The Synergetic Effect of 3D Printing and Electrospinning Techniques in the Fabrication of Bone Scaffolds

The primary goal of bone tissue engineering is to restore and rejuvenate bone defects by using a suitable three-dimensional scaffold, appropriate cells, and growth hormones. Various scaffolding methods are used to fabricate three-dimensional scaffolds, which provide the necessary environment for cell activity and bone formation. Multiple materials may be used to create scaffolds with hierarchical structures that are optimal for cell growth and specialization. This study examines a notion for creating an optimal framework for bone regeneration using a combination of the robocasting method and the electrospinning approach. Research indicates that the integration of these two procedures enhances the benefits of each method and provides a rationale for addressing their shortcomings via this combination. The hybrid approach is anticipated to provide a manufactured scaffold that can effectively replace bone defects while possessing the necessary qualities for bone regeneration.

Melt electrowriting scaffolds with fibre-guiding features for periodontal attachment

Periodontal regeneration requires the re-attachment of oblique and perpendicular periodontal ligament (PDL) fibres to newly formed cementum and alveolar bone, which has proven elusive with existing approaches. In this study, multiple fibre-guiding biphasic tissue engineered constructs were fabricated by melt electrowriting. The biphasic scaffolds were 95 % porous and consisted of a pore size gradient bone compartment and periodontal compartment made of fibre-guiding channels with micro-architectural features ranging from 100 to 60 µm aimed to direct PDL fibre alignment and attachment. In vitro evaluations over 3 and 7 days demonstrated a marked improvement in collagen fibre orientation (over 60 % fully aligned) for scaffolds with micro-architecture ≤100 µm. The biphasic scaffolds were placed on a dentine slice and implanted ectopically, and this demonstrated that all micro-channels groups facilitated oblique and perpendicular alignment and attachment on the dentine with a mean nuclei angle and mean collagen fibre angle of approximately 60° resembling the native periodontal ligament attachment. A further in vivo testing using a surgically created rodent periodontal model highlighted the 80 µm micro-channel group's effectiveness, showing a significant increase in oblique PDL fibre attachment (72 %) and periodontal regeneration (56 %) when compared to all other groups onto the tooth root compared to control groups. Further to this, immunohistochemistry demonstrated the presence of periostin in the newly formed ligament indicating that functional regeneration occurred These findings suggest that scaffold micro-architectures of 100 µm or below can play a crucial role in directing periodontal tissue regeneration, potentially addressing a critical gap in periodontal therapy. STATEMENT OF SIGNIFICANCE: Periodontal regeneration remains a significant clinical challenge. Essential to restoring dental health and function is the proper attachment of the periodontal ligament, which is functionally oriented, to regenerated bone and cementum. Our research presents an innovative biphasic scaffold, utilizing Melt Electrowriting to systematically guide tissue growth. Distinct from existing methods, our scaffold is highly porous, adaptable, and precisely guides periodontal ligament fibre attachment to the opposing tooth root and alveolar bone interfaces, a critical step for achieving periodontal functional regeneration. Our findings not only bridge a significant gap in biomaterial driven tissue guidance but also promise more predictable outcomes for patients, marking a transformative advancement in the field.

Biofabrication Strategies for Oral Soft Tissue Regeneration

Gingival recession, a prevalent condition affecting the gum tissues, is characterized by the exposure of tooth root surfaces due to the displacement of the gingival margin. This review explores conventional treatments, highlighting their limitations and the quest for innovative alternatives. Importantly, it emphasizes the critical considerations in gingival tissue engineering leveraging on cells, biomaterials, and signaling factors. Successful tissue-engineered gingival constructs hinge on strategic choices such as cell sources, scaffold design, mechanical properties, and growth factor delivery. Unveiling advancements in recent biofabrication technologies like 3D bioprinting, electrospinning, and microfluidic organ-on-chip systems, this review elucidates their precise control over cell arrangement, biomaterials, and signaling cues. These technologies empower the recapitulation of microphysiological features, enabling the development of gingival constructs that closely emulate the anatomical, physiological, and functional characteristics of native gingival tissues. The review explores diverse engineering strategies aiming at the biofabrication of realistic tissue-engineered gingival grafts. Further, the parallels between the skin and gingival tissues are highlighted, exploring the potential transfer of biofabrication approaches from skin tissue regeneration to gingival tissue engineering. To conclude, the exploration of innovative biofabrication technologies for gingival tissues and inspiration drawn from skin tissue engineering look forward to a transformative era in regenerative dentistry with improved clinical outcomes.

Manufacturing 3D Biomimetic Tissue: A Strategy Involving the Integration of Electrospun Nanofibers with a 3D-Printed Framework for Enhanced Tissue Regeneration

3D printing and electrospinning are versatile techniques employed to produce 3D structures, such as scaffolds and ultrathin fibers, facilitating the creation of a cellular microenvironment in vitro. These two approaches operate on distinct working principles and utilize different polymeric materials to generate the desired structure. This review provides an extensive overview of these techniques and their potential roles in biomedical applications. Despite their potential role in fabricating complex structures, each technique has its own limitations. Electrospun fibers may have ambiguous geometry, while 3D-printed constructs may exhibit poor resolution with limited mechanical complexity. Consequently, the integration of electrospinning and 3D-printing methods may be explored to maximize the benefits and overcome the individual limitations of these techniques. This review highlights recent advancements in combined techniques for generating structures with controlled porosities on the micro-nano scale, leading to improved mechanical structural integrity. Collectively, these techniques also allow the fabrication of nature-inspired structures, contributing to a paradigm shift in research and technology. Finally, the review concludes by examining the advantages, disadvantages, and future outlooks of existing technologies in addressing challenges and exploring potential opportunities.

Combination of melt-electrospun poly-ε-caprolactone scaffolds and hepatocyte-like cells from footprint-free hiPSCs to create 3D biohybrid constructs for liver tissue engineering

The liver is a vital organ with numerous functions, including metabolic functions, detoxification, and the synthesis of secretory proteins. The increasing prevalence of liver diseases requires the development of effective treatments, models, and regenerative approaches. The field of liver tissue engineering represents a significant advance in overcoming these challenges. In this study, 3D biohybrid constructs were created by combining hepatocyte-like cells (HLCs) derived from patient-specific footprint-free human induced pluripotent stem cells (hiPSCs) and 3D melt-electrospun poly-ε-caprolactone (PCL) scaffolds. First, a differentiation procedure was established to obtain autologous HCLs from hiPSCs reprogrammed from renal epithelial cells using self-replicating mRNA. The obtained cells expressed hepatocyte-specific markers and exhibited important hepatocyte functions, such as albumin synthesis, cytochrome P450 activity, glycogen storage, and indocyanine green metabolism. Biocompatible PCL scaffolds were fabricated by melt-electrospinning and seeded with pre-differentiated hepatoblasts, which uniformly attached to the fibers of the scaffolds and successfully matured into HLCs. The use of patient-specific, footprint-free hiPSC-derived HLCs represents a promising cell source for personalized liver regeneration strategies. In combination with biocompatible 3D scaffolds, this innovative approach has a broader range of applications spanning liver tissue engineering, drug testing and discovery, and disease modeling.

3D printing method for bone tissue engineering scaffold

3D printing technology is an emerging technology. It constructs solid bodies by stacking materials layer by layer, and can quickly and accurately prepare bone tissue engineering scaffolds with specific shapes and structures to meet the needs of different patients. The field of life sciences has received a great deal of attention. However, different 3D printing technologies and materials have their advantages and disadvantages, and there are limitations in clinical application. In this paper, the technology, materials and clinical applications of 3D printed bone tissue engineering scaffolds are reviewed, and the future development trends and challenges in this field are prospected.

Expanded Polytetrafluoroethylene Membranes for Vascular Stent Coating: Manufacturing, Biomedical and Surgical Applications, Innovations and Case Reports

Coated stents are defined as innovative stents surrounded by a thin polymer membrane based on polytetrafluoroethylene (PTFE)useful in the treatment of numerous vascular pathologies. Endovascular methodology involves the use of such devices to restore blood flow in small-, medium- and large-calibre arteries, both centrally and peripherally. These membranes cross the stent struts and act as a physical barrier to block the growth of intimal tissue in the lumen, preventing so-called intimal hyperplasia and late stent thrombosis. PTFE for vascular applications is known as expanded polytetrafluoroethylene (e-PTFE) and it can be rolled up to form a thin multilayer membrane expandable by 4 to 5 times its original diameter. This membrane plays an important role in initiating the restenotic process because wrapped graft stent could be used as the treatment option for trauma devices during emergency situations and to treat a number of pathological vascular disease. In this review, we will investigate the multidisciplinary techniques used for the production of e-PTFE membranes, the advantages and disadvantages of their use, the innovations and the results in biomedical and surgery field when used to cover graft stents.

Tissue integration and biodegradation of soft tissue substitutes with and without compression: an experimental study in the rat

OBJECTIVES

To analyze the influence of compression on tissue integration and degradation of soft tissue substitutes.

MATERIAL AND METHODS

Six subcutaneous pouches in twenty-eight rats were prepared and boxes made of Al₂O₃ were implanted and used as carriers for soft tissue substitutes: a collagen matrix (MG), two volume-stable collagen matrices (FG/MGA), and a polycaprolactone scaffold(E). The volume-stable materials (FG/MGA/E) were further implanted with a twofold (2) and a fourfold (4) compression, created by the stacking of additional layers of the substitute materials. The samples were retrieved at 1, 2, and 12 weeks (10 groups, 3 time points, n = 5 per time point and group, overall, 150 samples). The area fraction of infiltrated fibroblasts and inflammatory cells was evaluated histologically. Due to within-subject comparisons, mixed models were conducted for the primary outcome. The level of significance was set at 5%.

RESULTS

The area fraction of fibroblasts increased in all groups over time. At 12 weeks, the densely compressed materials FG4 (1.1%), MGA4 (1.7%), and MGA2 (2.5%) obtained lower values as compared to the other groups, ranging between 4.7 (E2) and 6.5% (MG). Statistically significant differences (p ≤ 0.05) were observed between groups FG4 vs MG/FG2/E/E4 as well as between MGA4 vs MG/FG2/E/E4 and E vs MGA2.

CONCLUSIONS

Higher levels of compression led to delayed tissue integration. The effect of different compression levels was more distinct when compared to the differences between the materials.

CLINICAL RELEVANCE

All biomaterials demonstrated tissue integration and a minimal concomitant inflammatory reaction. Clinically, it might be more favorable to obtain a sufficient flap release or to reduce the material size to improve the tissue integration processes.

Fibre-guiding biphasic scaffold for perpendicular periodontal ligament attachment

Periodontal regeneration is characterized by the attachment of oblique periodontal ligament fibres on the tooth root surface. To facilitate periodontal ligament attachment, a fibre-guiding tissue engineered biphasic construct was manufactured by melt electrowriting (MEW) for influencing reproducible cell guidance and tissue orientation. The biphasic scaffold contained fibre-guiding features in the periodontal ligament component comprising of 100 µm spaced channels (100CH), a pore size gradient in the bone component and maintained a highly porous and fully interconnected interface between the compartments. The efficacy of the fibre-guiding channels was assessed in an ectopic periodontal attachment model in immunocompromised rats. This demonstrated an unprecedented and systematic tissue alignment perpendicular to the dentin in the 100CH group, resulting in the close mimicry of native periodontal ligament architecture. In addition, the histology revealed high levels of tissue integration between the two compartments as observed by the perpendicular collagen attachment on the dentin surface, which also extended and infiltrated the scaffold's bone compartment. In conclusion, the 100 µm fibre-guiding scaffold induced a systematic tissue orientation at the dentin-ligament interface, resembling the native periodontium and thus resulting in enhanced alignment mimicking periodontal ligament regeneration. STATEMENT OF SIGNIFICANCE: Periodontitis is a prevalent inflammatory disease affecting a large portion of the adult population and leading to the destruction of the tooth-supporting structures (alveolar bone, periodontal ligament, and cementum). Current surgical treatments are unpredictable and generally result in repair rather than functional regeneration. A key feature of functional regeneration is the re-insertion of the oblique or perpendicularly orientated periodontal ligament fibre in both the alveolar bone and root surface. This study demonstrates that a highly porous scaffold featuring 100 µm width channels manufactured by the stacking of melt electrospun fibres, induced perpendicular alignment and attachment of the neo-ligament onto a dentine surface. The fibre guiding micro-architecture may pave the way for enhanced and more functional regeneration of the periodontium.

The Technological Advancement to Engineer Next-Generation Stent-Grafts: Design, Material, and Fabrication Techniques

Endovascular treatment of aortic disorders has gained wide acceptance due to reduced physiological burden to the patient compared to open surgery, and ongoing stent-graft evolution has made aortic repair an option for patients with more complex anatomies. To date, commercial stent-grafts are typically developed from established production techniques with simple design structures and limited material ranges. Despite the numerous updated versions of stent-grafts by manufacturers, the reoccurrence of device-related complications raises questions about whether the current manfacturing methods are technically able to eliminate these problems. The technology trend to produce efficient medical devices, including stent-grafts and all similar implants, should eventually change direction to advanced manufacturing techniques. It is expected that through recent advancements, especially the emergence of 4D-printing and smart materials, unprecedented features can be defined for cardiovascular medical implants, like shape change and remote battery-free self-monitoring. 4D-printing technology promises adaptive functionality, a highly desirable feature enabling printed cardiovascular implants to physically transform with time to perform a programmed task. This review provides a thorough assessment of the established technologies for existing stent-grafts and provides technical commentaries on known failure modes. They then discuss the future of advanced technologies and the efforts needed to produce next-generation endovascular implants.

Advanced In Vitro Lung Models for Drug and Toxicity Screening: The Promising Role of Induced Pluripotent Stem Cells

The substantial socioeconomic burden of lung diseases, recently highlighted by the disastrous impact of the coronavirus disease 2019 (COVID-19) pandemic, accentuates the need for interventive treatments capable of decelerating disease progression, limiting organ damage, and contributing to a functional tissue recovery. However, this is hampered by the lack of accurate human lung research models, which currently fail to reproduce the human pulmonary architecture and biochemical environment. Induced pluripotent stem cells (iPSCs) and organ-on-chip (OOC) technologies possess suitable characteristics for the generation of physiologically relevant in vitro lung models, allowing for developmental studies, disease modeling, and toxicological screening. Importantly, these platforms represent potential alternatives for animal testing, according to the 3Rs (replace, reduce, refine) principle, and hold promise for the identification and approval of new chemicals under the European REACH (registration, evaluation, authorization and restriction of chemicals) framework. As such, this review aims to summarize recent progress made in human iPSC- and OOC-based in vitro lung models. A general overview of the present applications of in vitro lung models is presented, followed by a summary of currently used protocols to generate different lung cell types from iPSCs. Lastly, recently developed iPSC-based lung models are discussed.

Comprehensive Review on Design and Manufacturing of Bio-scaffolds for Bone Reconstruction

Bio-scaffolds are synthetic entities widely employed in bone and soft-tissue regeneration applications. These bio-scaffolds are applied to the defect site to provide support and favor cell attachment and growth, thereby enhancing the regeneration of the defective site. The progressive research in bio-scaffold fabrication has led to identification of biocompatible and mechanically stable materials. The difficulties in obtaining grafts and expenditure incurred in the transplantation procedures have also been overcome by the implantation of bio-scaffolds. Drugs, cells, growth factors, and biomolecules can be embedded with bio-scaffolds to provide localized treatments. The right choice of materials and fabrication approaches can help in developing bio-scaffolds with required properties. This review mostly focuses on the available materials and bio-scaffold techniques for bone and soft-tissue regeneration application. The first part of this review gives insight into the various classes of biomaterials involved in bio-scaffold fabrication followed by design and simulation techniques. The latter discusses the various additive, subtractive, hybrid, and other improved techniques involved in the development of bio-scaffolds for bone regeneration applications. Techniques involving multimaterial printing and multidimensional printing have also been briefly discussed.

Electrospinning and Additive Manufacturing: Adding Three-Dimensionality to Electrospun Scaffolds for Tissue Engineering

The final biochemical and mechanical performance of an implant or scaffold are defined by its structure, as well as the raw materials and processing conditions used during its fabrication. Electrospinning and Additive Manufacturing (AM) are two contrasting processing technologies that have gained popularity amongst the fields of medical research i.e., tissue engineering, implant design, drug delivery. Electrospinning technology is favored for its ability to produce micro- to nanometer fibers from polymer solutions and melts, of which, the dimensions, alignment, porosity, and chemical composition are easily manipulatable to the desired application. AM, on the other hand, offers unrivalled levels of geometrical freedom, allowing highly complex components (i.e., patient-specific) to be built inexpensively within 24 hours. Hence, adopting both technologies together appears to be a progressive step in pursuit of scaffolds that better match the natural architecture of human tissues. Here, we present recent insights into the advances on hybrid scaffolds produced by combining electrospinning (melt electrospinning excluded) and AM, specifically multi-layered architectures consisting of alternating fibers and AM elements, and bioinks reinforced with fibers prior to AM. We discuss how cellular behavior (attachment, migration, and differentiation) is influenced by the co-existence of these micro- and nano-features.

In vivo performance of electrospun tubular hyaluronic acid/collagen nanofibrous scaffolds for vascular reconstruction in the rabbit model

One of the main challenges of tissue-engineered vascular prostheses is restenosis due to intimal hyperplasia. The aim of this study is to develop a material for scaffolds able to support cell growth while tolerating physiological conditions and maintaining the patency of carotid artery model. Tubular hyaluronic acid (HA)-functionalized collagen nanofibrous composite scaffolds were prepared by sequential electrospinning method. The tubular composite scaffold has well-controlled biophysical and biochemical signals, providing a good matrix for the adhesion and proliferation of vascular endothelial cells (ECs), but resisting to platelets adhesion when exposed to blood. Carotid artery replacement experiment from 6-week rabbits showed that the HA/collagen nanofibrous composite scaffold grafts with endothelialization on the luminal surface could maintain vascular patency. At retrieval, the composite scaffold maintained good structural integrity and had comparable mechanical strength as the native artery. This study indicating that electrospun scaffolds combined with cells may become an alternative to prosthetic grafts for vascular reconstruction.

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

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

Gallic acid for cancer therapy: Molecular mechanisms and boosting efficacy by nanoscopical delivery

Cancer is the second leading cause of death worldwide. Majority of recent research efforts in the field aim to address why cancer resistance to therapy develops and how to overcome or prevent it. In line with this, novel anti-cancer compounds are desperately needed for chemoresistant cancer cells. Phytochemicals, in view of their pharmacological activities and capacity to target various molecular pathways, are of great interest in the development of therapeutics against cancer. Plant-derived-natural products have poor bioavailability which restricts their anti-tumor activity. Gallic acid (GA) is a phenolic acid exclusively found in natural sources such as gallnut, sumac, tea leaves, and oak bark. In this review, we report on the most recent research related to anti-tumor activities of GA in various cancers with a focus on its underlying molecular mechanisms and cellular pathwaysthat that lead to apoptosis and migration of cancer cells. GA down-regulates the expression of molecular pathways involved in cancer progression such as PI3K/Akt. The co-administration of GA with chemotherapeutic agents shows improvements in suppressing cancer malignancy. Various nano-vehicles such as organic- and inorganic nano-materials have been developed for targeted delivery of GA at the tumor site. Here, we suggest that nano-vehicles improve GA bioavailability and its ability for tumor suppression.

Pliable, Scalable, and Degradable Scaffolds with Varying Spatial Stiffness and Tunable Compressive Modulus Produced by Adopting a Modular Design Strategy at the Macrolevel

Clinical results obtained when degradable polymer-based medical devices are used in breast reconstruction following mastectomy are promising. However, it remains challenging to develop a large scaffold structure capable of providing both sufficient external mechanical support and an internal cell-like environment to support breast tissue regeneration. We propose an internal-bra-like prototype to solve both challenges. The design combines a 3D-printed scaffold with knitted meshes and electrospun nanofibers and has properties suitable for both breast tissue regeneration and support of a silicone implant. Finite element analysis (FEA) was used to predict the macroscopic and microscopic stiffnesses of the proposed structure. The simulations show that introduction of the mesh leads to a macroscopic scaffold stiffness similar to the stiffness of breast tissue, and mechanical testing confirms that the introduction of more layers of mesh in the modular design results in a lower elastic modulus. The compressive modulus of the scaffold can be tailored within a range from hundreds of kPa to tens of kPa. Biaxial tensile testing reveals stiffening with increasing strain and indicates that rapid strain-induced softening occurs only within the first loading cycle. In addition, the microscopic local stiffness obtained from FEA simulations indicates that cells experience significant heterogeneous mechanical stimuli at different places in the scaffold and that the local mechanical stimulus generated by the strand surface is controlled by the elastic modulus of the polymer, rather than by the scaffold architecture. From in vitro experiments, it was observed that the addition of knitted mesh and an electrospun nanofiber layer to the scaffold significantly increased cell seeding efficiency, cell attachment, and proliferation compared to the 3D-printed scaffold alone. In summary, our results suggest that the proposed design strategy is promising for soft tissue engineering of scaffolds to assist breast reconstruction and regeneration.

Osteochondral Tissue Engineering: The Potential of Electrospinning and Additive Manufacturing

The socioeconomic impact of osteochondral (OC) damage has been increasing steadily over time in the global population, and the promise of tissue engineering in generating biomimetic tissues replicating the physiological OC environment and architecture has been falling short of its projected potential. The most recent advances in OC tissue engineering are summarised in this work, with a focus on electrospun and 3D printed biomaterials combined with stem cells and biochemical stimuli, to identify what is causing this pitfall between the bench and the patients' bedside. Even though significant progress has been achieved in electrospinning, 3D-(bio)printing, and induced pluripotent stem cell (iPSC) technologies, it is still challenging to artificially emulate the OC interface and achieve complete regeneration of bone and cartilage tissues. Their intricate architecture and the need for tight spatiotemporal control of cellular and biochemical cues hinder the attainment of long-term functional integration of tissue-engineered constructs. Moreover, this complexity and the high variability in experimental conditions used in different studies undermine the scalability and reproducibility of prospective regenerative medicine solutions. It is clear that further development of standardised, integrative, and economically viable methods regarding scaffold production, cell selection, and additional biochemical and biomechanical stimulation is likely to be the key to accelerate the clinical translation and fill the gap in OC treatment.

3D Electrospun Nanofiber-Based Scaffolds: From Preparations and Properties to Tissue Regeneration Applications

Electrospun nanofibers have been frequently used for tissue engineering due to their morphological similarities with the extracellular matrix (ECM) and tunable chemical and physical properties for regulating cell behaviors and functions. However, most of the existing electrospun nanofibers have a closely packed two-dimensional (2D) membrane with the intrinsic shortcomings of limited cellular infiltration, restricted nutrition diffusion, and unsatisfied thickness. Three-dimensional (3D) electrospun nanofiber-based scaffolds can provide stem cells with 3D microenvironments and biomimetic fibrous structures. Thus, they have been demonstrated to be good candidates for in vivo repair of different tissues. This review summarizes the recent developments in 3D electrospun nanofiber-based scaffolds (ENF-S) for tissue engineering. Three types of 3D ENF-S fabricated using different approaches classified into electrospun nanofiber 3D scaffolds, electrospun nanofiber/hydrogel composite 3D scaffolds, and electrospun nanofiber/porous matrix composite 3D scaffolds are discussed. New functions for these 3D ENF-S and properties, such as facilitated cell infiltration, 3D fibrous architecture, enhanced mechanical properties, and tunable degradability, meeting the requirements of tissue engineering scaffolds were discovered. The applications of 3D ENF-S in cartilage, bone, tendon, ligament, skeletal muscle, nerve, and cardiac tissue regeneration are then presented with a discussion of current challenges and future directions. Finally, we give summaries and future perspectives of 3D ENF-S in tissue engineering and clinical transformation.

Effect of Dual Pore Size Architecture on In Vitro Osteogenic Differentiation in Additively Manufactured Hierarchical Scaffolds

The combination of macro- and microporosity is a potent manner of enhancing osteogenic potential, but the biological events leading to this increase in osteogenesis are not well understood. In this study, we investigated the effect of a dual pore size scaffold on the physical and biological properties, with the hypothesis that cell condensation is the determining factor for enhanced osteogenic differentiation. To this end, a hierarchical scaffold possessing a dual (large and small) pore size was fabricated by combining two additive manufacturing techniques: melt electrospinning writing (MEW) and fused deposition modeling (FDM). The scaffolds showed a mechanical stiffness of 23.2 ± 1.5 MPa similar to the FDM control scaffold, while the hybrid revealed an increased specific surface area of 1.4 ± 0.1 m²/g. The scaffold was cultured with primary human osteoblasts for 28 days, which showed enhanced cell adhesion and proliferation. The hierarchical structure was also beneficial for in vitro alkaline phosphate activity and mineralization and showed an increased expression of osteogenic protein and genes. Mesenchymal condensation markers related to osteoblastic differentiation (CDH2, RhoA, Rac1, and Cdc42) were upregulated in the hybrid construct, demonstrating that the MEW membrane provided an environment more suitable for the recapitulation of cell condensation, which in turn leads to higher osteogenic differentiation. In summary, this study demonstrated that the hierarchical scaffold developed in this paper leads to a significant improvement in the scaffold properties such as increased specific surface area, initial cell adhesion, cell proliferation, and in vitro osteogenesis.

4D Biofabrication Using a Combination of 3D Printing and Melt-Electrowriting of Shape-Morphing Polymers

We report the fabrication of scroll-like scaffolds with anisotropic topography using 4D printing based on a combination of 3D extrusion printing of methacrylated alginate, melt-electrowriting of polycaprolactone fibers, and shape-morphing of the fabricated object. A combination of 3D extrusion printing and melt-electrowriting allows programmed deposition of different materials and fabrication of structures with high resolution. Shape-morphing allows the transformation of a patterned surface of a printed structure in a pattern on inner surface of a folded object that is used to align cells. We demonstrate that the concentration of calcium ions, the environment media, and the geometrical shape of the scaffold influences shape-morphing that allows it to be efficiently programmed. Myoblasts cultured inside a scrolled bilayer scaffold demonstrate excellent viability and proliferation. Moreover, the patterned surface generated by PCL fibers allow a very high degree of orientation of cells, which cannot be achieved on the alginate layer without fibers.

Tissue Engineering for the Insertions of Tendons and Ligaments: An Overview of Electrospun Biomaterials and Structures

The musculoskeletal system is composed by hard and soft tissue. These tissues are characterized by a wide range of mechanical properties that cause a progressive transition from one to the other. These material gradients are mandatory to reduce stress concentrations at the junction site. Nature has answered to this topic developing optimized interfaces, which enable a physiological transmission of load in a wide area over the junction. The interfaces connecting tendons and ligaments to bones are called entheses, while the ones between tendons and muscles are named myotendinous junctions. Several injuries can affect muscles, bones, tendons, or ligaments, and they often occur at the junction sites. For this reason, the main aim of the innovative field of the interfacial tissue engineering is to produce scaffolds with biomaterial gradients and mechanical properties to guide the cell growth and differentiation. Among the several strategies explored to mimic these tissues, the electrospinning technique is one of the most promising, allowing to generate polymeric nanofibers similar to the musculoskeletal extracellular matrix. Thanks to its extreme versatility, electrospinning has allowed the production of sophisticated scaffolds suitable for the regeneration of both the entheses and the myotendinous junctions. The aim of this review is to analyze the most relevant studies that applied electrospinning to produce scaffolds for the regeneration of the enthesis and the myotendinous junction, giving a comprehensive overview on the progress made in the field, in particular focusing on the electrospinning strategies to produce these scaffolds and their mechanical, in vitro, and in vivo outcomes.

Prevascularized Retrievable Hybrid Implant to Enhance Function of Subcutaneous Encapsulated Islets

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

Process hybridization schemes for multiscale engineered tissue biofabrication

Recapitulation of multiscale structure-function properties of cells, cell-secreted extracellular matrix, and 3D architecture of natural tissues is central to engineering biomimetic tissue substitutes. Toward achieving biomimicry, a variety of biofabrication processes have been developed, which can be broadly classified into five categories-fiber and fabric formation, additive manufacturing, surface modification, remote fields, and other notable processes-each with specific advantages and limitations. The majority of biofabrication literature has focused on using a single process at a time, which often limits the range of tissues that could be created with relevant features that span nano to macro scales. With multiscale biomimicry as the goal, development of hybrid biofabrication strategies that synergistically unite two or more processes to complement each other's strengths and limitations has been steadily increasing. This work discusses recent literature in this domain and attempts to equip the reader with the understanding of selecting appropriate processes that can harmonize toward creating engineered tissues with appropriate multiscale structure-function properties. Opportunities related to various hybridization schemes and a future outlook on scale-up biofabrication have also been discussed. This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.

Advances in Functional Polymer Nanofibers: From Spinning Fabrication Techniques to Recent Biomedical Applications

Functional polymeric micro-/nanofibers have emerged as promising materials for the construction of structures potentially useful in biomedical fields. Among all kinds of technologies to produce polymer fibers, spinning methods have gained considerable attention. Herein, we provide a recent review on advances in the design of micro- and nanofibrous platforms via spinning techniques for biomedical applications. Specifically, we emphasize electrospinning, solution blow spinning, centrifugal spinning, and microfluidic spinning approaches. We first introduce the fundamentals of these spinning methods and then highlight the potential biomedical applications of such micro- and nanostructured fibers for drug delivery, tissue engineering, regenerative medicine, disease modeling, and sensing/biosensing. Finally, we outline the current challenges and future perspectives of spinning techniques for the practical applications of polymer fibers in the biomedical field.

Next Stage Approach to Tissue Engineering Skeletal Muscle

Large-scale muscle injury in humans initiates a complex regeneration process, as not only the muscular, but also the vascular and neuro-muscular compartments have to be repaired. Conventional therapeutic strategies often fall short of reaching the desired functional outcome, due to the inherent complexity of natural skeletal muscle. Tissue engineering offers a promising alternative treatment strategy, aiming to achieve an engineered tissue close to natural tissue composition and function, able to induce long-term, functional regeneration after in vivo implantation. This review aims to summarize the latest approaches of tissue engineering skeletal muscle, with specific attention toward fabrication, neuro-angiogenesis, multicellularity and the biochemical cues that adjuvate the regeneration process.

Preparation of PI/PTFE-PAI Composite Nanofiber Aerogels with Hierarchical Structure and High-Filtration Efficiency

Electrospun nanofiber, showing large specific area and high porosity, has attracted much attention across various fields, especially in the field of air filtration. The small diameter contributes to the construction of filters with high-filtration efficiency for fine particulate matter (PM), however, along with an increase in air resistance. Herein, composited nanofiber aerogels (NAs), a truly three-dimensional (3D) derivative of the densely compacted electrospun mat, were constructed with the blocks of polytetrafluoroethylene-polyamideimide (PTFE-PAI) composite nanofiber and polyimide (PI) nanofiber. PI/PTFE-PAI NAs with hierarchically porous architecture and excellent mechanical properties have been obtained by thermally induced crosslink bonding. Results indicated that sintering at 400 °C for 30 min could complete the decomposition of polyethylene (PEO) and imidization of polyamic acid (PAA) into PI, as well as generate sufficient mechanical bonding between adjacent nanofibers in the NAs without extra additive. The well-prepared PI/PTFE-PAI NAs could withstand high temperature up to 500 °C. In addition, the filtration tests illustrated that the composite NAs had an excellent performance in PM filtration. More importantly, the filtration behavior could be adjusted to meet the requirements of various applications. The excellent thermal stability and high-filtration efficiency indicated its great potential in the field of high-temperature air filtration.

Highly tunable bioactive fiber-reinforced hydrogel for guided bone regeneration

One of the most damaging pathologies that affects the health of both soft and hard tissues around the tooth is periodontitis. Clinically, periodontal tissue destruction has been managed by an integrated approach involving elimination of injured tissues followed by regenerative strategies with bone substitutes and/or barrier membranes. Regrettably, a barrier membrane with predictable mechanical integrity and multifunctional therapeutic features has yet to be established. Herein, we report a fiber-reinforced hydrogel with unprecedented tunability in terms of mechanical competence and therapeutic features by integration of highly porous poly(ε-caprolactone) fibrous mesh(es) with well-controlled 3D architecture into bioactive amorphous magnesium phosphate-laden gelatin methacryloyl hydrogels. The presence of amorphous magnesium phosphate and PCL mesh in the hydrogel can control the mechanical properties and improve the osteogenic ability, opening a tremendous opportunity in guided bone regeneration (GBR). Results demonstrate that the presence of PCL meshes fabricated via melt electrowriting can delay hydrogel degradation preventing soft tissue invasion and providing the mechanical barrier to allow time for slower migrating progenitor cells to participate in bone regeneration due to their ability to differentiate into bone-forming cells. Altogether, our approach offers a platform technology for the development of the next-generation of GBR membranes with tunable mechanical and therapeutic properties to amplify bone regeneration in compromised sites. STATEMENT OF SIGNIFICANCE: In this study, we developed a fiber-reinforced hydrogel platform with unprecedented tunability in terms of mechanical competence and therapeutic features for guided bone regeneration. We successfully integrated highly porous poly(ε-caprolactone) [PCL] mesh(es) into amorphous magnesium phosphate-laden hydrogels. The stiffness of the engineered hydrogel was significantly enhanced, and this reinforcing effect could be modulated by altering the number of PCL meshes and tailoring the AMP concentration. Furthermore, the fiber-reinforced hydrogel showed favorable cellular responses, significantly higher rates of mineralization, upregulation of osteogenic-related genes and bone formation. In sum, these fiber-reinforced membranes in combination with therapeutic agent(s) embedded in the hydrogel offer a robust, highly tunable platform to amplify bone regeneration not only in periodontal defects, but also in other craniomaxillofacial sites.

New forms of electrospun nanofiber materials for biomedical applications

Over the past two decades, electrospinning has emerged as an enabling nanotechnology to produce nanofiber materials for various biomedical applications. In particular, therapeutic/cellloaded nanofiber scaffolds have been widely examined in drug delivery, wound healing, and tissue repair and regeneration. However, due to the insufficient porosity, small pore size, noninjectability, and inaccurate spatial control in nanofibers of scaffolds, many efforts have been devoted to exploring new forms of nanofiber materials including expanded nanofiber scaffolds, nanofiber aerogels, short nanofibers, and nanofiber microspheres. This short review discusses the preparation and potential biomedical applications of new forms of nanofiber materials.

Combination of electrospinning with other techniques for the fabrication of 3D polymeric and composite nanofibrous scaffolds with improved cellular interactions

The development of three-dimensional (3D) scaffolds with physical and chemical topological cues at the macro-, micro-, and nanometer scale is urgently needed for successful tissue engineering applications. 3D scaffolds can be manufactured by a wide variety of techniques. Electrospinning technology has emerged as a powerful manufacturing technique to produce non-woven nanofibrous scaffolds with very interesting features for tissue engineering products. However, electrospun scaffolds have some inherent limitations that compromise the regeneration of thick and complex tissues. By integrating electrospinning and other fabrication technologies, multifunctional 3D fibrous assemblies with micro/nanotopographical features can be created. The proper combination of techniques leads to materials with nano and macro-structure, allowing an improvement in the biological performance of tissue-engineered constructs. In this review, we focus on the most relevant strategies to produce electrospun polymer/composite scaffolds with 3D architecture. A detailed description of procedures involving physical and chemical agents to create structures with large pores and 3D fiber assemblies is introduced. Finally, characterization and biological assays including in vitro and in vivo studies of structures intended for the regeneration of functional tissues are briefly presented and discussed.

In Situ Biological Transmutation of Catalytic Lactic Acid Waste into Calcium Lactate in a Readily Processable Three-Dimensional Fibrillar Structure for Bone Tissue Engineering

A bioinspired three-dimensional (3D) fibrous structure possesses biomimicry, valuable functionality, and performance to scaffolding in tissue engineering. In particular, an electrospun fibrous mesh has been studied as a scaffold material in various tissue regeneration applications. We produced a low-density 3D polycaprolactone/lactic acid (LA) fibrous mesh (3D-PCLS) via the novel lactic-assisted 3D electrospinning technique exploiting the catalytic properties of LA as we reported previously. In the study, we demonstrated a strategy of recycling the LA component to synthesize the osteoinductive biomolecules in situ, calcium lactate (CaL), thereby forming a 3D bioactive PCL/CaL fibrous scaffold (3D-SCaL) for bone tissue engineering. The fiber morphology of 3D-PCLS and its packing degree could have been tailored by modifying the spinning solution and the collector design. 3D-SCaL demonstrated successful conversion of CaL from LA and exhibited the significantly enhanced biomineralization capacity, cell infiltration and proliferation rate, and osteoblastic differentiation in vitro with two different cell lines, MC3T3-e1 and bone marrow stem cells. In conclusion, 3D-SCaL proves to be a highly practical and accessible strategy using a variety of polymers to produce 3D fibers as a potential candidate for future regenerative medicine and tissue engineering applications.

3D-printing of solvent exchange deposition modeling (SEDM) for a bilayered flexible skin substitute of poly (lactide-co-glycolide) with bioorthogonally engineered EGF

Biodegradable polyesters have been widely used as rigid biomedical apparatus because of high mechanical properties but few flexible implants. Herein, we report a flexible poly(lactide-co-glycolide) (PLGA) scaffold using a rapid in situ formation system based on phase separation by solvent exchange deposition modeling (SEDM), which was different from traditional 3D printing of fused deposition modeling (FDM). The FDM printed product was rigidity, its Young's modulus was approximate 2.6 times higher than that of SEDM printed sample. In addition, the thickness of the solidified ink would not shrink during the SEDM printing process, its surface had nano-/micro pores in favor of protein immobilization and cell adhesion. Then a flexible bilayered scaffold with nano-/microstructure was constructed combing SEDM with electrospinning technology for skin substitute, wherein the SEDM printed sample acted as a sub-layer for cell and tissue ingrowth, the densely packed electrospun nanofibers served as an upper-layer improving the sub-layer's tensile strength by 57.07% and preventing from bacteria as physical barrier. Ultimately, the bilayered scaffold immobilized epidermal growth factor (EGF) by a bioorthogonal approach was successfully applied to facilitate full-thickness wound healing of rats.

Biofabrication of valentine-shaped heart with a composite hydrogel and sacrificial material

3D bioprinting represents a potential solution for organs regeneration, however, the production of complex tissues and organs that are in large size, randomly shaped, hollow, and contain integrated pre-vascularization still faces multiple challenges. This study aimed to test the feasibility of our 3D printing scheme for the manufacturing of micro-fluid channel networks complex three-dimensional tissue structures. The reverse engineering software was used to design the CAD model and polyvinyl alcohol (PVA) was used as the sacrificial material to print the sacrificial stent use the bioprinter nozzle 1. Hydrogel composite H9c2 and human umbilical vein endothelial cells (HUVECs) were mixed with sodium alginate, agarose solution and platelet-rich plasma (PRP) as cellular bioink, which was extruded through nozzle 2 to deposit the internal pores of the sacrificial scaffold. The scaffold dissolved, change to a flexible, hollow and micro-fluid channel networks complex structure. The 3D-bioprinting technology can construct a micro-fluid channel networks valentine heart with a self-defined height and hollow in suitable mechanical properties. The cells proliferate and maintain their biological properties within the printed constructs. This study demonstrates that valentine heart-like constructs can be fabricated with 3D bioprinting using sacrificial and hydrogel materials.

3D printing with peptide-polymer conjugates for single-step fabrication of spatially functionalized scaffolds

Biodegradable polymer-based scaffolds are widely used to provide support during early stages of regeneration and can be functionalized with various chemical groups or bioactive cues to promote desired cellular behavior. However, these scaffolds are often modified post-fabrication, which can lead to undesired changes and homogeneously distributed chemistries that fail to mimic the spatial biochemical organization found in native tissues. To address these challenges, surface functionalization can be achieved by 3D printing with pre-functionalized biodegradable polymers, such as peptide-modified polymer conjugates, to control the deposition of preferred chemistries. Peptide-PCL conjugates were synthesized with the canonical cell adhesion peptide motif RGDS or its negative control RGES and 3D printed into scaffolds displaying one or both peptides. The peptides were also modified with bioorthogonal groups, biotin and azide, to visualize peptide concentration and location by labeling with complementary fluorophores. Peptide concentration on the scaffold surface increased with increasing peptide-PCL conjugate concentration added to the ink prior to 3D printing, and scaffolds printed with the highest RGDS(biotin)-PCL concentrations showed a significant increase in NIH3T3 fibroblast adhesion. To demonstrate spatial control of peptide functionalization, multiple printer heads were used to print both peptide-PCL conjugates into the same construct in alternating patterns. Cells preferentially attached and spread on RGDS(biotin)-PCL fibers compared to RGES(azide)-PCL fibers, illustrating how spatial functionalization can be used to influence local cell behavior within a single biomaterial. This presents a versatile platform to generate multifunctional biomaterials that can mimic the biochemical organization found in native tissues to support functional regeneration.

Improving skin integration around long-term percutaneous devices using fibrous scaffolds in a reconstructed human skin equivalent model

The interface between synthetic percutaneous devices and skin is a common area for bacterial infection, which may ultimately result in failure of the device. Better integration of percutaneous devices with skin may help reduce infection rates due to the creation of a dermal seal. However, the mismatch in material and chemical properties of devices and skin presents a challenge for closing the dermal gap at the skin-device interface. Here, we have used a tissue engineering approach to tissue integration by creating a highly fibrous poly(ε-caprolactone) scaffold using melt electrowriting and seeding this with dermal fibroblasts, followed by maturation and insertion into a full-thickness defect made in an ex vivo skin model. The integration of seeded scaffolds was compared with controls including a non-seeded scaffold and a polymer tube with a smooth surface. Dermal fibroblast inclusion in the scaffold and epidermal upgrowth versus downgrowth/marsupialization around the device were used as measures of integration. Based on these measures, almost all pre-seeded scaffolds performed better than both the non-seeded scaffolds and smooth tubes. The hypothesis is that the fibroblasts act as a barrier to epithelial downward migration, and provide healthy tissue for nascent epidermal development.

Medical-grade polycaprolactone scaffolds made by melt electrospinning writing for oral bone regeneration - a pilot study in vitro

BACKGROUND

The spectrum of indications for the use of membranes and scaffolds in the field of oral and maxillofacial surgery includes, amongst others, guided bone regeneration (GBR). Currently available membrane systems face certain disadvantages such as difficult clinical handling, inconsistent degradation, undirected cell growth and a lack of stability that often complicate their application. Therefore, new membranes which can overcome these issues are of great interest in this field.

METHODS

In this pilot study, we investigated polycaprolactone (PCL) scaffolds intended to enhance oral wound healing by means of melt electrospinning writing (MEW), which allowed for three-dimensional (3D) printing of micron scale fibers and very exact fiber placement. A singular set of box-shaped scaffolds of different sizes consisting of medical-grade PCL was examined and the scaffolds' morphology was evaluated via scanning electron microscopy (SEM). Each prototype sample with box sizes of 225 μm, 300 μm, 375 μm, 450 μm and 500 μm was assessed for cytotoxicity and cell growth by seeding each scaffold with human osteoblast-like cell line MG63.

RESULTS

All scaffolds demonstrated good cytocompatibility according to cell viability, protein concentration, and cell number. SEM analysis revealed an exact fiber placement of the MEW scaffolds and the growth of viable MG63 cells on them. For the examined box-shaped scaffolds with pore sizes between 225 μm and 500 μm, a preferred box size for initial osteoblast attachment could not be found.

CONCLUSIONS

These well-defined 3D scaffolds consisting of medical-grade materials optimized for cell attachment and cell growth hold the key to a promising new approach in GBR in oral and maxillofacial surgery.

Droplet Mobility on Hydrophobic Fibrous Coatings Comprising Orthogonal Fibers

Water droplet mobility on a hydrophobic surface cannot be guaranteed even when the droplet exhibits a high contact angle (CA) with the surface. In fact, droplet mobility on a surface, especially a fibrous surface, has remained an unsolved empirical problem. This paper is a combined experimental-computational study focused on droplet mobility on a fibrous surface. Electrospun polystyrene (PS) coatings were used in this work for their ability to exhibit high CAs simultaneously with low droplet mobility. To simplify this otherwise complicated problem and better isolate droplet-fiber interactions, the orientation of the fibers in the coatings was limited to the x and y directions. As the earth gravity was not strong enough to mobilize small droplets on PS coatings, experiments were conducted using ferrofluid droplets, and a magnet was used to make them move on the surface. Experimentally validated numerical simulations were used to enhance our understanding of the forces acting on a droplet before moving on the surface. Effects of Young-Laplace CA and fiber-fiber spacing on droplet mobility were investigated. In particular, it was found that droplet mobility depends strongly on the balance of forces exerted on the droplet by the fibers on the receding and advancing sides.

Current state of fabrication technologies and materials for bone tissue engineering

A range of traditional and free-form fabrication technologies have been investigated and, in numerous occasions, commercialized for use in the field of regenerative tissue engineering (TE). The demand for technologies capable of treating bone defects inherently difficult to repair has been on the rise. This quest, accompanied by the advent of functionally tailored, biocompatible, and biodegradable materials, has garnered an enormous research interest in bone TE. As a result, different materials and fabrication methods have been investigated towards this end, leading to a deeper understanding of the geometrical, mechanical and biological requirements associated with bone scaffolds. As our understanding of the scaffold requirements expands, so do the capability requirements of the fabrication processes. The goal of this review is to provide a broad examination of existing scaffold fabrication processes and highlight future trends in their development. To appreciate the clinical requirements of bone scaffolds, a brief review of the biological process by which bone regenerates itself is presented first. This is followed by a summary and comparisons of commonly used implant techniques to highlight the advantages of TE-based approaches over traditional grafting methods. A detailed discussion on the clinical and mechanical requirements of bone scaffolds then follows. The remainder of the manuscript is dedicated to current scaffold fabrication methods, their unique capabilities and perceived shortcomings. The range of biomaterials employed in each fabrication method is summarized. Selected traditional and non-traditional fabrication methods are discussed with a highlight on their future potential from the authors' perspective. This study is motivated by the rapidly growing demand for effective scaffold fabrication processes capable of economically producing constructs with intricate and precisely controlled internal and external architectures. STATEMENT OF SIGNIFICANCE: The manuscript summarizes the current state of fabrication technologies and materials used for creating scaffolds in bone tissue engineering applications. A comprehensive analysis of different fabrication methods (traditional and free-form) were summarized in this review paper, with emphasis on recent developments in the field. The fabrication techniques suitable for creating scaffolds for tissue engineering was particularly targeted and their use in bone tissue engineering were articulated. Along with the fabrication techniques, we emphasized the choice of materials in these processes. Considering the limitations of each process, we highlighted the materials and the material properties critical in that particular process and provided a brief rational for the choice of the materials. The functional performance for bone tissue engineering are summarized for different fabrication processes and the choice of biomaterials. Finally, we provide a perspective on the future of the field, highlighting the knowledge gaps and promising avenues in pursuit of effective scaffolds for bone tissue engineering. This extensive review of the field will provide research community with a reference source for current approaches to scaffold preparation. We hope to encourage the researchers to generate next generation biomaterials to be used in these fabrication processes. By providing both advantages and disadvantage of each fabrication method in detail, new fabrication techniques might be devised that will overcome the limitations of the current approaches. These studies should facilitate the efforts of researchers interested in generating ideal scaffolds, and should have applications beyond the repair of bone tissue.