be assembled and programmed to transform their shapes based on the assigned tasks and environmental stimuli. This paper demonstrates the adaptivity of these systems via a combination of proprioceptive sensory feedback, modeling and controllers, as well as the challenges and future opportunities they present.

Effect of Bone Morphogenic Protein-2-Loaded Mesoporous Strontium Substitution Calcium Silicate/Recycled Fish Gelatin 3D Cell-Laden Scaffold for Bone Tissue Engineering

Bone has a complex hierarchical structure with the capability of self-regeneration. In the case of critical-sized defects, the regeneration capabilities of normal bones are severely impaired, thus causing non-union healing of bones. Therefore, bone tissue engineering has since emerged to solve problems relating to critical-sized bone defects. Amongst the many biomaterials available on the market, calcium silicate-based (CS) cements have garnered huge interest due to their versatility and good bioactivity. In the recent decade, scientists have attempted to modify or functionalize CS cement in order to enhance the bioactivity of CS. Reports have been made that the addition of mesoporous nanoparticles onto scaffolds could enhance the bone regenerative capabilities of scaffolds. For this study, the main objective was to reuse gelatin from fish wastes and use it to combine with bone morphogenetic protein (BMP)-2 and Sr-doped CS scaffolds to create a novel BMP-2-loaded, hydrogel-based mesoporous SrCS scaffold (FGSrB) and to evaluate for its composition and mechanical strength. From this study, it was shown that such a novel scaffold could be fabricated without affecting the structural properties of FGSr. In addition, it was proven that FGSrB could be used for drug delivery to allow stable localized drug release. Such modifications were found to enhance cellular proliferation, thus leading to enhanced secretion of alkaline phosphatase and calcium. The above results showed that such a modification could be used as a potential alternative for future bone tissue engineering research.

Shape-Adaptive Metastructures with Variable Bandgap Regions by 4D Printing

This article shows how four-dimensional (4D) printing technology can engineer adaptive metastructures that exploit resonating self-bending elements to filter vibrational and acoustic noises and change filtering ranges. Fused deposition modeling (FDM) is implemented to fabricate temperature-responsive shape-memory polymer (SMP) elements with self-bending features. Experiments are conducted to reveal how the speed of the 4D printer head can affect functionally graded prestrain regime, shape recovery and self-bending characteristics of the active elements. A 3D constitutive model, along with an in-house finite element (FE) method, is developed to replicate the shape recovery and self-bending of SMP beams 4D-printed at different speeds. Furthermore, a simple approach of prestrain modeling is introduced into the commercial FE software package to simulate material tailoring and self-bending mechanism. The accuracy of the straightforward FE approach is validated against experimental observations and computational results from the in-house FE MATLAB-based code. Two periodic architected temperature-sensitive metastructures with adaptive dynamical characteristics are proposed to use bandgap engineering to forbid specific frequencies from propagating through the material. The developed computational tool is finally implemented to numerically examine how bandgap size and frequency range can be controlled and broadened. It is found out that the size and frequency range of the bandgaps are linked to changes in the geometry of self-bending elements printed at different speeds. This research is likely to advance the state-of-the-art 4D printing and unlock potentials in the design of functional metastructures for a broad range of applications in acoustic and structural engineering, including sound wave filters and waveguides.

The Calcium Channel Affect Osteogenic Differentiation of Mesenchymal Stem Cells on Strontium-Substituted Calcium Silicate/Poly-ε-Caprolactone Scaffold

There had been a paradigm shift in tissue engineering studies over the past decades. Of which, part of the hype in such studies was based on exploring for novel biomaterials to enhance regeneration. Strontium ions have been reported by others to have a unique effect on osteogenesis. Both in vitro and in vivo studies had demonstrated that strontium ions were able to promote osteoblast growth, and yet at the same time, inhibit the formation of osteoclasts. Strontium is thus considered an important biomaterial in the field of bone tissue engineering. In this study, we developed a Strontium-calcium silicate scaffold using 3D printing technology and evaluated for its cellular proliferation capabilities by assessing for protein quantification and mineralization of Wharton’s Jelly mesenchymal stem cells. In addition, verapamil (an L-type of calcium channel blocker, CCB) was used to determine the mechanism of action of strontium ions. The results found that the relative cell proliferation rate on the scaffold was increased between 20% to 60% within 7 days of culture, while the CCB group only had up to approximately 10% proliferation as compared with the control specimen. Besides, the CCB group had downregulation and down expressions of all downstream cell signaling proteins (ERK and P38) and osteogenic-related protein (Col I, OPN, and OC). Furthermore, CCB was found to have 3–4 times lesser calcium deposition and quantification after 7 and 14 days of culture. These results effectively show that the 3D printed strontium-contained scaffold could effectively stimulate stem cells to undergo bone differentiation via activation of L-type calcium channels. Such results showed that strontium-calcium silicate scaffolds have high development potential for bone tissue engineering.