Selective laser sintering of hydroxyapatite reinforced polyethylene composites for bioactive implants and tissue scaffold development

Milestones and current achievements in development of multifunctional bioscaffolds for medical application

Tissue engineering (TE) is a rapidly growing interdisciplinary field, which aims to restore or improve lost tissue function. Despite that TE was introduced more than 20 years ago, innovative and more sophisticated trends and technologies point to new challenges and development. Current challenges involve the demand for multifunctional bioscaffolds which can stimulate tissue regrowth by biochemical curves, biomimetic patterns, active agents and proper cell types. For those purposes especially promising are carefully chosen primary cells or stem cells due to its high proliferative and differentiation potential. This review summarized a variety of recently reported advanced bioscaffolds which present new functions by combining polymers, nanomaterials, bioactive agents and cells depending on its desired application. In particular necessity of study biomaterial-cell interactions with in vitro cell culture models, and studies using animals with in vivo systems were discuss to permit the analysis of full material biocompatibility. Although these bioscaffolds have shown a significant therapeutic effect in nervous, cardiovascular and muscle, tissue engineering, there are still many remaining unsolved challenges for scaffolds improvement.

A Brief Review on Additive Manufacturing of Polymeric Composites and Nanocomposites

In this research article, a mini-review study is performed on the additive manufacturing (AM) of the polymeric matrix composites (PMCs) and nanocomposites. In this regard, some methods for manufacturing and important and applied results are briefly introduced and presented. AM of polymeric matrix composites and nanocomposites has attracted great attention and is emerging as it can make extensively customized parts with appreciably modified and improved mechanical properties compared to the unreinforced polymer materials. However, some matters must be addressed containing reduced bonding of reinforcement and matrix, the slip between reinforcement and matrix, lower creep strength, void configurations, high-speed crack propagation, obstruction because of filler inclusion, enhanced curing time, simulation and modeling, and the cost of manufacturing. In this review, some selected and significant results regarding AM or three-dimensional (3D) printing of polymeric matrix composites and nanocomposites are summarized and discuss. In addition, this article discusses the difficulties in preparing composite feedstock filaments and printing issues with nanocomposites and short and continuous fiber composites. It is discussed how to print various thermoplastic composites ranging from amorphous to crystalline polymers. In addition, the analytical and numerical models used for simulating AM, including the Fused deposition modeling (FDM) printing process and estimating the mechanical properties of printed parts, are explained in detail. Particle, fiber, and nanomaterial-reinforced polymer composites are highlighted for their performance. Finally, key limitations are identified in order to stimulate further 3D printing research in the future.

3D printed PEEK/HA composites for bone tissue engineering applications: Effect of material formulation on mechanical performance and bioactive potential

Polyetheretherketone (PEEK) is a biocompatible polymer widely used for biomedical applications. Because it is biologically inert, bioactive phases, such as nano-hydroxyapatite (HA), have been added to PEEK in order to improve its bioactivity. 3D printing (3DP) technologies are being increasingly used today to manufacture patient specific devices and implants. However, processing of PEEK is challenging due to its high melting point which is above 340 °C. In this study, PEEK-based filaments containing 10 wt% of pure nano-HA, strontium (Sr)- doped nano-HA and Zinc (Zn)-doped nano-HA were produced via hot-melt extrusion and subsequently 3D printed via fused deposition modelling (FDM), following an initial optimization process. The raw materials, extruded filaments and 3D printed samples were characterized in terms of physicochemical, thermal and morphological analysis. Moreover, the mechanical performance of 3D printed specimens was assessed via tensile tensing. Although an increase in the melting point and a reduction in crystallization temperature was observed with the addition of HA and doped HA to pure PEEK, there was no noticeable increase in the degree of crystallinity. Regarding the mechanical behavior, no significant differences were detected following the addition of the inorganic phases to the polymeric matrix, although a small reduction in the ultimate tensile strength (~14%) and Young's modulus (~5%) in PEEK/HA was observed in comparison to pure PEEK. Moreover, in vitro bioactivity of 3D printed samples was evaluated via a simulated body fluid immersion test for up to 28 days; the formation of apatite was observed on the surfaces of sample surfaces containing HA, SrHA and ZnHA. These results indicate the potential to produce bioactive, 3DP PEEK composites for challenging applications such as in craniofacial bone repair.

Solvent-Free Approaches for the Processing of Scaffolds in Regenerative Medicine

The regenerative medicine field is seeking novel strategies for the production of synthetic scaffolds that are able to promote the in vivo regeneration of a fully functional tissue. The choices of the scaffold formulation and the manufacturing method are crucial to determine the rate of success of the graft for the intended tissue regeneration process. On one hand, the incorporation of bioactive compounds such as growth factors and drugs in the scaffolds can efficiently guide and promote the spreading, differentiation, growth, and proliferation of cells as well as alleviate post-surgical complications such as foreign body responses and infections. On the other hand, the manufacturing method will determine the feasible morphological properties of the scaffolds and, in certain cases, it can compromise their biocompatibility. In the case of medicated scaffolds, the manufacturing method has also a key effect in the incorporation yield and retained activity of the loaded bioactive agents. In this work, solvent-free methods for scaffolds production, i.e., technological approaches leading to the processing of the porous material with no use of solvents, are presented as advantageous solutions for the processing of medicated scaffolds in terms of efficiency and versatility. The principles of these solvent-free technologies (melt molding, 3D printing by fused deposition modeling, sintering of solid microspheres, gas foaming, and compressed CO2 and supercritical CO2-assisted foaming), a critical discussion of advantages and limitations, as well as selected examples for regenerative medicine purposes are herein presented.

3D Printing of Polymeric Multi-Layer Micro-Perforated Panels for Tunable Wideband Sound Absorption

The increasing concern about noise pollution has accelerated the development of acoustic absorption and damping devices. However, conventional subtractive manufacturing can only fabricate absorption devices with simple geometric shapes that are unable to achieve high absorption coefficients in wide frequency ranges. In this paper, novel multi-layer micro-perforated panels (MPPs) with tunable wideband absorption are designed and fabricated by 3D printing or additive manufacturing. Selective laser sintering (SLS), which is an advanced powder-based 3D printing technique, is newly introduced for MPP manufacturing with polyamide 12 as the feedstock. The acoustic performances of the MPPs are investigated by theoretical, numerical, and experimental methods. The results reveal that the absorption frequency bandwidths of the structures are wider than those of conventional single-layer MPPs, while the absorption coefficients remain comparable or even higher. The frequency ranges can be tuned by varying the air gap distances and the inter-layer distances. Furthermore, an optimization method is introduced for structural designs of MPPs with the most effective sound absorption performances in the target frequency ranges. This study reveals the potential of 3D printing to fabricate acoustic devices with effective tunable sound absorption behaviors and provides an optimization method for future structural design of the wideband sound absorption devices.

Investigation into the Differences in the Selective Laser Sintering between Amorphous and Semi-crystalline Polymers

Significant different thermal properties between amorphous and semi-crystalline polymers have a great effect on the selection of proper sintering parameters and the resulting properties of the parts made by selective laser sintering (SLS) process. This paper studied the differences in the part bed temperature (Tb), and relative density, tensile strength and dimensional accuracy of the SLS fabricated parts between semi-crystalline and amorphous polymers, by measuring and comparing the laser sintering properties of polystyrene (PS), a typical amorphous polymer, and nylon-12 (PA12), a typical semi-crystalline polymer. The results show that: the part bed temperatures (Tb) of amorphous polymers and semi-crystalline polymers should be kept close to glass transition temperature (Tg) and initial melting temperature (Tim) respectively, which can be measured by differential scanning calorimetry (DSC), and this rule combined with trial and error experiments can determine Tb of a polymer in the SLS process; the amorphous polymer SLS parts have very low relative densities and much lower tensile strengths than the strengths of their fully dense forms, while the semi-crystalline polymer SLS parts have higher relative densities and their tensile strengths are close to the strengths of their fully dense forms; the dimensional accuracy of the SLS parts of amorphous polymers is higher than that of semi-crystalline polymer SLS parts at the same processing parameters. The obtained results will be helpful for the development of new SLS materials and the setting of processing parameters.

Selective laser sintering in biomedical engineering

Selective laser sintering (SLS) is a solid freeform fabrication technique, developed by Carl Deckard for his master's thesis at the University of Texas, patented in 1989. SLS manufacturing is a technique that produces physical models through a selective solidification of a variety of fine powders. SLS technology is getting a great amount of attention in the clinical field. In this paper the characteristics features of SLS and the materials that have been developed for are reviewed together with a discussion on the principles of the above-mentioned manufacturing technique. The applications of SLS in tissue engineering, and at-large in the biomedical field, are reviewed and discussed.

Fabrication, mechanical and in vivo performance of polycaprolactone/tricalcium phosphate composite scaffolds

This paper explores the use of selective laser sintering (SLS) for the generation of bone tissue engineering scaffolds from polycaprolactone (PCL) and PCL/tricalcium phosphate (TCP). Different scaffold designs are generated, and assessed from the point of view of manufacturability, porosity and mechanical performance. Large scaffold specimens are produced, with a preferred design, and are assessed through an in vivo study of the critical size bone defect in sheep tibia with subsequent microscopic, histological and mechanical evaluation. Further explorations are performed to generate scaffolds with increasing TCP content. Scaffold fabrication from PCL and PCL/TCP mixtures with up to 50 mass% TCP is shown to be possible. With increasing macroporosity the stiffness of the scaffolds is seen to drop; however, the stiffness can be increased by minor geometrical changes, such as the addition of a cage around the scaffold. In the animal study the selected scaffold for implantation did not perform as well as the TCP control in terms of new bone formation and the resulting mechanical performance of the defect area. A possible cause for this is presented.

Laser sintering for the fabrication of tissue engineering scaffolds

Laser sintering (LS) utilises a laser to sinter powder particles. A volumetric model is sliced and processed cross section by cross section to create a physical part. In theory, all powdered materials are suitable for sintering; however, only few have been tested successfully. For tissue engineering (TE) applications of this rapid prototyping technology it is an advantage that no toxic solvents or binders are necessary. This chapter reviews the direct and indirect use of LS to fabricate scaffolds for TE from single and multiphase materials.

Laser direct writing of micro- and nano-scale medical devices

Laser-based direct writing of materials has undergone significant development in recent years. The ability to modify a variety of materials at small length scales and using short production times provides laser direct writing with unique capabilities for fabrication of medical devices. In many laser-based rapid prototyping methods, microscale and submicroscale structuring of materials is controlled by computer-generated models. Various laser-based direct write methods, including selective laser sintering/melting, laser machining, matrix-assisted pulsed-laser evaporation direct write, stereolithography and two-photon polymerization, are described. Their use in fabrication of microstructured and nanostructured medical devices is discussed. Laser direct writing may be used for processing a wide variety of advanced medical devices, including patient-specific prostheses, drug delivery devices, biosensors, stents and tissue-engineering scaffolds.

Selective laser sintering of hydroxyapatite/poly-epsilon-caprolactone scaffolds

Selective laser sintering (SLS) enables the fabrication of complex geometries with the intricate and controllable internal architecture required in the field of tissue engineering. In this study hydroxyapatite and poly-epsilon-caprolactone, considered suitable for hard tissue engineering purposes, were used in a weight ratio of 30:70. The quality of the fabricated parts is influenced by various process parameters. Among them Four parameters, namely laser fill power, outline laser power, scan spacing and part orientation, were identified as important. These parameters were investigated according to a central composite design and a model of the effects of these parameters on the accuracy and mechanical properties of the fabricated parts was developed. The dimensions of the fabricated parts were strongly dependent on the manufacturing direction and scan spacing. Repeatability analysis shows that the fabricated features can be well reproduced. However, there were deviations from the nominal dimensions, with the features being larger than those designed. The compressive modulus and yield strength of the fabricated microstructures with a designed relative density of 0.33 varied between 0.6 and 2.3 and 0.1 and 0.6 MPa, respectively. The mechanical behavior was strongly dependent on the manufacturing direction.

Bioactive ceramic-reinforced composites for bone augmentation

Biomaterials have been used to repair the human body for millennia, but it is only since the 1970s that man-made composites have been used. Hydroxyapatite (HA)-reinforced polyethylene (PE) is the first of the 'second-generation' biomaterials that have been developed to be bioactive rather than bioinert. The mechanical properties have been characterized using quasi-static, fatigue, creep and fracture toughness testing, and these studies have allowed optimization of the production method. The in vitro and in vivo biological properties have been investigated with a range of filler content and have shown that the presence of sufficient bioactive filler leads to a bioactive composite. Finally, the material has been applied clinically, initially in the orbital floor and later in the middle ear. From this initial combination of HA in PE other bioactive ceramic polymer composites have been developed.

In vitro biocompatibility of hydroxyapatite-reinforced polymeric composites manufactured by selective laser sintering

The selective laser sintering (SLS) technique was used to manufacture hydroxyapatite-reinforced polyethylene and polyamide composites as potential customized maxillofacial implants. In vitro tests were carried out to assess cellular responses, in terms of cell attachment, morphology, proliferation, differentiation, and mineralized nodule formation, using primary human osteoblast cells. This study showed that the SLS composite processed was biocompatible, with no adverse effects observed on cell viability and metabolic activity, supporting a normal metabolism and growth pattern for osteoblasts. Positive von Kossa staining demonstrated the presence of bone-like mineral on the SLS materials. Higher hydroxyapatite content composites enhanced cell proliferation, increased alkaline phosphatase activity, and produced more osteocalcin. The present findings showed that SLS materials have good in vitro biocompatibility and hence demonstrated biologically the potential of SLS for medical applications.

Biocompatibility and osteogenic potential of human fetal femur-derived cells on surface selective laser sintered scaffolds

For optimal bone regeneration, scaffolds need to fit anatomically into the requisite bone defects and, ideally, augment cell growth and differentiation. In this study we evaluated novel computationally designed surface selective laser sintering (SSLS) scaffolds for their biocompatibility as templates, in vitro and in vivo, for human fetal femur-derived cell viability, growth and osteogenesis. Fetal femur-derived cells were successfully cultured on SSLS-poly(d,l)-lactic acid (SSLS-PLA) scaffolds expressing alkaline phosphatase activity after 7days. Cell proliferation, ingrowth, Alcian blue/Sirius red and type I collagen positive staining of matrix deposition were observed for fetal femur-derived cells cultured on SSLS-PLA scaffolds in vitro and in vivo. SSLS-PLA scaffolds and SSLS-PLA scaffolds seeded with fetal femur-derived cells implanted into a murine critical-sized femur segmental defect model aided the regeneration of the bone defect. SSLS techniques allow fabrication of biocompatible/biodegradable scaffolds, computationally designed to fit any defect, providing a template for cell osteogenesis in vitro and in vivo.

Fabrication and evaluation of calcium phosphate cement scaffold with controlled internal channel architecture and complex shape

The ability to have precise control over internal channel architecture, porosity, and external shape is essential for tissue engineering. The feasibility of using indirect stereo-lithography (SL) to produce scaffolds from calcium phosphate cement materials for bone tissue engineering has been investigated. The internal channel architecture of the scaffolds was created by removal of the negative resin moulds made with SL. Scanning electron microscopy (SEM) showed highly open, well-interconnected channel architecture. The X-ray diffraction examination revealed that the hydroxyapatite phase formed at room temperature in the cement was basically stable up to 850 °C. There was no phase decomposition of hydroxyapatite, although the crystallinity and grain size were different. The ability of resulting structure to support osteoblastic cells culture was tested in vitro. Cells were evenly distributed on exterior surfaces and grew into the internal channels of scaffolds. To exploit the ability of this technique, anatomically shaped femoral supracondylar scaffolds with 300-800 μm interconnected channels were produced and characterized.

Characterization of selective laser-sintered hydroxyapatite-based biocomposite structures for bone replacement

Integration of the bone into the implant is highly desirable for the long-term performance of the implant. The development of a bone–implant interface is influenced by the surface morphology and roughness, surface wettability and porosity of the implants. This study characterizes these important properties of a hydroxyapatite-based biocomposite structure fabricated by selective laser sintering (SLS) with a comparison to a moulded specimen. The sintered specimens exhibited a rougher surface with open surface pores and a highly interconnected internal porous structure. It was shown that the characteristics of the powder particles used in the SLS provided a more influential means to modify the surface morphology and the features of the internal pores than laser parameter variation. The correlation of wettability and porous structure shows that although surface open pores could help cell ingrowth and bone regeneration, they resulted in a poorer wettability of the materials, which may not encourage initial cell attachment and adhesion. The potential solution to improve the wettability and cell anchorage is discussed.