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Systermans S, Cobraiville E, Camby S, Meyer C, Louvrier A, Lie SA, Schouman T, Siciliano S, Beckers O, Poulet V, Ullmann N, Nolens G, Biscaccianti V, Nizet JL, Hascoët JY, Gilon Y, Vidal L. An innovative 3D hydroxyapatite patient-specific implant for maxillofacial bone reconstruction: A case series of 13 patients. J Craniomaxillofac Surg 2024; 52:420-431. [PMID: 38461138 DOI: 10.1016/j.jcms.2024.02.026] [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: 08/21/2023] [Revised: 11/28/2023] [Accepted: 02/17/2024] [Indexed: 03/11/2024] Open
Abstract
The study aimed to evaluate and discuss the use of an innovative PSI made of porous hydroxyapatite, with interconnected porosity promoting osteointegration, called MyBone Custom® implant (MBCI), for maxillofacial bone reconstruction. A multicentric cohort of 13 patients underwent maxillofacial bone reconstruction surgery using MBCIs for various applications, from genioplasty to orbital floor reconstruction, including zygomatic and mandibular bone reconstruction, both for segmental defects and bone augmentation. The mean follow-up period was 9 months (1-22 months). No infections, displacements, or postoperative fractures were reported. Perioperative modifications of the MBCIs were possible when necessary. Additionally, surgeons reported significant time saved during surgery. For patients with postoperative CT scans, osteointegration signs were visible at the 6-month postoperative follow-up control, and continuous osteointegration was observed after 1 year. The advantages and disadvantages compared with current techniques used are discussed. MBCIs offer new bone reconstruction possibilities with long-term perspectives, while precluding the drawbacks of titanium and PEEK. The low level of postoperative complications associated with the high osteointegration potential of MBCIs paves the way to more extensive use of this new hydroxyapatite PSI in maxillofacial bone reconstruction.
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Affiliation(s)
- Simon Systermans
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium; Department of Oral and Maxillofacial Surgery, ZOL Genk, Genk, Belgium
| | | | - Séverine Camby
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Christophe Meyer
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU, Université de Franche-Comté, Besançon, France
| | - Aurélien Louvrier
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU, Université de Franche-Comté, Besançon, France
| | - Suen An Lie
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Thomas Schouman
- Department of Maxillofacial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Sergio Siciliano
- Department of Stomatology and Maxillofacial Surgery, Clinique Sainte Elisabeth, Brussels, Belgium
| | - Olivier Beckers
- Department of Oral and Maxillofacial Surgery, ZOL Genk, Genk, Belgium
| | - Vinciane Poulet
- Department of Maxillofacial Surgery, Toulouse Purpan University Hospital, Toulouse, France
| | - Nicolas Ullmann
- Service de Chirurgie Maxillo-faciale et Stomatologie, Hôpital de Villeneuve Saint Georges, France
| | | | - Vincent Biscaccianti
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France
| | - Jean-Luc Nizet
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Jean-Yves Hascoët
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France
| | - Yves Gilon
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Luciano Vidal
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France; Department of Plastic and Reconstructive Surgery, Clinique Bretéché - ELSAN, Nantes, France.
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Amaya-Rivas JL, Perero BS, Helguero CG, Hurel JL, Peralta JM, Flores FA, Alvarado JD. Future trends of additive manufacturing in medical applications: An overview. Heliyon 2024; 10:e26641. [PMID: 38444512 PMCID: PMC10912264 DOI: 10.1016/j.heliyon.2024.e26641] [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: 12/13/2022] [Revised: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024] Open
Abstract
Additive Manufacturing (AM) has recently demonstrated significant medical progress. Due to advancements in materials and methodologies, various processes have been developed to cater to the medical sector's requirements, including bioprinting and 4D, 5D, and 6D printing. However, only a few studies have captured these emerging trends and their medical applications. Therefore, this overview presents an analysis of the advancements and achievements obtained in AM for the medical industry, focusing on the principal trends identified in the annual report of AM3DP.
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Affiliation(s)
- Jorge L. Amaya-Rivas
- Advanced Manufacturing and Prototyping Laboratory (CAMPRO), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - Bryan S. Perero
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - Carlos G. Helguero
- Advanced Manufacturing and Prototyping Laboratory (CAMPRO), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - Jorge L. Hurel
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - Juan M. Peralta
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - Francisca A. Flores
- Faculty of Natural Sciences and Mathematics (FCNM), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
| | - José D. Alvarado
- Faculty of Mechanical Engineering and Production Sciences (FIMCP), ESPOL Polytechnic University, Km 30.5 Vía Perimetral, P.O. Box: 09-01-5863, Guayaquil, Ecuador
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Reiss S, Kulker D, Laure B, Paré A. Reconstruction of the orbitozygomatic framework: State of the art and perspectives. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101788. [PMID: 38281701 DOI: 10.1016/j.jormas.2024.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 01/30/2024]
Abstract
The reconstruction of the whole orbitozygomatic framework (OZF) is complex and can be encountered in cases of congenital midface deformity, after tumor ablative surgery and in severe facial trauma. Nowadays, surgeon has a wide range of available techniques that have continually grown over the past years, optimizing the surgical management and the aesthetical outcomes. Among them, the autologous bone graft (ABG) remains one of the most suitable options : ABG is easy to harvest and has optimal biological properties for bone healing. It can be tailored to the patient anatomy thanks to the recent advances in computer-assisted surgery. However, substantial drawbacks remain such as the early resorption of the non-vascularized graft, the need of a donor site and its potential morbidity. Alloplastic reconstruction is another option that can resolve both the resorption issue and the donor site morbidity. Moreover, the 3D-printing technologies also allows the manufacturing of patient specific implants. However, alloplastic materials have a variable success, especially due to the high risk of infection or exposure. Consequently, regenerative medicine is a promising field that aims to find a procedure without the disadvantages of ABG or alloplastic based reconstructions, but displaying similar or even higher success rate. Indeed, recent tissue engineering strategies have demonstrated encouraging results for bone regeneration using natural or synthetic biomaterials, patient cells and synthetic bioactive substances. The objective of this review is to present the etiologies of OZF defect, the available reconstruction procedures as well as the current state of the research.
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Affiliation(s)
- Ségolène Reiss
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Dimitri Kulker
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Boris Laure
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Arnaud Paré
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France.
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Charbonnier B, Weiss P. [Regeneration of dental tissues: Which biomaterials, which prospects?]. Med Sci (Paris) 2024; 40:88-91. [PMID: 38299909 DOI: 10.1051/medsci/2023201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Après avoir évoqué l’avenir des biomatériaux de réparation des tissus dentaires calcifiés (émail et dentine) en essayant d’être biomimétique et même de stimuler aux interfaces la régénération dentinaire, nous évoquons dans cet article l’avenir des biomatériaux utilisés pour régénérer les tissus de soutien de la dent, le parodonte qui inclut l’os alvéolaire.
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Affiliation(s)
- Baptiste Charbonnier
- Université de Nantes, Oniris, Inserm UMRS 1229, 1 place Alexis Ricordeau, 44042 Nantes, France
| | - Pierre Weiss
- Université de Nantes, Oniris, Inserm UMRS 1229, 1 place Alexis Ricordeau, 44042 Nantes, France
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Mavrodontis II, Trikoupis IG, Kontogeorgakos VA, Savvidou OD, Papagelopoulos PJ. Point-of-Care Orthopedic Oncology Device Development. Curr Oncol 2023; 31:211-228. [PMID: 38248099 PMCID: PMC10814108 DOI: 10.3390/curroncol31010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/08/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The triad of 3D design, 3D printing, and xReality technologies is explored and exploited to collaboratively realize patient-specific products in a timely manner with an emphasis on designs with meta-(bio)materials. METHODS A case study on pelvic reconstruction after oncological resection (osteosarcoma) was selected and conducted to evaluate the applicability and performance of an inter-epistemic workflow and the feasibility and potential of 3D technologies for modeling, optimizing, and materializing individualized orthopedic devices at the point of care (PoC). RESULTS Image-based diagnosis and treatment at the PoC can be readily deployed to develop orthopedic devices for pre-operative planning, training, intra-operative navigation, and bone substitution. CONCLUSIONS Inter-epistemic symbiosis between orthopedic surgeons and (bio)mechanical engineers at the PoC, fostered by appropriate quality management systems and end-to-end workflows under suitable scientifically amalgamated synergies, could maximize the potential benefits. However, increased awareness is recommended to explore and exploit the full potential of 3D technologies at the PoC to deliver medical devices with greater customization, innovation in design, cost-effectiveness, and high quality.
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Affiliation(s)
- Ioannis I. Mavrodontis
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.T.); (V.A.K.); (O.D.S.); (P.J.P.)
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Govoni FA, Felici N, Ornelli M, Marcelli VA, Migliano E, Pesucci BA, Pistilli R. Total mandible and bilateral TMJ reconstruction combining a customized jaw implant with a free fibular flap: a case report and literature review. Maxillofac Plast Reconstr Surg 2023; 45:6. [PMID: 36689098 PMCID: PMC9871153 DOI: 10.1186/s40902-023-00374-w] [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: 08/10/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The need for whole mandibular bone reconstruction and bilateral joint replacement is fortunately rare, but it is an extremely challenging topic in maxillofacial surgery, due to its functional implications. CAD-CAM techniques development has opened new broad horizons in the surgical planning of complex maxillofacial reconstructions, in terms of accuracy, predictability, and functional cosmetic results. The review of the literature has revealed a small number of scientific reports on total mandibulectomy including the condyles, with only eleven cases from 1980. Most of the works describe reconstructions secondary to dysplastic or inflammatory diseases affecting the lower jaw. The aim of this work, reporting a rare case of massive fibrous dysplasia of the whole mandible, is to share our experience in the management of extended mandibular and bilateral joint reconstruction, using porous titanium patient-specific implants. CASE PRESENTATION The authors present a 20-year-old male patient suffering from massive bone fibrous dysplasia of the mandible. The mandibular body and both the rami and the condylar processes had been involved, causing severe functional impairment, tooth loss, and facial deformation. The young patient, after repeated ineffective conservative surgical treatments, has required a biarticular mandibular replacement. Using virtual surgical planning (VSP) software, the authors, in collaboration with medical engineers, have created a custom-made original titanium porous mandibular implant, suspended from a bilateral artificial temporomandibular joint. The mandibular titanium implant body has been specifically designed to support soft tissues and to fix, in the alveolar region, a free fibular bone graft, for delayed dental implant prosthetic rehabilitation. CONCLUSION The surgical and technical details, as well as the new trends in mandibular reconstructions using porous titanium implants, are reported, and discussed, reviewing literature reports on this topic. Satisfactory functional and cosmetic restorative results have been obtained, and no major complications have occurred. The patient, currently in the 18th month clinical and radiological follow-up, has recently completed the functional restoration program by an implant-supported full-arch dental prosthesis.
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Affiliation(s)
- Flavio Andrea Govoni
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Nicola Felici
- grid.416308.80000 0004 1805 3485Unit of Plastic and Reconstructive Surgery of the Limbs, San Camillo-Forlanini Hospital, Rome, Italy
| | - Matteo Ornelli
- grid.416308.80000 0004 1805 3485Unit of Plastic and Reconstructive Surgery of the Limbs, San Camillo-Forlanini Hospital, Rome, Italy
| | - Vincenzo Antonio Marcelli
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Emilia Migliano
- grid.419467.90000 0004 1757 4473Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS I.F.O, Rome, Italy
| | - Bruno Andrea Pesucci
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Roberto Pistilli
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
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Paré A, Charbonnier B, Veziers J, Vignes C, Dutilleul M, De Pinieux G, Laure B, Bossard A, Saucet-Zerbib A, Touzot-Jourde G, Weiss P, Corre P, Gauthier O, Marchat D. Standardized and axially vascularized calcium phosphate-based implants for segmental mandibular defects: A promising proof of concept. Acta Biomater 2022; 154:626-640. [PMID: 36210043 DOI: 10.1016/j.actbio.2022.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
The reconstruction of massive segmental mandibular bone defects (SMDs) remains challenging even today; the current gold standard in human clinics being vascularized bone transplantation (VBT). As alternative to this onerous approach, bone tissue engineering strategies have been widely investigated. However, they displayed limited clinical success, particularly in failing to address the essential problem of quick vascularization of the implant. Although routinely used in clinics, the insertion of intrinsic vascularization in bioengineered constructs for the rapid formation of a feeding angiosome remains uncommon. In a clinically relevant model (sheep), a custom calcium phosphate-based bioceramic soaked with autologous bone marrow and perfused by an arteriovenous loop was tested to regenerate a massive SMD and was compared to VBT (clinical standard). Animals did not support well the VBT treatment, and the study was aborted 2 weeks after surgery due to ethical and animal welfare considerations. SMD regeneration was successful with the custom vascularized bone construct. Implants were well osseointegrated and vascularized after only 3 months of implantation and totally entrapped in lamellar bone after 12 months; a healthy yellow bone marrow filled the remaining space. STATEMENT OF SIGNIFICANCE: Regenerative medicine struggles with the generation of large functional bone volume. Among them segmental mandibular defects are particularly challenging to restore. The standard of care, based on bone free flaps, still displays ethical and technical drawbacks (e.g., donor site morbidity). Modern engineering technologies (e.g., 3D printing, digital chain) were combined to relevant surgical techniques to provide a pre-clinical proof of concept, investigating for the benefits of such a strategy in bone-related regenerative field. Results proved that a synthetic-biologics-free approach is able to regenerate a critical size segmental mandibular defect of 15 cm3 in a relevant preclinical model, mimicking real life scenarii of segmental mandibular defect, with a full physiological regeneration of the defect after 12 months.
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Affiliation(s)
- Arnaud Paré
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Baptiste Charbonnier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France
| | - Joëlle Veziers
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Caroline Vignes
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Maeva Dutilleul
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Gonzague De Pinieux
- Department of Pathology, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Boris Laure
- Department of Maxillofacial and Plastic surgery, Burn Unit, University Hospital of Tours, Trousseau Hospital, Avenue de la République, Chambray lès Tours 37170, France
| | - Adeline Bossard
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Annaëlle Saucet-Zerbib
- ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Gwenola Touzot-Jourde
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - Pierre Weiss
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Pierre Corre
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; Clinique de Stomatologie et Chirurgie Maxillo-Faciale, Nantes University Hospital, 1 Place Alexis Ricordeau, Nantes 44042, France
| | - Olivier Gauthier
- INSERM, U 1229, Laboratory of Regenerative Medicine and Skeleton, RMeS, Nantes Université, 1 Place Alexis Ricordeau, Nantes 44042, France; ONIRIS Nantes-Atlantic College of Veterinary Medicine, Research Center of Preclinical Invesitagtion (CRIP), Site de la Chantrerie, 101 route de Gachet, Nantes 44307, France
| | - David Marchat
- Mines Saint-Étienne, Univ Jean Monnet, INSERM, U 1059 Sainbiose, 42023, Saint-Étienne, France.
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Lv B, Wu J, Xiong Y, Xie X, Lin Z, Mi B, Liu G. Functionalized multidimensional biomaterials for bone microenvironment engineering applications: Focus on osteoimmunomodulation. Front Bioeng Biotechnol 2022; 10:1023231. [PMID: 36406210 PMCID: PMC9672076 DOI: 10.3389/fbioe.2022.1023231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/20/2022] [Indexed: 09/26/2023] Open
Abstract
As bone biology develops, it is gradually recognized that bone regeneration is a pathophysiological process that requires the simultaneous participation of multiple systems. With the introduction of osteoimmunology, the interplay between the immune system and the musculoskeletal diseases has been the conceptual framework for a thorough understanding of both systems and the advancement of osteoimmunomodulaty biomaterials. Various therapeutic strategies which include intervention of the surface characteristics or the local delivery systems with the incorporation of bioactive molecules have been applied to create an ideal bone microenvironment for bone tissue regeneration. Our review systematically summarized the current research that is being undertaken in the field of osteoimmunomodulaty bone biomaterials on a case-by-case basis, aiming to inspire more extensive research and promote clinical conversion.
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Affiliation(s)
| | | | | | | | | | - Bobin Mi
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guohui Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Tao J, Zhu S, Liao X, Wang Y, Zhou N, Li Z, Wan H, Tang Y, Sen Y, Du T, Yang Y, Song J, Liu R. DLP-based bioprinting of void-forming hydrogels for enhanced stem-cell-mediated bone regeneration. Mater Today Bio 2022; 17:100487. [PMID: 36388461 PMCID: PMC9649380 DOI: 10.1016/j.mtbio.2022.100487] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
The integration of 3D bioprinting and stem cells is of great promise in facilitating the reconstruction of cranial defects. However, the effectiveness of the scaffolds has been hampered by the limited cell behavior and functions. Herein, a therapeutic cell-laden hydrogel for bone regeneration is therefore developed through the design of a void-forming hydrogel. This hydrogel is prepared by digital light processing (DLP)-based bioprinting of the bone marrow stem cells (BMSCs) mixed with gelatin methacrylate (GelMA)/dextran emulsion. The 3D-bioprinted hydrogel can not only promote the proliferation, migration, and spreading of the encapsulated BMSCs, but also stimulate the YAP signal pathway, thus leading to the enhanced osteogenic differentiation of BMSCs. In addition, the in vivo therapeutic assessments reveal that the void-forming hydrogel shows great potential for BMSCs delivery and can significantly promote bone regeneration. These findings suggest that the unique 3D-bioprinted void-forming hydrogels are promising candidates for applications in bone regeneration.
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10
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Yang Z, Xie L, Zhang B, Zhang G, Huo F, Zhou C, Liang X, Fan Y, Tian W, Tan Y. Preparation of BMP-2/PDA-BCP Bioceramic Scaffold by DLP 3D Printing and its Ability for Inducing Continuous Bone Formation. Front Bioeng Biotechnol 2022; 10:854693. [PMID: 35464724 PMCID: PMC9019734 DOI: 10.3389/fbioe.2022.854693] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/16/2022] [Indexed: 02/05/2023] Open
Abstract
Digital light processing (DLP)-based 3D printing is suitable to fabricate bone scaffolds with small size and high precision. However, the published literature mainly deals with the fabrication procedure and parameters of DLP printed bioceramic scaffold, but lacks the subsequent systematic biological evaluations for bone regeneration application. In this work, a biphasic calcium phosphate (BCP) macroporous scaffold was constructed by DLP-based 3D printing technique. Furthermore, bone morphogenetic protein-2 (BMP-2) was facilely incorporated into this scaffold through a facile polydopamine (PDA) modification process. The resultant scaffold presents an interconnected porous structure with pore size of ∼570 μm, compressive strength (∼3.6 MPa), and the self-assembly Ca-P/PDA nanocoating exhibited excellent sustained-release property for BMP-2. Notably, this BMP-2/PDA-BCP scaffold presents favorable effects on the adhesion, proliferation, osteogenic differentiation, and mineralization of bone marrow stromal cells (BMSCs). Furthermore, in vivo experiments conducted on rats demonstrated that the scaffolds could induce cell layer aggregation adjacent to the scaffolds and continuous new bone generation within the scaffold. Collectively, this work demonstrated that the BMP-2/PDA-BCP scaffold is of immense potential to treat small craniofacial bone defects in demand of high accuracy.
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Affiliation(s)
- Ziyang Yang
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.,State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Xie
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Boqing Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Gang Zhang
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Fangjun Huo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Xi Liang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yinghui Tan
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
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Tao J, Zhu S, Zhou N, Wang Y, Wan H, Zhang L, Tang Y, Pan Y, Yang Y, Zhang J, Liu R. Nanoparticle-Stabilized Emulsion Bioink for Digital Light Processing Based 3D Bioprinting of Porous Tissue Constructs. Adv Healthc Mater 2022; 11:e2102810. [PMID: 35194975 DOI: 10.1002/adhm.202102810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/17/2022] [Indexed: 01/24/2023]
Abstract
A challenge for bioprinting tissue constructs is enabling the viability and functionality of encapsulated cells. Rationally designed bioink that can create appropriate biophysical cues shows great promise for overcoming such challenges. Here, a nanoparticle-stabilized emulsion bioink for direct fabrication of porous tissue constructs by digital light processing based 3D bioprinting technology is introduced. The emulsion bioink is integrated by the mixture of aqueous dextran microdroplets and gelatin methacryloyl solution and is further rendered stable by β-lactoglobulin nanoparticles. After bioprinting, the printed tissue constructs create the macroporous structure via removal of dextran, thereby providing favorable biophysical cues to promote the viability, proliferation, and spreading of the encapsulated cells. Moreover, a trachea-shaped construct containing chondrocytes is bioprinted and implanted in vivo. The results demonstrate that the generated macroporous construct is of benefit to cartilage tissue rebuilding. This work offers an advanced bioink for the fabrication of living tissue constructs by activating the cell behaviors and functions in situ and can lead to the development of 3D bioprinting.
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Affiliation(s)
- Jie Tao
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Shunyao Zhu
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Nazi Zhou
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Yu Wang
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Haoyuan Wan
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Lin Zhang
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Yaping Tang
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Yingzi Pan
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
- Basic Medical College Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Yang Yang
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
| | - Jianxiang Zhang
- Department of Pharmaceutics College of Pharmacy Army Medical University (The Third Military Medical University) Chongqing 400038 China
| | - Rui Liu
- Department of Stomatology Daping Hospital Army Medical University (The Third Military Medical University) Chongqing 400042 China
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12
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Wang W, Xiong Y, Zhao R, Li X, Jia W. A novel hierarchical biofunctionalized 3D-printed porous Ti6Al4V scaffold with enhanced osteoporotic osseointegration through osteoimmunomodulation. J Nanobiotechnology 2022; 20:68. [PMID: 35123501 PMCID: PMC8817481 DOI: 10.1186/s12951-022-01277-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
Background Femoral stem of titanium alloy has been widely used for hip arthroplasty with considerable efficacy; however, the application of this implant in patients with osteoporosis is limited due to excessive bone resorption. Macrophages participate in the regulation of inflammatory response and have been a topic of increasing research interest in implant field. However, few study has explored the link between macrophage polarization and osteogenic–osteoclastic differentiation. The present study aims to develop a novel hierarchical biofunctionalized 3D-printed porous Ti6Al4V scaffold with enhanced osteoporotic osseointegration through immunotherapy. Method To improve the osteointegration under osteoporosis, we developed a hierarchical biofunctionalized 3D-printed porous Ti6Al4V scaffold (PT). Biomimetic extracellular matrix (ECM) was constructed inside the interconnected pores of PT in micro-scale. And in nano-scale, a drug cargo icariin@Mg-MOF-74 (ICA@MOF) was wrapped in ECM-like structure that can control release of icariin and Mg2+. Results In this novel hierarchical biofunctionalized 3D-printed porous Ti6Al4V scaffold, the macroporous structure provides mechanical support, the microporous structure facilitates cell adhesion and enhances biocompatibility, and the nanostructure plays a biological effect. We also demonstrate the formation of abundant new bone at peripheral and internal sites after intramedullary implantation of the biofunctionalized PT into the distal femur in osteoporotic rats. We further find that the controlled-release of icariin and Mg2+ from the biofunctionalized PT can significantly improve the polarization of M0 macrophages to M2-type by inhibiting notch1 signaling pathway and induce the secretion of anti-inflammatory cytokines; thus, it significantly ameliorates bone metabolism, which contributes to improving the osseointegration between the PT and osteoporotic bone. Conclusion The therapeutic potential of hierarchical PT implants containing controlled release system are effective in geriatric orthopaedic osseointegration. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12951-022-01277-0.
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Wang Y, Huang H, Jia G, Zeng H, Yuan G. Fatigue and dynamic biodegradation behavior of additively manufactured Mg scaffolds. Acta Biomater 2021; 135:705-722. [PMID: 34469790 DOI: 10.1016/j.actbio.2021.08.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022]
Abstract
Additive manufacturing (AM) has enabled the fabrication of biodegradable porous metals to satisfy the desired characteristics for orthopedic applications. The geometrical design on AM biodegradable metallic scaffolds has been found to offer a favorable opportunity to regulate their mechanical and degradation performance in previous studies, however mostly confined to static responses. In this study, we presented the effect of the geometrical design on the dynamic responses of AM Mg scaffolds for the first time. Three different types of porous structures, based on various unit cells (i.e., biomimetic, diamond, and sheet-based gyroid), were established and then subjected to selective laser melting (SLM) process using group-developed Mg-Nd-Zn-Zr alloy (JDBM) powders. The topology after dynamic electropolishing, dynamic compressive properties, and dynamic biodegradation behavior of the AM Mg scaffolds were comprehensively evaluated. It was found that dynamic electropolishing effectively removed the excessive adhered powders on the surfaces and resulted in similar geometrical deviations amongst the AM Mg scaffolds, independent of their porous structures. The geometrical design significantly affected the compressive fatigue properties of the AM Mg scaffolds, of which the sheeted-based gyroid structure demonstrated a superior fatigue endurance limit of 0.85 at 106 cycles. Furthermore, in vitro dynamic immersion behaviors of the AM Mg scaffolds revealed a decent dependence on local architectures, where the sheeted-based gyroid scaffold experienced the lowest structural loss with a relatively uniform degradation mode. The obtained results indicate that the geometrical design could provide a promising strategy to develop desirable bone substitutes for the treatment of critical-size load-bearing defects. STATEMENT OF SIGNIFICANCE: Additive manufacturing (AM) has provided unprecedented opportunities to fabricate geometrically complex biodegradable scaffolds where the topological design becomes a key determinant on comprehensive performance. In this paper, we fabricate 3 AM biodegradable Mg scaffolds (i.e., biomimetic, diamond, and sheet-based gyroid) and report the effect of the geometrical design on the dynamic responses of AM Mg scaffolds for the first time. The results revealed that the sheeted-based gyroid scaffold exhibited the best combination of superior compressive fatigue properties and relatively uniform dynamic biodegradation mode, suggesting that the regulation of the porous structures could be an effective approach for the optimization of AM Mg scaffolds as to satisfy clinical requirements in orthopedic applications.
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Affiliation(s)
- Yinchuan Wang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hua Huang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Gaozhi Jia
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Hui Zeng
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China.
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
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