Fabrication of 13-93 bioactive glass scaffolds for bone tissue engineering using indirect selective laser sintering

Bioactive Glass Microscaffolds Fabricated by Two-Photon Lithography

Porous scaffolds made of bioactive glass (BG) are of great interest for tissue engineering as they can bond to bone rapidly and promote new bone formation. Pores and channels between 100 and 500 µm provide space for cell intrusion and nutrient supply, facilitating bone ingrowth and vascularization. Furthermore, smaller pores and structural features of a few microns in size influence cell behavior, such as adhesion and osteogenic differentiation. Additive manufacturing (AM) is well suited to fabricate such geometries. However, microstructuring BG is demanding and common AM techniques are unable to achieve features below 100 µm. In this work, two-photon lithography (TPL) is used for the first time to structure BG with single-micron features. A composite containing BG nanoparticles is structured using TPL and thermally processed to receive glass scaffolds. The glass used in this study demonstrates in vitro bioactivity in simulated body fluid (SBF) and cytocompatibility toward human mesenchymal stromal cells (MSCs), making it a suitable material for tissue engineering. This process will open a toolbox for a variety of existing BG particles to be shaped with features as small as 6 µm and will broaden the understanding of the influence of scaffold design on cell behavior.

Ceramic-based 3D printed bone graft in bone tissue reconstruction: a systematic review and proportional meta-analysis of clinical studies

INTRODUCTION

This systematic review and proportional meta-analysis aims to evaluate the postoperative complication rate (CR%) of ceramic-based 3D-printed bone grafts based on the reported scientific articles conducted with human individuals.

METHODS

MEDLINE and SCOPUS were used as information sources. The synthesis of the study was carried out from studies with human individuals and the use of 3D-printed bone graft-ceramic as inclusion criteria. Cohen's kappa (κ) was calculated for interrater reliability. Qualitative analysis was performed based on the characteristics and outcomes of the individual study, and quantitative analysis was performed using proportional meta-analysis for CR%.

RESULTS

A total of 1352 records were identified through databases and resulted in 11 included studies (κ = 0.81-1.00) consisting of prospective clinical trials (64.63%), case series (16.67%), and case reports (18.18%). The overall postoperative complication rate was 14.3% (95% Cl: 0.19-53.6). The postoperative complication rate for studies conducted on the cranial defect, the maxillofacial-zygomatic defect, and the tibial-femoral defect was 2.7%, 11.1%, and 15.6%, respectively. This review also highlights common 3D printing techniques, materials, and grafs' characteristics, as well as their clinical applications.

CONCLUSIONS

Ceramic-based 3D-printed bone grafts show potential as alternatives for bone tissue reconstruction.

Achievements in 3D printing of silica-based materials for bone tissue engineering

Silica-based materials have been commonly studied in the field of bone tissue regeneration, due to their high bioactivity and osteogenic properties. There are two main strategies to obtain silica-based materials, a melt-quenching process using high temperatures, or a sol-gel reaction which can be carried out at mild conditions. Both techniques allow the preparation of calcium silicates and bioactive glasses, but pure silica can only be prepared through the sol-gel method. Furthermore, current clinical treatments require personalized scaffolds and these materials can be combined with the use of 3D printing techniques to obtain patient-specific scaffolds in a fast and precise fabrication process. This review focuses on the different silica-based 3D printable materials available nowadays as well as their physical, chemical and biological properties. Using high temperature, composites can be developed using Fused Deposition Modelling (FDM), while pure silica scaffolds can be prepared through Selective Laser Sintering (SLS) using silica particles. Moreover, silica particles can be 3D printed when combining polymeric binders and SLS, Stereolitography (SLA) or Direct Ink Writing (DIW); however, binder has to be removed at high temperatures after 3D printing. Alternatively, 3D printable silica materials can be obtained at mild temperatures through DIW or SLA, in this case only allowing the printing of composites or hybrids so far, with different proportions of silica. The properties of the resultant materials as well as the main advantages and disadvantages of the printing approaches are summarized in this review, together with the future perspectives in the field of silica 3D printed scaffolds.

Angiogenesis in bone tissue engineering via ceramic scaffolds: A review of concepts and recent advancements

Due to organ donor shortages, long transplant waitlists, and the complications/limitations associated with auto and allotransplantation, biomaterials and tissue-engineered models are gaining attention as feasible alternatives for replacing and reconstructing damaged organs and tissues. Among various tissue engineering applications, bone tissue engineering has become a promising strategy to replace or repair damaged bone. We aimed to provide an overview of bioactive ceramic scaffolds in bone tissue engineering, focusing on angiogenesis and the effect of different biofunctionalization strategies. Different routes to angiogenesis, including chemical induction through signaling molecules immobilized covalently or non-covalently, in situ secretion of angiogenic growth factors, and the degradation of inorganic scaffolds, are described. Physical induction mechanisms are also discussed, followed by a review of methods for fabricating bioactive ceramic scaffolds via microfabrication methods, such as photolithography and 3D printing. Finally, the strengths and weaknesses of the commonly used methodologies and future directions are discussed.

Influence of polylactide coating stereochemistry on mechanical and in vitro degradation properties of porous bioactive glass scaffolds for bone regeneration

The mechanical properties of polylactide stereocomplexes (PLA SC) have been primarily studied through tensile testing, with inconsistent results, and the compressive properties of PLA SC compared to homocrystalline or amorphous PLA remain poorly understood. In this study, we coated porous bioactive glass 13-93 scaffolds with amorphous, homocrystalline, or stereocomplex PLA to investigate their mechanical and degradation properties before and after immersion in simulated body fluid. The glass scaffolds had interconnected pores and an average porosity of 76%. The PLA coatings, which were 10-100 μm thick and approximately 3% of the glass scaffold mass, covered the glass to a large extent. The compressive strength and toughness of all PLA-coated scaffolds were significantly higher than those of uncoated scaffolds, with approximately a fourfold increase before immersion and a twofold increase after immersion. The compressive strength and toughness of PLA SC-coated scaffolds were similar to those of scaffolds with homocrystalline PLA coating, and significantly higher than for scaffolds with amorphous PLA coating. All PLA coatings moderated the initial pH increase caused by the glass, which could benefit surrounding cells and bone tissue in vivo after implantation.

Additive Manufacturing of Bioactive Glass and Its Polymer Composites as Bone Tissue Engineering Scaffolds: A Review

Bioactive glass (BG) and its polymer composites have demonstrated great potential as scaffolds for bone defect healing. Nonetheless, processing these materials into complex geometry to achieve either anatomy-fitting designs or the desired degradation behavior remains challenging. Additive manufacturing (AM) enables the fabrication of BG and BG/polymer objects with well-defined shapes and intricate porous structures. This work reviewed the recent advancements made in the AM of BG and BG/polymer composite scaffolds intended for bone tissue engineering. A literature search was performed using the Scopus database to include publications relevant to this topic. The properties of BG based on different inorganic glass formers, as well as BG/polymer composites, are first introduced. Melt extrusion, direct ink writing, powder bed fusion, and vat photopolymerization are AM technologies that are compatible with BG or BG/polymer processing and were reviewed in terms of their recent advances. The value of AM in the fabrication of BG or BG/polymer composites lies in its ability to produce scaffolds with patient-specific designs and the on-demand spatial distribution of biomaterials, both contributing to effective bone defect healing, as demonstrated by in vivo studies. Based on the relationships among structure, physiochemical properties, and biological function, AM-fabricated BG or BG/polymer composite scaffolds are valuable for achieving safer and more efficient bone defect healing in the future.

A Review on Manufacturing Processes of Biocomposites Based on Poly(α-Esters) and Bioactive Glass Fillers for Bone Regeneration

The incorporation of bioactive and biocompatible fillers improve the bone cell adhesion, proliferation and differentiation, thus facilitating new bone tissue formation upon implantation. During these last 20 years, those biocomposites have been explored for making complex geometry devices likes screws or 3D porous scaffolds for the repair of bone defects. This review provides an overview of the current development of manufacturing process with synthetic biodegradable poly(α-ester)s reinforced with bioactive fillers for bone tissue engineering applications. Firstly, the properties of poly(α-ester), bioactive fillers, as well as their composites will be defined. Then, the different works based on these biocomposites will be classified according to their manufacturing process. New processing techniques, particularly additive manufacturing processes, open up a new range of possibilities. These techniques have shown the possibility to customize bone implants for each patient and even create scaffolds with a complex structure similar to bone. At the end of this manuscript, a contextualization exercise will be performed to identify the main issues of process/resorbable biocomposites combination identified in the literature and especially for resorbable load-bearing applications.

Additive Manufacturing of Biomaterials-Design Principles and Their Implementation

Additive manufacturing (AM, also known as 3D printing) is an advanced manufacturing technique that has enabled progress in the design and fabrication of customised or patient-specific (meta-)biomaterials and biomedical devices (e.g., implants, prosthetics, and orthotics) with complex internal microstructures and tuneable properties. In the past few decades, several design guidelines have been proposed for creating porous lattice structures, particularly for biomedical applications. Meanwhile, the capabilities of AM to fabricate a wide range of biomaterials, including metals and their alloys, polymers, and ceramics, have been exploited, offering unprecedented benefits to medical professionals and patients alike. In this review article, we provide an overview of the design principles that have been developed and used for the AM of biomaterials as well as those dealing with three major categories of biomaterials, i.e., metals (and their alloys), polymers, and ceramics. The design strategies can be categorised as: library-based design, topology optimisation, bio-inspired design, and meta-biomaterials. Recent developments related to the biomedical applications and fabrication methods of AM aimed at enhancing the quality of final 3D-printed biomaterials and improving their physical, mechanical, and biological characteristics are also highlighted. Finally, examples of 3D-printed biomaterials with tuned properties and functionalities are presented.

Laser Sintering Approaches for Bone Tissue Engineering

The adoption of additive manufacturing (AM) techniques into the medical space has revolutionised tissue engineering. Depending upon the tissue type, specific AM approaches are capable of closely matching the physical and biological tissue attributes, to guide tissue regeneration. For hard tissue such as bone, powder bed fusion (PBF) techniques have significant potential, as they are capable of fabricating materials that can match the mechanical requirements necessary to maintain bone functionality and support regeneration. This review focuses on the PBF techniques that utilize laser sintering for creating scaffolds for bone tissue engineering (BTE) applications. Optimal scaffold requirements are explained, ranging from material biocompatibility and bioactivity, to generating specific architectures to recapitulate the porosity, interconnectivity, and mechanical properties of native human bone. The main objective of the review is to outline the most common materials processed using PBF in the context of BTE; initially outlining the most common polymers, including polyamide, polycaprolactone, polyethylene, and polyetheretherketone. Subsequent sections investigate the use of metals and ceramics in similar systems for BTE applications. The last section explores how composite materials can be used. Within each material section, the benefits and shortcomings are outlined, including their mechanical and biological performance, as well as associated printing parameters. The framework provided can be applied to the development of new, novel materials or laser-based approaches to ultimately generate bone tissue analogues or for guiding bone regeneration.

Bioactive Ceramic Scaffolds for Bone Tissue Engineering by Powder Bed Selective Laser Processing: A Review

The implementation of a powder bed selective laser processing (PBSLP) technique for bioactive ceramics, including selective laser sintering and melting (SLM/SLS), a laser powder bed fusion (L-PBF) approach is far more challenging when compared to its metallic and polymeric counterparts for the fabrication of biomedical materials. Direct PBSLP can offer binder-free fabrication of bioactive scaffolds without involving postprocessing techniques. This review explicitly focuses on the PBSLP technique for bioactive ceramics and encompasses a detailed overview of the PBSLP process and the general requirements and properties of the bioactive scaffolds for bone tissue growth. The bioactive ceramics enclosing calcium phosphate (CaP) and calcium silicates (CS) and their respective composite scaffolds processed through PBSLP are also extensively discussed. This review paper also categorizes the bone regeneration strategies of the bioactive scaffolds processed through PBSLP with the various modes of functionalization through the incorporation of drugs, stem cells, and growth factors to ameliorate critical-sized bone defects based on the fracture site length for personalized medicine.

Dissolution of Amorphous S53P4 Glass Scaffolds in Dynamic In Vitro Conditions

The silicate-based bioactive glass S53P4 is clinically used in bone regenerative applications in granule form. However, utilization of the glass in scaffold form has been limited by the high tendency of the glass to crystallize during sintering. Here, careful optimization of sintering parameters enabled the manufacture of porous amorphous S53P4 scaffolds with a strength high enough for surgical procedures in bone applications (5 MPa). Sintering was conducted in a laboratory furnace for times ranging from 25 to 300 min at 630 °C, i.e., narrowly below the commencement of the crystallization. The phase composition of the scaffolds was verified with XRD, and the ion release was tested in vitro and compared with granules in continuous flow of Tris buffer and simulated body fluid (SBF). The amorphous, porous S53P4 scaffolds present the possibility of using the glass composition in a wider range of applications.

Multi-Dimensional Printing for Bone Tissue Engineering

The development of 3D printing has significantly advanced the field of bone tissue engineering by enabling the fabrication of scaffolds that faithfully recapitulate desired mechanical properties and architectures. In addition, computer-based manufacturing relying on patient-derived medical images permits the fabrication of customized modules in a patient-specific manner. In addition to conventional 3D fabrication, progress in materials engineering has led to the development of 4D printing, allowing time-sensitive interventions such as programed therapeutics delivery and modulable mechanical features. Therapeutic interventions established via multi-dimensional engineering are expected to enhance the development of personalized treatment in various fields, including bone tissue regeneration. Here, recent studies utilizing 3D printed systems for bone tissue regeneration are summarized and advances in 4D printed systems are highlighted. Challenges and perspectives for the future development of multi-dimensional printed systems toward personalized bone regeneration are also discussed.

Applications of 3D printed bone tissue engineering scaffolds in the stem cell field

Due to traffic accidents, injuries, burns, congenital malformations and other reasons, a large number of patients with tissue or organ defects need urgent treatment every year. The shortage of donors, graft rejection and other problems cause a deficient supply for organ and tissue replacement, repair and regeneration of patients, so regenerative medicine came into being. Stem cell therapy plays an important role in the field of regenerative medicine, but it is difficult to fill large tissue defects by injection alone. The scientists combine three-dimensional (3D) printed bone tissue engineering scaffolds with stem cells to achieve the desired effect. These scaffolds can mimic the extracellular matrix (ECM), bone and cartilage, and eventually form functional tissues or organs by providing structural support and promoting attachment, proliferation and differentiation. This paper mainly discussed the applications of 3D printed bone tissue engineering scaffolds in stem cell regenerative medicine. The application examples of different 3D printing technologies and different raw materials are introduced and compared. Then we discuss the superiority of 3D printing technology over traditional methods, put forward some problems and limitations, and look forward to the future.

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.

3D-printed Biomimetic Bioactive Glass Scaffolds for Bone Regeneration in Rat Calvarial Defects

The pore geometry of scaffold intended for the use in the bone repair or replacement is one of the most important parameters in bone tissue engineering. It affects not only the mechanical properties of the scaffold but also the amount of bone regeneration after implantation. Scaffolds with five different architectures (cubic, spherical, x, gyroid, and diamond) at different porosities were fabricated with bioactive borate glass using the selective laser sintering (SLS) process. The compressive strength of scaffolds with porosities ranging from 60% to 30% varied from 1.7 to 15.5 MPa. The scaffold's compressive strength decreased significantly (up to 90%) after 1-week immersion in simulated body fluids. Degradation of scaffolds is dependent on porosity, in which the scaffold with the largest surface area has the largest reduction in strength. Scaffolds with traditional cubic architecture and biomimetic diamond architecture were implanted in 4.6 mm diameter full-thickness rat calvarial defects for 6 weeks to evaluate the bone regeneration with or without bone morphogenetic protein 2 (BMP-2). Histological analysis indicated no significant difference in bone formation in the defects treated with the two different architectures. However, the defects treated with the diamond architecture scaffolds had more fibrous tissue formation and thus have the potential for faster bone formation. Overall, the results indicated that borate glass scaffolds fabricated using the SLS process have the potential for bone repair and the addition of BMP-2 significantly improves bone regeneration.

Dentistry 4.0 Concept in the Design and Manufacturing of Prosthetic Dental Restorations

The paper is a comprehensive but compact review of the literature on the state of illnesses of the human stomatognathic system, related consequences in the form of dental deficiencies, and the resulting need for prosthetic treatment. Types of prosthetic restorations, including implants, as well as new classes of implantable devices called implant-scaffolds with a porous part integrated with a solid core, as well as biological engineering materials with the use of living cells, have been characterized. A review of works on current trends in the technical development of dental prosthetics aiding, called Dentistry 4.0, analogous to the concept of the highest stage of Industry 4.0 of the industrial revolution, has been presented. Authors’ own augmented holistic model of Industry 4.0 has been developed and presented. The studies on the significance of cone-beam computed tomography (CBCT) in planning prosthetic treatment, as well as in the design and manufacture of prosthetic restorations, have been described. The presented and fully digital approach is a radical turnaround in both clinical procedures and the technologies of implant preparation using computer-aided design and manufacturing methods (CAD/CAM) and additive manufacturing (AM) technologies, including selective laser sintering (SLS). The authors’ research illustrates the practical application of the Dentistry 4.0 approach for several types of prosthetic restorations. The development process of the modern approach is being observed all over the world. The use of the principles of the augmented holistic model of Industry 4.0 in advanced dental engineering indicates a change in the traditional relationship between a dentist and a dental engineer. The overall conclusion demonstrates that it is inevitable and extremely beneficial to implement the idea of Dentistry 4.0 following the assumptions of the authors’ own, holistic Industry 4.0 model.

Dolomite-Foamed Bioactive Silicate Scaffolds for Bone Tissue Repair

The use of three-dimensional (3D) scaffolds is recognized worldwide as a valuable biomedical approach for promoting tissue regeneration in critical-size bone defects. Over the last 50 years, bioactive glasses have been intensively investigated in a wide range of different clinical applications, from orthopedics to soft tissue healing. Bioactive glasses exhibit the unique capability to chemically bond to the host tissue and, furthermore, their processing versatility makes them very appealing due to the availability of different manufacturing techniques for the production of porous and interconnected synthetic bone grafts able to support new tissue growth over the whole duration of the treatment. As a novel contribution to the broad field of scaffold manufacturing, we report here an effective and relatively easy method to produce silicate glass-derived scaffolds by using, for the first time in the biomedical field, dolomite powder as a foaming agent for the formation of 3D bone-like porous structures. Morphological/structural features, crystallization behavior, and in vitro bioactivity in a simulated body fluid (SBF) were investigated. All the tested scaffolds were found to fulfil the minimum requirements that a scaffold for osseous repair should exhibit, including porosity (65-83 vol.%) and compressive strength (1.3-3.9 MPa) comparable to those of cancellous bone, as well as hydroxyapatite-forming ability (bioactivity). This study proves the suitability of a dolomite-foaming method for the production of potentially suitable bone grafts based on bioactive glass systems.

Mechanical performance of highly permeable laser melted Ti6Al4V bone scaffolds

Critically engineered stiffness and strength of a scaffold are crucial for managing maladapted stress concentration and reducing stress shielding. At the same time, suitable porosity and permeability are key to facilitate biological activities associated with bone growth and nutrient delivery. A systematic balance of all these parameters are required for the development of an effective bone scaffold. Traditionally, the approach has been to study each of these parameters in isolation without considering their interdependence to achieve specific properties at a certain porosity. The purpose of this study is to undertake a holistic investigation considering the stiffness, strength, permeability, and stress concentration of six scaffold architectures featuring a 68.46-90.98% porosity. With an initial target of a tibial host segment, the permeability was characterised using Computational Fluid Dynamics (CFD) in conjunction with Darcy's law. Following this, Ashby's criterion, experimental tests, and Finite Element Method (FEM) were employed to study the mechanical behaviour and their interdependencies under uniaxial compression. The FE model was validated and further extended to study the influence of stress concentration on both the stiffness and strength of the scaffolds. The results showed that the pore shape can influence permeability, stiffness, strength, and the stress concentration factor of Ti6Al4V bone scaffolds. Furthermore, the numerical results demonstrate the effect to which structural performance of highly porous scaffolds deviate, as a result of the Selective Laser Melting (SLM) process. In addition, the study demonstrates that stiffness and strength of bone scaffold at a targeted porosity is linked to the pore shape and the associated stress concentration allowing to exploit the design freedom associated with SLM.

3D Printing of Bioceramic Scaffolds-Barriers to the Clinical Translation: From Promise to Reality, and Future Perspectives

In this review, we summarize the challenges of the three-dimensional (3D) printing of porous bioceramics and their translational hurdles to clinical applications. The state-of-the-art of the major 3D printing techniques (powder-based and slurry-based), their limitations and key processing parameters are discussed in detail. The significant roadblocks that prevent implementation of 3D printed bioceramics in tissue engineering strategies, and medical applications are outlined, and the future directions where new research may overcome the limitations are proposed. In recent years, there has been an increasing demand for a nanoscale control in 3D fabrication of bioceramic scaffolds via emerging techniques such as digital light processing, two-photon polymerization, or large area maskless photopolymerization. However, these techniques are still in a developmental stage and not capable of fabrication of large-sized bioceramic scaffolds; thus, there is a lack of sufficient data to evaluate their contribution. This review will also not cover polymer matrix composites reinforced with particulate bioceramics, hydrogels reinforced with particulate bioceramics, polymers coated with bioceramics and non-porous bioceramics.

Mechanical properties of bioactive glasses, ceramics, glass-ceramics and composites: State-of-the-art review and future challenges

The repair and restoration of bone defects in orthopaedic and dental surgery remains a major challenge despite advances in surgical procedures and post-operative treatments. Bioactive glasses, ceramics, glass-ceramics and composites show considerable potential for such applications as they can promote bone tissue regeneration. This paper presents an overview of the mechanical properties of various bioactive materials, which have the potential for bone regeneration. It also identifies current strategies for improving the mechanical properties of these novel materials, as these are rarely ideal as direct replacements for human bone. For this reason bioactive organic-inorganic composites and hybrids that have tailorable mechanical properties are of particular interest. The inorganic component (bioactive glass, ceramic or glass-ceramic) can provide both strength and bioactivity, while the organic component can add structural reinforcement, toughness and processability. Another topic presented in this paper includes 3D porous scaffolds that act as a template for cell attachment, proliferation and bone growth. Mechanical limitations of existing glass and ceramic scaffolds are discussed, along with the relevant challenges and strategies for further improvement. Advantages and disadvantages of different bioactive materials are critically examined. This paper is focused on optimization of biomaterials properties, in particular mechanical properties and bioactivity.

Advances in additive manufacturing for bone tissue engineering scaffolds

This article reviews the current state of the art of additive manufacturing techniques for the production of bone tissue engineering (BTE) scaffolds. The most well-known of these techniques include: stereolithography, selective laser sintering, fused deposition modelling and three-dimensional printing. This review analyses in detail the basic physical principles and main applications of these techniques and presents a list of biomaterials for BTE applications, including commercial trademarks. It also describes and compares the main advantages and disadvantages and explains the highlights of each additive manufacturing technique and their evolution. Finally, is discusses both their capabilities and limitations and proposes potential strategies to improve this field.

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.

Preparation and characterization of bioactive glass tablets and evaluation of bioactivity and cytotoxicity in vitro

In this study, the SiO2-CaO-P2O5 ternary component of bioactive glass particles were successfully synthesized by sol-gel method, then the bioactive glass particles were pressed into tablets with dry pressing molding technology. The physicochemical structure, in-vitro bioactivity and biocompatibility of BG tablets were characterized by various methods, such as XRD、SEM、FTIR, etc. The results showed that the sol-gel bioactive glass particle was distinguished with its amorphous structure and micron-size. After being soaked in Tris-Hcl solution for 15 d, the bioactive glass tablets didn't collapse. Also, the mineralization assay in vitro showed that the bioactive glass tablets had good capability of inducing the formation of hydroxycarbonate apatite (HCA) after being immersed in simulated body fluid (SBF). In addition, the cytotoxicity assay indicated that the osteoblast (MC3T3) grew well on the surface of bioactive glass tablets. According to the above results, the bioactive glass tablets presented good mechanical strength, excellent apatite-forming activity and high biocompatibility, which demonstrated their potential applications in the field of bone defect repairing.

3D printing of ceramic-based scaffolds for bone tissue engineering: an overview

Currently, one of the most promising strategies in bone tissue engineering focuses on the development of biomimetic scaffolds. Ceramic-based scaffolds with favorable osteogenic ability and mechanical properties are promising candidates for bone repair. Three-dimensional (3D) printing is an additive manufacturing technique, which allows the fabrication of patient-specific scaffolds with high structural complexity and design flexibility, and gains growing attention. This review aims to highlight advances in 3D printing of ceramic-based scaffolds for bone tissue engineering. Technical limitations and practical challenges are emphasized and design considerations are also discussed.

Additive manufacturing of biomaterials

Biomaterials are used to engineer functional restoration of different tissues to improve human health and the quality of life. Biomaterials can be natural or synthetic. Additive manufacturing (AM) is a novel materials processing approach to create parts or prototypes layer-by-layer directly from a computer aided design (CAD) file. The combination of additive manufacturing and biomaterials is very promising, especially towards patient specific clinical applications. Challenges of AM technology along with related materials issues need to be realized to make this approach feasible for broader clinical needs. This approach is already making a significant gain towards numerous commercial biomedical devices. In this review, key additive manufacturing methods are first introduced followed by AM of different materials, and finally applications of AM in various treatment options. Realization of critical challenges and technical issues for different AM methods and biomaterial selections based on clinical needs are vital. Multidisciplinary research will be necessary to face those challenges and fully realize the potential of AM in the coming days.

Magnesium-based bioceramics in orthopedic applications

Magnesium ions are directly involved in numerous biological mechanisms; for example, they play an important part in the regulation of ion channels, DNA stabilization, enzyme activation and stimulation of cell growth and proliferation. This alkaline earth metal has gained great popularity in orthopedic applications in recent years. Magnesium-based bioceramics include a large group of magnesium containing compounds such as oxides, phosphates and silicates, that are involved in orthopedic applications like bone cements, bone scaffolds or implant coatings. This article aims to give a comprehensive review on different magnesium-based bioceramics, e.g. magnesium phosphates (MgO-P₂O₅), calcium magnesium phosphates (CaO-MgO-P₂O₅), and magnesium glasses (SiO₂-MgO) with a strong focus on the chemistry and properties of magnesium phosphate containing cements as the main application form. In addition, the processing of magnesium phosphate minerals into macroporous scaffolds for tissue engineering applications by either using traditional porogens or by additive manufacturing approaches are reflected. Finally, the biological in vitro and in vivo properties of magnesium phosphates for bone regeneration are summarized, which show promising results regarding the application as bone replacement material, but still lack in terms of testing in large animal models, load-bearing application sites and clinical data.

STATEMENT OF SIGNIFICANCE

Though bone substitutes from calcium phosphates have been investigated for a long time, a new trend is visible in the biomaterials sector: magnesium based bioceramics from magnesium phosphates and silicates due to the special biological significance of magnesium ions in enzymatic activation, cell growth and proliferation, etc. In contrast to pure magnesium implants, such formulations do not release hydrogen during degradation. As with calcium based bioceramics, magnesium based bioceramics are used for the development of diverse applications such as cements, macroporous scaffolds and coatings. From this perspective, we present a systematic overview on diverse kinds of magnesium based bioceramics, their processing regimes for different clinical purposes and their behavior both in vitro and in vivo.

FTIR characterization and release of bovine serum albumin from bioactive glasses

BACKGROUND

Bioactive glass has attracted substantial interest in orthopedics, but it has been less explored as a drug carrier. This study investigated the bovine serum albumin (BSA) release from bioactive 13-93B0 and 13-93B3 glasses.

METHODS

Glass disks (13-93B0 and 13-93B3; n = 5) were loaded with 4 mg of BSA and coated under different chitosan-coating conditions. The amount of BSA released in phosphate-buffered saline (PBS) was evaluated, and a degradation study was performed to find out the weight loss and pH of PBS. Secondary structures of BSA on 13-93B0 were characterized by Fourier transform infrared (FTIR) spectroscopy.

RESULTS

One hundred percent protein release occurred by 24 hours for all 13-93B3 groups. However, chitosan coating delayed 100% release up to 72 hours in 13-93B0 groups. The 13-93B3 glass showed higher degradation rates than 13-93B0 regardless of chitosan-coating status. Multilayer and sandwich chitosan coatings further delayed BSA release from 13-93B0. FTIR analysis revealed that α-helical structure was the highest among all groups and significantly higher in the 2% sandwich chitosan coating group (32.0% ± 2.1%), compared with uncoated and 4% chitosan groups.

CONCLUSIONS

Chitosan coating can delay the burst release of BSA from 13-93B0 glass and be a potential coating on bioactive glass for drug delivery purposes.

Comparison of the effects of 45S5 and 1393 bioactive glass microparticles on hMSC behavior

Bioactive glasses (BAGs) are highly interesting materials for bone regeneration applications in orthopedic and dental defects. It is quite well known that ionic release from BAGs influences cell behavior and function. Mindful of the clinical scenario, we hypothesized that local cell populations might additionally physically interact with the implanted BAG particles and respond differently than to just the ionic stimuli. We therefore studied the biological effect of two BAG types (45S5 and 1393) applied to human mesenchymal stromal cells (hMSCs) in three distinct presentation modes: (a) direct contact; and to dissolution products in (b) 2D, and (c) 3D culture. We furthermore investigated how the dose-dependence of these BAG particles, in concentrations ranging from 0.1 to 2.5 w/v %, influenced hMSC metabolic activity, proliferation, and cell spreading. These cellular functions were significantly hampered when hMSCs were exposed to high concentrations of either glasses, but the effects were more pronounced in the 45S5 groups and when the cells were in direct contact with the BAGs. Furthermore the biological effect of 1393 BAG outperformed that of 45S5 BAG in all tested presentation modes. These outcomes highlight the importance of investigating cell-BAG interactions in experimental set-ups that recapitulate host cell interactions with BAG particles. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2772-2782, 2017.

3D-Printing Technologies for Craniofacial Rehabilitation, Reconstruction, and Regeneration

The treatment of craniofacial defects can present many challenges due to the variety of tissue-specific requirements and the complexity of anatomical structures in that region. 3D-printing technologies provide clinicians, engineers and scientists with the ability to create patient-specific solutions for craniofacial defects. Currently, there are three key strategies that utilize these technologies to restore both appearance and function to patients: rehabilitation, reconstruction and regeneration. In rehabilitation, 3D-printing can be used to create prostheses to replace or cover damaged tissues. Reconstruction, through plastic surgery, can also leverage 3D-printing technologies to create custom cutting guides, fixation devices, practice models and implanted medical devices to improve patient outcomes. Regeneration of tissue attempts to replace defects with biological materials. 3D-printing can be used to create either scaffolds or living, cellular constructs to signal tissue-forming cells to regenerate defect regions. By integrating these three approaches, 3D-printing technologies afford the opportunity to develop personalized treatment plans and design-driven manufacturing solutions to improve aesthetic and functional outcomes for patients with craniofacial defects.

Open-Source Selective Laser Sintering (OpenSLS) of Nylon and Biocompatible Polycaprolactone

Selective Laser Sintering (SLS) is an additive manufacturing process that uses a laser to fuse powdered starting materials into solid 3D structures. Despite the potential for fabrication of complex, high-resolution structures with SLS using diverse starting materials (including biomaterials), prohibitive costs of commercial SLS systems have hindered the wide adoption of this technology in the scientific community. Here, we developed a low-cost, open-source SLS system (OpenSLS) and demonstrated its capacity to fabricate structures in nylon with sub-millimeter features and overhanging regions. Subsequently, we demonstrated fabrication of polycaprolactone (PCL) into macroporous structures such as a diamond lattice. Widespread interest in using PCL for bone tissue engineering suggests that PCL lattices are relevant model scaffold geometries for engineering bone. SLS of materials with large powder grain size (~500 μm) leads to part surfaces with high roughness, so we further introduced a simple vapor-smoothing technique to reduce the surface roughness of sintered PCL structures which further improves their elastic modulus and yield stress. Vapor-smoothed PCL can also be used for sacrificial templating of perfusable fluidic networks within orthogonal materials such as poly(dimethylsiloxane) silicone. Finally, we demonstrated that human mesenchymal stem cells were able to adhere, survive, and differentiate down an osteogenic lineage on sintered and smoothed PCL surfaces, suggesting that OpenSLS has the potential to produce PCL scaffolds useful for cell studies. OpenSLS provides the scientific community with an accessible platform for the study of laser sintering and the fabrication of complex geometries in diverse materials.

Bioactive Glasses: Frontiers and Challenges

Bioactive glasses were discovered in 1969 and provided for the first time an alternative to nearly inert implant materials. Bioglass formed a rapid, strong, and stable bond with host tissues. This article examines the frontiers of research crossed to achieve clinical use of bioactive glasses and glass-ceramics. In the 1980s, it was discovered that bioactive glasses could be used in particulate form to stimulate osteogenesis, which thereby led to the concept of regeneration of tissues. Later, it was discovered that the dissolution ions from the glasses behaved like growth factors, providing signals to the cells. This article summarizes the frontiers of knowledge crossed during four eras of development of bioactive glasses that have led from concept of bioactivity to widespread clinical and commercial use, with emphasis on the first composition, 45S5 Bioglass(®). The four eras are (a) discovery, (b) clinical application, (c) tissue regeneration, and (d) innovation. Questions still to be answered for the fourth era are included to stimulate innovation in the field and exploration of new frontiers that can be the basis for a general theory of bioactive stimulation of regeneration of tissues and application to numerous clinical needs.

Reprint of: Review of bioactive glass: From Hench to hybrids

Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.

Diopside modified porous polyglycolide scaffolds with improved properties

In this research, diopside was incorporated into PGA scaffolds for enhancing mechanical and biological properties. The porous scaffolds were fabricated via selective laser sintering.

Polymer coated phosphate glass/hydroxyapatite composite scaffolds for bone tissue engineering applications

Biopolymer coated PG/HA composite scaffolds were prepared with enhanced mechanical properties for bone tissue engineering applications.

The effects of 3D bioactive glass scaffolds and BMP-2 on bone formation in rat femoral critical size defects and adjacent bones

Reconstruction of critical size defects in the load-bearing area has long been a challenge in orthopaedics. In the past, we have demonstrated the feasibility of using a biodegradable load-sharing scaffold fabricated from poly(propylene fumarate)/tricalcium phosphate (PPF/TCP) loaded with bone morphogenetic protein-2 (BMP-2) to successfully induce healing in those defects. However, there is limited osteoconduction observed with the PPF/TCP scaffold itself. For this reason, 13-93 bioactive glass scaffolds with local BMP-2 delivery were investigated in this study for inducing segmental defect repairs in a load-bearing region. Furthermore, a recent review on BMP-2 revealed greater risks in radiculitis, ectopic bone formation, osteolysis and poor global outcome in association with the use of BMP-2 for spinal fusion. We also evaluated the potential side effects of locally delivered BMP-2 on the structures of adjacent bones. Therefore, cylindrical 13-93 glass scaffolds were fabricated by indirect selective laser sintering with side holes on the cylinder filled with dicalcium phosphate dehydrate as a BMP-2 carrier. The scaffolds were implanted into critical size defects created in rat femurs with and without 10 μg of BMP-2. The x-ray and micro-CT results showed that a bridging callus was found as soon as three weeks and progressed gradually in the BMP group while minimal bone formation was observed in the control group. Degradation of the scaffolds was noted in both groups. Stiffness, peak load and energy to break of the BMP group were all higher than the control group. There was no statistical difference in bone mineral density, bone area and bone mineral content in the tibiae and contralateral femurs of the control and BMP groups. In conclusion, a 13-93 bioactive glass scaffold with local BMP-2 delivery has been demonstrated for its potential application in treating large bone defects.

Biomaterials for orbital implants and ocular prostheses: overview and future prospects

The removal of an eye is one of the most difficult and dramatic decisions that a surgeon must consider in case of severe trauma or life-threatening diseases to the patient. The philosophy behind the design of orbital implants has evolved significantly over the last 60 years, and the use of ever more appropriate biomaterials has successfully reduced the complication rate and improved the patient's clinical outcomes and satisfaction. This review provides a comprehensive picture of the main advances that have been made in the development of innovative biomaterials for orbital implants and ocular prostheses. Specifically, the advantages, limitations and performance of the existing devices are examined and critically compared, and the potential of new, smart and suitable biomaterials are described and discussed in detail to outline a forecast for future research directions.

DEVELOPMENT OF COMPLEX POROUS POLYVINYL ALCOHOL SCAFFOLDS: MICROSTRUCTURE, MECHANICAL, AND BIOLOGICAL EVALUATIONS

Complex three-dimensional (3D) porous scaffolds with macro-pore size of 400–800 μm based on polyvinyl alcohol (PVA) powder were successfully developed by selective laser sintering (SLS) technology. The PVA scaffolds had customizable shape, controlled and totally interconnected porous structure, and high porosity. The microstructure and mechanical property were performed for their suitability for tissue engineering (TE). The results showed that PVA did not decompose while the degree of crystallization decreased in a given sintering condition. Moreover, there were micro-pores with sizes of 20–100 μm in the scaffold. The actual porosity of sintered scaffolds could be up to 82.35%, which was higher than the value of the designed models. An in vitro biocompatibility test showed MG-63 cells could well spread on the scaffold surface. The presented work demonstrates the favorable potential of PVA powder as TE scaffolds fabricated via SLS.

Review of bioactive glass: from Hench to hybrids

Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.

Additive manufacturing techniques for the production of tissue engineering constructs

'Additive manufacturing' (AM) refers to a class of manufacturing processes based on the building of a solid object from three-dimensional (3D) model data by joining materials, usually layer upon layer. Among the vast array of techniques developed for the production of tissue-engineering (TE) scaffolds, AM techniques are gaining great interest for their suitability in achieving complex shapes and microstructures with a high degree of automation, good accuracy and reproducibility. In addition, the possibility of rapidly producing tissue-engineered constructs meeting patient's specific requirements, in terms of tissue defect size and geometry as well as autologous biological features, makes them a powerful way of enhancing clinical routine procedures. This paper gives an extensive overview of different AM techniques classes (i.e. stereolithography, selective laser sintering, 3D printing, melt-extrusion-based techniques, solution/slurry extrusion-based techniques, and tissue and organ printing) employed for the development of tissue-engineered constructs made of different materials (i.e. polymeric, ceramic and composite, alone or in combination with bioactive agents), by highlighting their principles and technological solutions.

Biofabrication and in vitro study of hydroxyapatite/mPEG-PCL-mPEG scaffolds for bone tissue engineering using air pressure-aided deposition technology

The aims of this study were to fabricate biopolymer and biocomposite scaffolds for bone tissue engineering by an air pressure-aided deposition system and to carry out osteoblast cell culture tests to validate the biocompatibility of fabricated scaffolds. A mPEG-PCL-mPEG triblock copolymer was synthesized as a biopolymer material. Biocomposite material was composed of synthesized biopolymer and hydroxyapatite (HA) with a mean diameter of 100 μm. The weight ratio of HA added to the synthesized biopolymer was 0.1, 0.25, 0.5 and 1. The experimental results show that the maximum average compressive strength of biocomposite scaffolds, made of weight ratio 0.5, with mean pore size of 410 μm (porosity 81%) is 18.38 MPa which is two times stronger than that of biopolymer scaffolds. Osteoblast cells, MC3T3-E1, were seeded on both types of fabricated scaffolds to validate the biocompatibility using methylthianzol tetrazolium (MTT) assay and cell morphology observation. After 28 days of in vitro culturing, the seeded osteoblasts were well distributed in the interior of both types of scaffolds. Furthermore, MTT experimental results show that the cell viability of the biocomposite scaffold is higher than that of the biopolymer scaffold. This indicates that adding HA into synthesized biopolymer can enhance compressive strength and the proliferation of the osteoblast cell.

Modelling and Tissue Engineering of Three Layers of Calvarial Bone as a Biomimetic Scaffold

In this Study, a New Zealand Rabbit Parietal Bone Was Cross-Sectioned, and Parameters such as Entire Thickness and the Thicknesses of the Compact and Spongy Tables Were Morphometrically Measured by Imagej Software. the Pore Size of the Cancellous Table Was Also Analysed, and a Calvarial Bone Model Was Created. Based upon a Natural Model for Bone Repair, a Nano-Structured Scaffold Was Designed Using Bioglass and Gelatin (BG) as its Main Components. the Scaffold Was Prepared Using Layer Solvent Casting Combined with Freeze-Drying, Layering Techniques, and other Commonly Used Techniques. the Fabricated BG Scaffolds Were Made with Different Percentages of Nanoparticles, and the 10% and 30% Constructions Were Found to Be Respectively Similar to Compact and Spongy Bone. we Fabricated Three Lamellar Scaffolds with Two Compact Layers on the outside and One Spongy Layer in the Middle to Mimic the Composition and Structure of Natural Bone. the Chemical, Physical, and Biological Tests (including Cell Seeding on Scaffold and MTT Assay) that Evaluated this Scaffold Examined its Capacity to Promote Bone Repair. Fabricated Scaffolds Implanted in Rabbit Calvaria and Evaluated the Bone Repair by X-Ray. this Mimetic BG Scaffold Could Be an Excellent Candidate for a Synthetic Calvarial Bone Graft.

Effect of material, process parameters, and simulated body fluids on mechanical properties of 13-93 bioactive glass porous constructs made by selective laser sintering

The effect of particle size distribution, binder content, processing parameters, and sintering schedule on the microstructure and mechanical properties of porous constructs was investigated. The porous constructs were produced by indirect selective laser sintering (SLS) of 13-93 bioactive glass using stearic acid as a polymeric binder. The binder content and d(50) particle size in the feedstock powders were simultaneously reduced from 22 to 12 wt% and from 20 to 11 μm, respectively, to identify the minimum binder content required for the SLS fabrication. An average particle size of ∼16 μm with a binder content of 15 wt% significantly reduced post-processing time and improved mechanical properties. Increasing the laser power and scan speed at the energy density of 1 cal/cm² maintained the feature sharpness of the parts during the fabrication of green parts and could almost double the mechanical properties of the sintered parts. Changes in the heating rates, ranging from 0.1 to 2 °C/min, during the post-processing of the fabricated "green" scaffolds showed that the heating rate significantly affects the densification and mechanical properties of the sintered scaffolds. The compressive strength of the scaffolds manufactured with the optimized parameters varied from 41 MPa, for a scaffold with a porosity of ∼50%, to 157 MPa, for a dense part. The bioactive scaffolds soaked in simulated body fluids for durations up to 6 weeks were used to evaluate the change in mechanical properties in vitro.