Effect of Material and Pad Abrasion on Shear Bond Strength of 3D-Printed Orthodontic Brackets

OBJECTIVE

To investigate the effect of printing material and air abrasion of bracket pads on the shear bond strength of 3D-printed plastic orthodontic brackets when bonded to the enamel of extracted human teeth.

MATERIALS AND METHODS

Premolar brackets were 3D-printed using the design of a commercially available plastic bracket in two biocompatible resins: Dental LT Resin and Dental SG Resin (n = 40/material). 3D-printed brackets and commercially manufactured plastic brackets were divided into two groups (n = 20/group), one of which was air abraded. All brackets were bonded to extracted human premolars, and shear bond strength tests were performed. The failure types of each sample were classified using a 5-category modified adhesive remnant index (ARI) scoring system.

RESULTS

Bracket material and bracket pad surface treatment presented statistically significant effects for shear bond strengths, and a significant interaction effect between bracket material and bracket pad surface treatment was observed. The non-air abraded (NAA) SG group (8.87 ± 0.64 MPa) had a statistically significantly lower shear bond strength than the air abraded (AA) SG group (12.09 ± 1.23 MPa). In the manufactured brackets and LT Resin groups, the NAA and AA groups were not statistically significantly different within each resin. A significant effect of bracket material and bracket pad surface treatment on ARI score was observed, but no significant interaction effect between bracket material and pad treatment was found.

CONCLUSION

3D-printed orthodontic brackets presented clinically sufficient shear bond strengths both with and without AA prior to bonding. The effect of bracket pad AA on shear bond strength depends on the bracket material.

Colour stability of 3D-Printed orthodontic brackets using filled resins

OBJECTIVE

To determine the effect of common beverages and accelerated aging on the colour stability of filled resins, which could potentially be used for fabrication of 3D-printed orthodontic brackets.

MATERIALS AND METHODS

GR-17.1 (shades A1, A2, and A3), and GR-10 Guide resins (pro3dure medical, Eden Prairie, MN) were printed on an Asiga MAX UV printer into discs 2 mm thick, with a diameter of 10 mm, and then post-print processed as per manufacturer's instructions. Discs were immersed in 5 mL of coffee, tea, red wine, or distilled water for 7 days. Another group was subjected to accelerated aging in accordance with ISO Standard 4892-2. Ten samples were produced per resin, per treatment condition. Colour measurements were taken on the discs before and after treatment using a spectrophotometer against white and black reference tiles to assess colour and translucency differences with the CIEDE2000 colour difference formula.

RESULTS

While initial colour of the printed resin discs was acceptable, all resin groups underwent significant colour change during the experiment. Red wine and coffee produced the greatest colour and translucency change, followed by tea, with accelerated aging producing the least change in colour and translucency.

CONCLUSION

The 3D-printed resins tested underwent significant changes in colour and translucency following exposure to endogenous and exogenous sources of staining, which may affect their acceptability for fabrication of aesthetic orthodontic brackets.

Three-Dimensional Printing Bioceramic Scaffolds Using Direct-Ink-Writing for Craniomaxillofacial Bone Regeneration

Defects characterized as large osseous voids in bone, in certain circumstances, are difficult to treat, requiring extensive treatments which lead to an increased financial burden, pain, and prolonged hospital stays. Grafts exist to aid in bone tissue regeneration (BTR), among which ceramic-based grafts have become increasingly popular due to their biocompatibility and resorbability. BTR using bioceramic materials such as β-tricalcium phosphate has seen tremendous progress and has been extensively used in the fabrication of biomimetic scaffolds through the three-dimensional printing (3DP) workflow. 3DP has hence revolutionized BTR by offering unparalleled potential for the creation of complex, patient, and anatomic location-specific structures. More importantly, it has enabled the production of biomimetic scaffolds with porous structures that mimic the natural extracellular matrix while allowing for cell growth-a critical factor in determining the overall success of the BTR modality. While the concept of 3DP bioceramic bone tissue scaffolds for human applications is nascent, numerous studies have highlighted its potential in restoring both form and function of critically sized defects in a wide variety of translational models. In this review, we summarize these recent advancements and present a review of the engineering principles and methodologies that are vital for using 3DP technology for craniomaxillofacial reconstructive applications. Moreover, we highlight future advances in the field of dynamic 3D printed constructs via shape-memory effect, and comment on pharmacological manipulation and bioactive molecules required to treat a wider range of boney defects.

Bringing hydrogel-based craniofacial therapies to the clinic

This review explores the evolution of the use of hydrogels for craniofacial soft tissue engineering, ranging in complexity from acellular injectable fillers to fabricated, cell-laden constructs with complex compositions and architectures. Addressing both in situ and ex vivo approaches, tissue restoration secondary to trauma or tumor resection is discussed. Beginning with relatively simple epithelia of oral mucosa and gingiva, then moving to more functional units like vocal cords or soft tissues with multilayer branched structures, such as salivary glands, various approaches are presented toward the design of function-driven architectures, inspired by native tissue organization. Multiple tissue replacement paradigms are presented here, including the application of hydrogels as structural materials and as delivery platforms for cells and/or therapeutics. A practical hierarchy is proposed for hydrogel systems in craniofacial applications, based on their material and cellular complexity, spatial order, and biological cargo(s). This hierarchy reflects the regulatory complexity dictated by the Food and Drug Administration (FDA) in the United States prior to commercialization of these systems for use in humans. The wide array of available biofabrication methods, ranging from simple syringe extrusion of a biomaterial to light-based spatial patterning for complex architectures, is considered within the history of FDA-approved commercial therapies. Lastly, the review assesses the impact of these regulatory pathways on the translational potential of promising pre-clinical technologies for craniofacial applications. STATEMENT OF SIGNIFICANCE: While many commercially available hydrogel-based products are in use for the craniofacial region, most are simple formulations that either are applied topically or injected into tissue for aesthetic purposes. The academic literature previews many exciting applications that harness the versatility of hydrogels for craniofacial soft tissue engineering. One of the most exciting developments in the field is the emergence of advanced biofabrication methods to design complex hydrogel systems that can promote the functional or structural repair of tissues. To date, no clinically available hydrogel-based therapy takes full advantage of current pre-clinical advances. This review surveys the increasing complexity of the current landscape of available clinical therapies and presents a framework for future expanded use of hydrogels with an eye toward translatability and U.S. regulatory approval for craniofacial applications.

Effect of print orientation on the dimensional accuracy of orthodontic aligners printed 3-dimensionally

INTRODUCTION

Fabrication of orthodontic aligners directly via 3-dimensional (3D) printing presents the potential to increase the efficiency of aligner production relative to traditional workflows; however tunable aspects of the 3D-printing process might affect the dimensional fidelity of the fabricated appliances. This study aimed to investigate the effect of print orientation on the dimensional accuracy of orthodontic aligners printed directly with a 3D printer.

METHODS

A digitally designed aligner of 500 μm thickness was printed in 3D in Grey V4 (Formlabs, Somerville, Mass) resin at 8 angulations at 45° intervals (n = 10 per angulation) using a stereolithography 3D printer. Each aligner was scanned with an optical scanner, and all but the intaglio surface of each scan was digitally removed. Each resultant scan file was superimposed onto the isolated intaglio of the designed master aligner file. The dimensional deviation was quantified with Geomagic Control software (3D Systems, Rock Hill, SC), and data were analyzed using R statistical software (version 2018; R Core Team, Vienna, Austria) (P <0.05).

RESULTS

Print angle showed a statistically significant effect on standard deviation, average positive deviation, absolute average negative deviation, and percentage of points out of bounds (tolerance bounds defined as ±250 μm) (P <0.05). Qualitative analysis of the 3D surface deviation maps indicated that the 0° and 90° groups showed less deviation and appeared to be the most accurate in the anterior regions. Overall, the majority of the print angle groups studied were not printed within clinically acceptable tolerance ranges, with the major exception being the 90° group, which printed nominally within clinically acceptable tolerance ranges.

CONCLUSIONS

With the workflow applied, print orientation significantly affects the dimensional accuracy of directly 3D-printed orthodontic aligners. Within the limitations of this study, printing at the 90° angulation would be advised as it is the group with the most accurate prints relative to the 7 other orientations investigated, although not all differences were statistically significant.

Evaluation of current additive manufacturing systems for orthodontic 3-dimensional printing

INTRODUCTION

The objective of this research was to evaluate and compare linear and surface accuracy of dental models fabricated using 3 different vat photopolymerization printing units: digital light synthesis (M2 Printer; Carbon, Redwood City, Calif), digital light processing (Juell 3D Flash OC; Park Dental Research, New York, NY), and stereolithography apparatus (Form 2; Formlabs Inc, Somerville, Mass), and a material jetting printing unit: PolyJet (Objet Eden 260VS; Stratasys, Eden Prairie, Minn).

METHODS

Maxillary and mandibular dental arches of 20 patients with the American Board of Orthodontics Discrepancy Index scores ranging between 10 and 30 were scanned using an intraoral scanner. Stereolithographic files of each patient were printed via the 3-dimensional (3D) printers and were digitized again using a 3D desktop scanner to enable comparisons with the original scan data. One-sample t test and linear regression analyses were performed. To further graphically examine the accuracy between the different methods, Bland-Altman plots were computed. The level of significance was set at P <0.05.

RESULTS

Bland-Altman analysis showed no fixed bias of one approach vs the other, and random errors were detected in all linear accuracy comparisons. When a 0.25 mm tolerance level was deemed acceptable for any positive or negative surface changes, only the models manufactured from digital light processing and PolyJet units showed more than 97% match with the original scans.

CONCLUSION

The surface area of 3D printed models did not yield an utterly identical match to the original scan data and was affected by the type of printer. The clinical relevance of the differences observed on the 3D printed dental model surfaces requires application-specific judgments.

Effect of build angle and layer height on the accuracy of 3-dimensional printed dental models

INTRODUCTION

Three-dimensional (3D) printing technologies are profoundly changing the landscape of orthodontics. To optimize treatment-oriented applications, dimensional fidelity is required for 3D-printed orthodontic models. This study aimed to evaluate the effect of build angle and layer height on the accuracy of 3D-printed dental models and if each of their influences on print accuracy was conditional on the other.

METHODS

A maxillary cast was scanned using an intraoral scanner. One hundred thirty-two study models were printed at various combinations of build angle (0°, 30°, 60°, 90°) and layer height (20 μm, 50 μm, 100 μm) with a digital light processing printer (n = 11 per group). The models were digitally scanned, and deviation analyzed using a 3D best-fit algorithm in metrology software.

RESULTS

A statistically significant interaction was consistently found between build angle and layer height for each positive deviation, negative deviation, and proportion out of bounds. Average deviations of all study models were within clinically acceptable ranges, but the least accurate models were printed at 0°/20 μm. Although there was a tendency for an oblique build angle of 30° or 60° with a smaller layer height of 20 μm or 50 μm to print the most accurate models, 95 % confidence intervals overlapped with all other angles and heights except for 0°/20 μm.

CONCLUSIONS

Build angle and layer height have statistically significant interactive effects on the accuracy of 3D-printed dental models. Overall, digital light processing printers produced models within clinically acceptable bounds, but the choice of build angle and layer height should be considered in conjunction with the clinical application, desired print time, and preferred efficiency of each print job.

Colour stability of 3D-printed resin orthodontic brackets

OBJECTIVE

To evaluate the colour stability of polymeric resins that could be used to 3D-print orthodontic brackets.

DESIGN

In vitro, laboratory study.

MATERIALS AND METHODS

Disc-shaped specimens were fabricated via 3D printing using three resins: Dental LT; Dental SG; and Clear. Five conditions were evaluated for each resin (n = 10 per treatment per resin) to assess its corresponding effect on colour and translucency: immersion in (1) red wine, (2) coffee, (3) tea and (4) distilled water (control), and (5) exposure to accelerated aging. Colour and translucency measurements were made before and after exposure using a spectrophotometer. Mean colour differences (ΔE₀₀) and changes in translucency parameter (ΔTP₀₀) were calculated for each sample using the CIEDE2000 colour difference formula.

RESULTS

Statistically significant effects of the resin material, the treatment condition and interactions effects of material and condition were observed for ΔE₀₀ and ΔTP₀₀ (P < 0.001). The most pronounced changes in colour (ΔE₀₀) were a result of the staining effects of wine on all three resins, ranging from 14.5 ± 0.6 to 20.8 ± 1.2. Dental LT, Dental SG and Clear resins all showed changes in colour when exposed to certain staining agents. Dental SG and Clear resins exhibited changes in colour with aging, while the colour of Dental LT resin remained stable with aging.

CONCLUSIONS

The colour changes of the resins investigated does not support their use in 3D-printed aesthetic bracket applications.

Evaluation of the dimensional accuracy of thermoformed appliances taken from 3D printed models with varied shell thicknesses: An in vitro study

OBJECTIVE

Clinicians make numerous decisions when 3D printing models for fabrication of thermoformed appliances, including printing solid or hollow models. While hollow models can reduce resin use, models intended for thermoformed appliance fabrication must be printed with sufficient thickness to withstand thermoforming. The aim of the study was to determine for hollow 3D printed orthodontic models if there is an effect of shell thickness on the dimensional accuracy of retainers thermoformed upon them as compared with solid models and, if so, to identify the minimum shell thickness that ensures dimensional accuracy of the thermoformed retainer under the conditions investigated.

MATERIAL AND METHODS

Thermoformed appliances were fabricated on 3D printed models of six shell thicknesses: 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm, and solid (n=10/group). The models were scanned before and after thermoforming. Thermoformed appliances were captured by two methods: scanning a polyvinylsiloxane casting of the appliance and scanning the appliance interior surface (intaglio surface). Each model-appliance pair was compared using superimposition software. A generalized linear model and post-hoc Tukey contrasts (α=0.05) were applied to compare each thickness.

RESULTS

Model thickness has a statistically significant effect on dimensional accuracy of thermoformed appliances. Appliances fabricated on 1.0mm and 1.5mm models displayed poor accuracy, with a statistically significantly lower percentage of data points within tolerance (±0.250mm) than appliances fabricated on models printed at 2.0mm thickness and greater.

CONCLUSIONS

3D printed model thickness affects the dimensional accuracy of a thermoformed retainer. To ensure minimal deformation and promote clinical utility of the thermoformed appliance, models should be printed with a minimum shell thickness of 2.0mm for the materials investigated.

Wear Resistance of 3D Printed and Prefabricated Denture Teeth Opposing Zirconia

PURPOSE

To evaluate the wear resistance of a recently developed three-dimensional (3D) printed denture teeth resin compared to three commercially available prefabricated denture teeth.

MATERIALS AND METHODS

A total of 88 maxillary first molar denture teeth were evaluated: C (Classic; Dentsply Sirona, York, PA), DCL (SR Postaris DCL; Ivoclar Vivadent, Schaan, Liechtenstein), IPN (Portrait IPN; Dentsply Sirona, York, PA), and F (Denture Teeth A2 Resin 1 L; Formlabs, Somerville, MA). The 3D printed denture tooth specimens were fabricated from a methacrylate-based photopolymerizing resin using stereolithography (SLA). Denture teeth were subjected to a three-body wear test with a poly(methylmethacrylate) (PMMA) abrasive slurry. A Leinfelder-style four station wear apparatus with custom bullet-shaped milled zirconia styli was utilized with a load force of 36-40 N at 1.7 Hz for 200,000 cycles. Maximum depth of wear was measured using a lab grade scanner and analyzing software program. Data were analyzed using a one-way ANOVA followed by the Tukey's Multiple Comparisons post hoc test (α = 0.05).

RESULTS

A statistically significant difference in depth of wear was found between denture tooth materials (p < 0.001). The mean vertical depth of wear for the 3D printed denture teeth (0.016 ± 0.010 mm) was statistically significantly less than the prefabricated denture teeth. The highly cross-linked denture teeth, DCL (0.036 ± 0.011 mm) and IPN (0.035 ± 0.014 mm), exhibited statistically significantly less wear than the conventional acrylic denture teeth. The conventional acrylic denture teeth demonstrated the greatest wear (0.058 ± 0.014 mm). No significant difference in depth of wear was found between DCL and IPN (p > 0.001).

CONCLUSIONS

Denture tooth material significantly influences the depth of wear. The 3D printed denture teeth demonstrated superior wear resistance compared to the commercially available prefabricated denture teeth when opposed to zirconia. Denture teeth fabricated with SLA technology may have a promising future in prosthetic dentistry.

Analysis of the thickness of 3-dimensional-printed orthodontic aligners

INTRODUCTION

This study aimed to investigate the effect of digitally designed aligner thickness on the thickness of the corresponding 3-dimensional (3D)-printed aligner.

METHODS

Digitally designed aligners of 3 different thicknesses (0.500 mm, 0.750 mm, and 1.000 mm) were 3D printed in 2 different resins-Dental LT (n = 10 per group) and Grey V4 (n = 10 per group)-using a stereolithography format 3D printer. The Dental LT aligners were coated with a contrast spray and scanned with an optical scanner. The Grey V4 aligners were scanned before and after the application of the spray. Aligner scans were superimposed onto the corresponding digital design file. Average wall thickness across the aligner for each specimen was measured with metrology software.

RESULTS

Superimpositions showed that 3D-printed aligners were thicker overall than the corresponding design file. The Dental LT aligners had the largest thickness deviation, whereas the Grey V4 without spray had the smallest. For the 0.500-mm, 0.750-mm, and 1.000-mm groups, Dental LT average thickness deviation from the input file was 0.254 ± 0.061 mm, 0.267 ± 0.052 mm, and 0.274 ± 0.034 mm, respectively, and average thickness differences between the Grey V4 with and without spray was 0.076 ± 0.016 mm, 0.070 ± 0.036 mm, and 0.080 ± 0.017 mm, respectively. These results indicate that the excess thickness in the Dental LT groups could not be attributed to spray alone.

CONCLUSIONS

Fabrication of clear aligners directly by 3D printing with the workflow applied resulted in an increased thickness that may deleteriously affect the clinical utility of the aligners.

Three-Dimensional Printing for Craniofacial Bone Tissue Engineering

The basic concepts from the fields of biology and engineering are integrated into tissue engineering to develop constructs for the repair of damaged and/or absent tissues, respectively. The field has grown substantially over the past two decades, with particular interest in bone tissue engineering (BTE). Clinically, there are circumstances in which the quantity of bone that is necessary to restore form and function either exceeds the patient's healing capacity or bone's intrinsic regenerative capabilities. Vascularized osseous or osteocutaneous free flaps are the standard of care with autologous bone remaining the gold standard, but is commonly associated with donor site morbidity, graft resorption, increased operating time, and cost. Regardless of the size of a craniofacial defect, from trauma, pathology, and osteonecrosis, surgeons and engineers involved with reconstruction need to consider the complex three-dimensional (3D) geometry of the defect and its relationship to local structures. Three-dimensional printing has garnered significant attention and presents opportunities to use craniofacial BTE as a technology that offers a personalized approach to bony reconstruction. Clinicians and engineers are able to work together to produce patient-specific space-maintaining scaffolds tailored to site-specific defects, which are osteogenic, osseoconductive, osseoinductive, encourage angiogenesis/vasculogenesis, and mechanically stable upon implantation to prevent immediate failure. In this work, we review biological and engineering principles important in applying 3D printing technology to BTE for craniofacial reconstruction as well as present recent translational advancements in 3D printed bioactive ceramic scaffold technology.

Effect of Radiation on DCE-MRI Pharmacokinetic Parameters in a Rabbit Model of Compromised Maxillofacial Wound Healing: A Pilot Study

PURPOSE

Osteoradionecrosis (ORN), a potentially debilitating complication of maxillofacial radiation, continues to present a challenging clinical scenario, with limited treatment options that often fail. Translational animal models that can accurately mimic the human characteristics of the condition are lacking. In the present pilot study, we aimed to characterize the effects of radiation on the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters in a rabbit model of compromised maxillofacial wound healing to determine its potential as a translational model of ORN.

MATERIALS AND METHODS

An experimental group underwent fractionated radiation of the mandible totaling 36 Gy. At 4 weeks after irradiation, the experimental and control groups (n = 8 rabbits each) underwent a surgical procedure to create a critical size defect in the mandibular bone. DCE-MRI scans were acquired 1 week after arrival (baseline; time point 1), 4 weeks after completion of irradiation in the experimental group (just before surgery, time point 2), and 4 weeks after surgery (time point 3).

RESULTS

No differences in the analyzed DCE-MRI parameters were noted within the experimental or control group between the baseline values (time point 1) and those after irradiation (time point 2). The whole blood volume fraction (v_b) in the experimental group was increased compared with that in the control group after irradiation (time point 2; P < .05). After surgery (time point 3), both the forward flux rate of contrast from blood plasma and the extracellular extravascular space and the v_b were increased in the control group compared with the experimental group (P < .05).

CONCLUSIONS

The results of the present study suggest that DCE-MRI of a rabbit model of compromised maxillofacial wound healing could reflect the DCE-MRI characteristics of human patients with ORN and those at risk of developing the condition. Future studies will focus on further characterization of this rabbit model as a translational preclinical model of ORN.

Development and Characterization of a Rabbit Model of Compromised Maxillofacial Wound Healing

IMPACT STATEMENT

Maxillofacial defects often present the clinical challenge of a compromised wound bed. Preclinical evaluation of tissue engineering techniques developed to facilitate healing and reconstruction typically involves animal models with ideal wound beds. The healthy wound bed scenario does not fully mimic the complex clinical environment in patients, which can lead to technology failure when translating from preclinical in vivo research to clinical use. The reported preclinical animal model of compromised wound healing enables investigation of tissue engineering technologies in a more clinically relevant scenario, potentially fostering translation of promising results in preclinical research to patients.

Comparison of automated grading of digital orthodontic models and hand grading of 3-dimensionally printed models

INTRODUCTION

Emerging workflows in orthodontics enable automated analysis of digital models and production of physical study models from digital files for the evaluation of treatment outcomes. The objective of this study was to compare the automated assessment of digital orthodontic models and the hand grading of 3D-printed models with the use of the American Board of Orthodontics cast-radiograph evaluation (ABO CRE) system.

METHODS

Plaster models from 15 cases were scanned with the use of a desktop model scanner to create digital models from which physical models were produced with the use of a stereolithography-based 3D printer. All digital models from each case were graded with the use of an automated software tool (SureSmile), and 3D-printed models were scored by hand with the use of the ABO CRE grading system. All hand-graded models were scored a second time at least 2 weeks later.

RESULTS

SureSmile gave statistically significantly higher scores to alignment and rotations (P < 0.001), overjet (P < 0.001), occlusal contacts (P < 0.001), and total score (P < 0.001). Hand grading scored higher in buccolingual inclination (P < 0.001). No significant differences were found in marginal ridges, occlusal relationships, and interproximal contacts.

CONCLUSIONS

Scores assessed in an automated manner by SureSmile are generally significantly greater than those assessed by hand grading.

Efficacy of the mini tooth positioner in improving orthodontic finishes

INTRODUCTION

The primary objective of this study was to assess the effectiveness of the mini tooth positioner in improving the quality of orthodontic treatment outcomes, as measured by the American Board of Orthodontics (ABO) cast-radiograph evaluation (CRE).

METHODS

Thirty patients were treated prospectively with a minipositioner for 4-6 weeks immediately after debond. Sixteen patients who had received a maxillary vacuum-formed retainer (VFR) and fixed mandibular canine-to-canine retainer at time of debond were enrolled retrospectively as control subjects. Models from time of debond (T1) were graded with the use of the ABO CRE and compared with models obtained 4-6 weeks after debond (T2) for each group.

RESULTS

For the minipositioner group, the overall CRE score improved significantly by an average of 6.77 points. Significant improvements were noted in the categories of alignment and rotations (-0.68), marginal ridges (-1.40), buccolingual inclination (-0.45), overjet (-0.97), and occlusal contacts (-3.00). For the control group, overall CRE score improved significantly by an average of 1.16 points. Only the categories of overjet (-0.38) and occlusal contacts (-1.22) showed significant improvements.

CONCLUSIONS

The minipositioner is an effective tool in improving the overall finish of orthodontic treatment. In the 4-6 weeks after debond evaluated in this study, the minipositioner significantly outperformed the maxillary VFR/mandibular fixed canine-to-canine retainer in improving final treatment outcomes.

Silver diamine fluoride and bond strength to enamel in vitro: A pilot study

PURPOSE

To evaluate if pre-treatment with silver diamine fluoride (SDF) adversely affects the bond strength of orthodontic brackets to enamel.

METHODS

30 extracted non-carious permanent molar teeth were embedded in acrylic resin cylinders with buccal surfaces exposed and randomly divided equally into two groups. The experimental enamel surfaces were treated with 38% SDF applied for 1 minute between phosphoric acid etch and metal orthodontic bracket bonding with Transbond XT Light Cure Adhesive. Control groups were treated with 37% phosphoric acid etch followed by bonding. All samples were subjected to 500 thermocycles between 5°C and 55°C prior to shear load testing. Mean values and standard deviations of shear bond strengths for each group were analyzed using a general linear model at P< 0.05. Characteristics of bond failure were also recorded via Adhesive Remnant Index (ARI) and analyzed using an ordinal logistic regression at P< 0.05.

RESULTS

No significant difference in shear bond strength to enamel was observed between the control and experimental groups (P= 0.65). Comparison of ARI did demonstrate a significant difference between the groups (P= 0.013); SDF significantly altered the characteristic of bond failure, resulting in more adhesive remaining bonded to enamel after failure. No silver staining of treated surfaces was observed.

CLINICAL SIGNIFICANCE

The application of SDF to etched non-carious enamel in vitro prior to orthodontic bracket bonding does not adversely affect bond strength.

Approaches for building bioactive elements into synthetic scaffolds for bone tissue engineering

Bone tissue engineering (BTE) is emerging as a possible solution for regeneration of bone in a number of applications. For effective utilization, BTE scaffolds often need modifications to impart biological cues that drive diverse cellular functions such as adhesion, migration, survival, proliferation, differentiation, and biomineralization. This review provides an outline of various approaches for building bioactive elements into synthetic scaffolds for BTE and classifies them broadly under two distinct schemes; namely, the top-down approach and the bottom-up approach. Synthetic and natural routes for top-down approaches to production of bioactive constructs for BTE, such as generation of scaffold-extracellular matrix (ECM) hybrid constructs or decellularized and demineralized scaffolds, are provided. Similarly, traditional scaffold-based bottom-up approaches, including growth factor immobilization or peptide-tethered scaffolds, are provided. Finally, a brief overview of emerging bottom-up approaches for generating biologically active constructs for BTE is given. A discussion of the key areas for further investigation, challenges, and opportunities is also presented.

Technical Report: Correlation Between the Repair of Cartilage and Subchondral Bone in an Osteochondral Defect Using Bilayered, Biodegradable Hydrogel Composites

The present work investigated correlations between cartilage and subchondral bone repair, facilitated by a growth factor-delivering scaffold, in a rabbit osteochondral defect model. Histological scoring indices and microcomputed tomography morphological parameters were used to evaluate cartilage and bone repair, respectively, at 6 and 12 weeks. Correlation analysis revealed significant associations between specific cartilage indices and subchondral bone parameters that varied with location in the defect (cortical vs. trabecular region), time point (6 vs. 12 weeks), and experimental group (insulin-like growth factor-1 only, bone morphogenetic protein-2 only, or both growth factors). In particular, significant correlations consistently existed between cartilage surface regularity and bone quantity parameters. Overall, correlation analysis between cartilage and bone repair provided a fuller understanding of osteochondral repair and can help drive informed studies for future osteochondral regeneration strategies.

Effects of Electron Beam Sterilization on Mechanical Properties of a Porous Polymethylmethacrylate Space Maintenance Device

Sterilization is a vital component of the manufacturing process for any medical device. However, some sterilization techniques may alter device properties. While it is known that electron beam sterilization can change the mechanical properties of solid polymethylmethacrylate (PMMA) constructs, its effect on porous PMMA has not been explored. Therefore, porous PMMA space maintainer constructs designed for the treatment of craniofacial bone defects were sterilized at dosages of 30 kGy and 40 kGy. Electron beam sterilization was shown to increase the compressive properties of porous PMMA space maintainer devices.

Strategies for controlled delivery of biologics for cartilage repair

The delivery of biologics is an important component in the treatment of osteoarthritis and the functional restoration of articular cartilage. Numerous factors have been implicated in the cartilage repair process, but the uncontrolled delivery of these factors may not only reduce their full reparative potential but can also cause unwanted morphological effects. It is therefore imperative to consider the type of biologic to be delivered, the method of delivery, and the temporal as well as spatial presentation of the biologic to achieve the desired effect in cartilage repair. Additionally, the delivery of a single factor may not be sufficient in guiding neo-tissue formation, motivating recent research toward the delivery of multiple factors. This review will discuss the roles of various biologics involved in cartilage repair and the different methods of delivery for appropriate healing responses. A number of spatiotemporal strategies will then be emphasized for the controlled delivery of single and multiple bioactive factors in both in vitro and in vivo cartilage tissue engineering applications.

Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model

The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material.

Fabrication of cell-laden macroporous biodegradable hydrogels with tunable porosities and pore sizes

In this work, we investigated a cytocompatible particulate leaching method for the fabrication of cell-laden macroporous hydrogels. We used dehydrated and uncrosslinked gelatin microspheres as leachable porogens to create macroporous oligo(poly(ethylene glycol) fumarate) hydrogels. Varying gelatin content and size resulted in a wide range of porosities and pore sizes, respectively. Encapsulated mesenchymal stem cells (MSCs) exhibited high viability immediately following the fabrication process, and culture of cell-laden hydrogels revealed improved cell viability with increasing porosity. Additionally, the osteogenic potential of the encapsulated MSCs was evaluated over 16 days. Overall, this study presents a robust method for the preparation of cell-laden macroporous hydrogels with desired porosity and pore size for tissue engineering applications.

Synthetic biodegradable hydrogel delivery of demineralized bone matrix for bone augmentation in a rat model

There exists a strong clinical need for a more capable and robust method to achieve bone augmentation, and a system with fine-tuned delivery of demineralized bone matrix (DBM) has the potential to meet that need. As such, the objective of the present study was to investigate a synthetic biodegradable hydrogel for the delivery of DBM for bone augmentation in a rat model. Oligo(poly(ethylene glycol) fumarate) (OPF) constructs were designed and fabricated by varying the content of rat-derived DBM particles (either 1:3, 1:1 or 3:1 DBM:OPF weight ratio on a dry basis) and using two DBM particle size ranges (50-150 or 150-250 μm). The physical properties of the constructs and the bioactivity of the DBM were evaluated. Selected formulations (1:1 and 3:1 with 50-150 μm DBM) were evaluated in vivo compared to an empty control to investigate the effect of DBM dose and construct properties on bone augmentation. Overall, 3:1 constructs with higher DBM content achieved the greatest volume of bone augmentation, exceeding 1:1 constructs and empty implants by 3- and 5-fold, respectively. As such, we have established that a synthetic, biodegradable hydrogel can function as a carrier for DBM, and that the volume of bone augmentation achieved by the constructs correlates directly to the DBM dose.

Osteochondral tissue regeneration through polymeric delivery of DNA encoding for the SOX trio and RUNX2

Native osteochondral repair is often inadequate owing to the inherent properties of the tissue, and current clinical repair strategies can result in healing with a limited lifespan and donor site morbidity. This work investigates the use of polymeric gene therapy to address this problem by delivering DNA encoding for transcription factors complexed with the branched poly(ethylenimine)-hyaluronic acid (bPEI-HA) delivery vector via a porous oligo[poly(ethylene glycol) fumarate] hydrogel scaffold. To evaluate the potential of this approach, a bilayered scaffold mimicking native osteochondral tissue organization was loaded with DNA/bPEI-HA complexes. Next, bilayered implants either unloaded or loaded in a spatial fashion with bPEI-HA and DNA encoding for either Runt-related transcription factor 2 (RUNX2) or SRY (sex determining region Y)-box 5, 6, and 9 (the SOX trio), to generate bone and cartilage tissues respectively, were fabricated and implanted in a rat osteochondral defect. At 6weeks post-implantation, micro-computed tomography analysis and histological scoring were performed on the explants to evaluate the quality and quantity of tissue repair in each group. The incorporation of DNA encoding for RUNX2 in the bone layer of these scaffolds significantly increased bone growth. Additionally, a spatially loaded combination of RUNX2 and SOX trio DNA loading significantly improved healing relative to empty hydrogels or either factor alone. Finally, the results of this study suggest that subchondral bone formation is necessary for correct cartilage healing.

Osteochondral defect repair using bilayered hydrogels encapsulating both chondrogenically and osteogenically pre-differentiated mesenchymal stem cells in a rabbit model

OBJECTIVE

To investigate the ability of cell-laden bilayered hydrogels encapsulating chondrogenically and osteogenically (OS) pre-differentiated mesenchymal stem cells (MSCs) to effect osteochondral defect repair in a rabbit model. By varying the period of chondrogenic pre-differentiation from 7 (CG7) to 14 days (CG14), the effect of chondrogenic differentiation stage on osteochondral tissue repair was also investigated.

METHODS

Rabbit MSCs were subjected to either chondrogenic or osteogenic pre-differentiation, encapsulated within respective chondral/subchondral layers of a bilayered hydrogel construct, and then implanted into femoral condyle osteochondral defects. Rabbits were randomized into one of four groups (MSC/MSC, MSC/OS, CG7/OS, and CG14/OS; chondral/subchondral) and received two similar constructs bilaterally. Defects were evaluated after 12 weeks.

RESULTS

All groups exhibited similar overall neo-tissue filling. The delivery of OS cells when compared to undifferentiated MSCs in the subchondral construct layer resulted in improvements in neo-cartilage thickness and regularity. However, the addition of CG cells in the chondral layer, with OS cells in the subchondral layer, did not augment tissue repair as influenced by the latter when compared to the control. Instead, CG7/OS implants resulted in more irregular neo-tissue surfaces when compared to MSC/OS implants. Notably, the delivery of CG7 cells, when compared to CG14 cells, with OS cells stimulated morphologically superior cartilage repair. However, neither osteogenic nor chondrogenic pre-differentiation affected detectable changes in subchondral tissue repair.

CONCLUSIONS

Cartilage regeneration in osteochondral defects can be enhanced by MSCs that are chondrogenically and osteogenically pre-differentiated prior to implantation. Longer chondrogenic pre-differentiation periods, however, lead to diminished cartilage repair.

Novel applications of statins for bone regeneration

The use of statins for bone regeneration is a promising and growing area of research. Statins, originally developed to treat high cholesterol, are inhibitors of the enzyme 3-hydroxy-3-methylglutaryl, the rate-limiting enzyme of the mevalonate pathway. Because the mevalonate pathway is responsible for the synthesis of a wide variety of important biochemical molecules, including cholesterol and other isoprenoids, the effects of statins are pleiotropic. In particular, statins can greatly affect the process of bone turnover and regeneration via effects on important cell types, including mesenchymal stem cells, osteoblasts, endothelial cells, and osteoclasts. Statins have also been shown to have anti-inflammatory and antimicrobial properties that may be useful since infection can derail normal bone healing. This review will explore the pleiotropic effects of statins, discuss the current use of statins for bone regeneration, particularly with regard to biomaterials-based controlled delivery, and offer perspectives on the challenges and future directions of this emerging area of bone tissue engineering.

Dual growth factor delivery from bilayered, biodegradable hydrogel composites for spatially-guided osteochondral tissue repair

The present work investigated the use of biodegradable hydrogel composite scaffolds, based on the macromer oligo(poly(ethylene glycol) fumarate) (OPF), to deliver growth factors for the repair of osteochondral tissue in a rabbit model. In particular, bilayered OPF composites were used to mimic the structural layers of the osteochondral unit, and insulin-like growth factor-1 (IGF-1) and bone morphogenetic protein-2 (BMP-2) were loaded into gelatin microparticles and embedded within the OPF hydrogel matrix in a spatially controlled manner. Three different scaffold formulations were implanted in a medial femoral condyle osteochondral defect: 1) IGF-1 in the chondral layer, 2) BMP-2 in the subchondral layer, and 3) IGF-1 and BMP-2 in their respective separate layers. The quantity and quality of osteochondral repair was evaluated at 6 and 12 weeks with histological scoring and micro-computed tomography (micro-CT). While histological scoring results at 6 weeks showed no differences between experimental groups, micro-CT analysis revealed that the delivery of BMP-2 alone increased the number of bony trabecular islets formed, an indication of early bone formation, over that of IGF-1 delivery alone. At 12 weeks post-implantation, minimal differences were detected between the three groups for cartilage repair. However, the dual delivery of IGF-1 and BMP-2 had a higher proportion of subchondral bone repair, greater bone growth at the defect margins, and lower bone specific surface than the single delivery of IGF-1. These results suggest that the delivery of BMP-2 enhances subchondral bone formation and that, while the dual delivery of IGF-1 and BMP-2 in separate layers does not improve cartilage repair under the conditions studied, they may synergistically enhance the degree of subchondral bone formation. Overall, bilayered OPF hydrogel composites demonstrate potential as spatially-guided, multiple growth factor release vehicles for osteochondral tissue repair.

Enhancing chondrogenic phenotype for cartilage tissue engineering: monoculture and coculture of articular chondrocytes and mesenchymal stem cells

Articular cartilage exhibits an inherently low rate of regeneration. Consequently, damage to articular cartilage often requires surgical intervention. However, existing treatments generally result in the formation of fibrocartilage tissue, which is inferior to native articular cartilage. As a result, cartilage engineering strategies seek to repair or replace damaged cartilage with an engineered tissue that restores full functionality to the impaired joint. These strategies often involve the use of chondrocytes, yet in vitro expansion and culture can lead to undesirable changes in chondrocyte phenotype. This review focuses on the use of articular chondrocytes and mesenchymal stem cells (MSCs) in either monoculture or coculture for the enhancement of chondrogenesis. Coculture strategies increasingly outperform their monoculture counterparts with regard to chondrogenesis and present unique opportunities to attain chondrocyte phenotype stability in vitro. Methods to prevent chondrocyte dedifferentiation and promote chondrocyte redifferentiation as well as to promote the chondrogenic differentiation of MSCs while preventing MSC hypertrophy are discussed.

Articular chondrocytes and mesenchymal stem cells seeded on biodegradable scaffolds for the repair of cartilage in a rat osteochondral defect model

This work investigated the ability of co-cultures of articular chondrocytes and mesenchymal stem cells (MSCs) to repair articular cartilage in osteochondral defects. Bovine articular chondrocytes and rat MSCs were seeded in isolation or in co-culture onto electrospun poly(ɛ-caprolactone) (PCL) scaffolds and implanted into an osteochondral defect in the trochlear groove of 12-week old Lewis rats. Additionally, a blank PCL scaffold and untreated defect were investigated. After 12 weeks, the extent of cartilage repair was analyzed through histological analysis, and the extent of bone healing was assessed by quantifying the total volume of mineralized bone in the defect through microcomputed tomography. Histological analysis revealed that the articular chondrocytes and co-cultures led to repair tissue that consisted of more hyaline-like cartilage tissue that was thicker and possessed more intense Safranin O staining. The MSC, blank PCL scaffold, and empty treatment groups generally led to the formation of fibrocartilage repair tissue. Microcomputed tomography revealed that while there was an equivalent amount of mineralized bone formation in the MSC, blank PCL, and empty treatment groups, the defects treated with chondrocytes or co-cultures had negligible mineralized bone formation. Overall, even with a reduced number of chondrocytes, co-cultures led to an equal level of cartilage repair compared to the chondrocyte samples, thus demonstrating the potential for the use of co-cultures of articular chondrocytes and MSCs for the in vivo repair of cartilage defects.

Chondrogenic phenotype of articular chondrocytes in monoculture and co-culture with mesenchymal stem cells in flow perfusion

This work investigated the effect of flow perfusion bioreactor culture with and without transforming growth factor-β3 (TGF-β3) supplementation on the proliferation, extracellular matrix (ECM) production, and chondrogenic gene expression of chondrocytes both in monoculture and in co-culture with bone marrow-derived mesenchymal stem cells (MSCs). Both cell populations were cultured on electrospun poly(ɛ-caprolactone) scaffolds for 2 weeks in static or flow perfusion culture with and without TGF-β3. Overall, it was observed that without growth factors, flow perfusion culture resulted in increased cell proliferation and ECM with a more cartilage-like composition. While with TGF-β3 induction, flow perfusion constructs generally had lower chondrogenic gene expression than the corresponding static cultures, the growth factor still had an inductive effect on the cells with enhanced gene expression compared with the corresponding noninduced cultures. In addition, while flow perfusion cultures generally had reduced overall ECM content, the ECM distribution was more homogenous compared with the corresponding static cultures. These results are significant in that they indicate that while flow perfusion culture has some beneficial effects on the chondrogenic phenotype of articular chondrocytes, flow perfusion alone is not sufficient to maintain the chondrogenic phenotype of chondrocytes in either monoculture or co-culture, thus demonstrating the advantages of using exogenously added growth factors in flow perfusion culture. Furthermore, the results demonstrate the advantages of flow perfusion culture for the creation of large tissue engineered constructs and the potential of co-cultures of articular chondrocytes and MSCs to be used in flow perfusion culture.

Mesenchymal stem cell and gelatin microparticle encapsulation in thermally and chemically gelling injectable hydrogels for tissue engineering

In this work, we investigated the viability and osteogenic differentiation of mesenchymal stem cells encapsulated with gelatin microparticles (GMPs) in an injectable, chemically and thermally gelling hydrogel system combining poly(N-isopropylacrylamide)-based thermogelling macromers containing pendant epoxy rings with polyamidoamine-based hydrophilic and degradable diamine crosslinking macromers. Specifically, we studied how the parameters of GMP size and loading ratio affected the viability and differentiation of cells encapsulated within the hydrogel. We also examined the effects of cell and GMP co-encapsulation on hydrogel mineralization. Cells demonstrated long-term viability within the hydrogels, which was shown to depend on GMP size and loading ratio. In particular, increased interaction of cells and GMPs through greater available GMP surface area, use of an epoxy-based chemical gelation mechanism, and the tunable high water content of the thermogelled hydrogels led to favorable long-term cell viability. Compared with cellular hydrogels without GMPs, hydrogels co-encapsulating cells and GMPs demonstrated greater production of alkaline phosphatase by cells at all time-points and a transient early enhancement of hydrogel mineralization for larger GMPs at higher loading ratios. Such injectable, in situ forming hydrogels capable of delivering and maintaining populations of encapsulated mesenchymal stem cells and promoting mineralization in vitro offer promise as novel therapies for applications in tissue engineering and regenerative medicine.

Direct and indirect co-culture of chondrocytes and mesenchymal stem cells for the generation of polymer/extracellular matrix hybrid constructs

In this work, the influence of direct cell-cell contact in co-cultures of mesenchymal stem cells (MSCs) and chondrocytes for the improved deposition of cartilage-like extracellular matrix (ECM) within nonwoven fibrous poly(∊-caprolactone) (PCL) scaffolds was examined. To this end, chondrocytes and MSCs were either co-cultured in direct contact by mixing on a single PCL scaffold or produced via indirect co-culture, whereby the two cell types were seeded on separate scaffolds which were then cultured together in the same system either statically or under media perfusion in a bioreactor. In static cultures, the chondrocyte scaffold of an indirectly co-cultured group generated significantly greater amounts of glycosaminoglycan and collagen than the direct co-culture group initially seeded with the same number of chondrocytes. Furthermore, improved ECM production was linked to greater cellular proliferation and distribution throughout the scaffold in static culture. In perfusion cultures, flow had a significant effect on the proliferation of the chondrocytes. The ECM contents within the chondrocyte-containing scaffolds of the indirect co-culture groups either approximated or surpassed the amounts generated within the direct co-culture group. Additionally, within bioreactor culture there were indications that chondrocytes had an influence on the chondrogenesis of MSCs as evidenced by increases in cartilaginous ECM synthetic capacity. This work demonstrates that it is possible to generate PCL/ECM hybrid scaffolds for cartilage regeneration by utilizing the factors secreted by two different cell types, chondrocytes and MSCs, even in the absence of juxtacrine signaling.

Synthesis and characterization of injectable, biodegradable, phosphate-containing, chemically cross-linkable, thermoresponsive macromers for bone tissue engineering

Novel, injectable, biodegradable macromer solutions that form hydrogels when elevated to physiologic temperature via a dual chemical and thermo-gelation were fabricated and characterized. A thermogelling, poly(N-isopropylacrylamide)-based macromer with pendant phosphate groups was synthesized and subsequently functionalized with chemically cross-linkable methacrylate groups via degradable phosphate ester bonds, yielding a dual-gelling macromer. These dual-gelling macromers were tuned to have transition temperatures between room temperature and physiologic temperature, allowing them to undergo instantaneous thermogelation as well as chemical gelation when elevated to physiologic temperature. Additionally, the chemical cross-linking of the hydrogels was shown to mitigate hydrogel syneresis, which commonly occurs when thermogelling materials are raised above their transition temperature. Finally, degradation of the phosphate ester bonds of the cross-linked hydrogels yielded macromers that were soluble at physiologic temperature. Further characterization of the hydrogels demonstrated minimal cytotoxicity of hydrogel leachables as well as in vitro calcification, making these novel, injectable macromers promising materials for use in bone tissue engineering.

Phosphorous-containing polymers for regenerative medicine

Disease and injury have resulted in a large, unmet need for functional tissue replacements. Polymeric scaffolds can be used to deliver cells and bioactive signals to address this need for regenerating damaged tissue. Phosphorous-containing polymers have been implemented to improve and accelerate the formation of native tissue both by mimicking the native role of phosphorous groups in the body and by attachment of other bioactive molecules. This manuscript reviews the synthesis, properties, and performance of phosphorous-containing polymers that can be useful in regenerative medicine applications.

Generation of osteochondral tissue constructs with chondrogenically and osteogenically predifferentiated mesenchymal stem cells encapsulated in bilayered hydrogels

This study investigated the ability of chondrogenic and osteogenic predifferentiation of mesenchymal stem cells (MSCs) to play a role in the development of osteochondral tissue constructs using injectable bilayered oligo(poly(ethylene glycol) fumarate) (OPF) hydrogel composites. We hypothesized that the combinatorial approach of encapsulating cell populations of both chondrogenic and osteogenic lineages in a spatially controlled manner within bilayered constructs would enable these cells to maintain their respective phenotypes via the exchange of biochemical factors even without the influence of external growth factors. During monolayer expansion prior to hydrogel encapsulation, it was found that 7 (CG7) and 14 (CG14) days of MSC exposure to TGF-β3 allowed for the generation of distinct cell populations with corresponding chondrogenic maturities as indicated by increasing aggrecan and type II collagen/type I collagen expression. Chondrogenic and osteogenic cells were then encapsulated within their respective (chondral/subchondral) layers in bilayered hydrogel composites to include four experimental groups. Encapsulated CG7 cells within the chondral layer exhibited enhanced chondrogenic phenotype when compared to other cell populations based on stronger type II collagen and aggrecan gene expression and higher glycosaminoglycan-to-hydroxyproline ratios. Osteogenic cells that were co-cultured with chondrogenic cells (in the chondral layer) showed higher cellularity over time, suggesting that chondrogenic cells stimulated the proliferation of osteogenic cells. Groups with osteogenic cells displayed mineralization in the subchondral layer, confirming the effect of osteogenic predifferentiation. In summary, it was found that MSCs that underwent 7 days, but not 14 days, of chondrogenic predifferentiation most closely resembled the phenotype of native hyaline cartilage when combined with osteogenic cells in a bilayered OPF hydrogel composite, indicating that the duration of chondrogenic preconditioning is an important factor to control. Furthermore, the respective chondrogenic and osteogenic phenotypes were maintained for 28 days in vitro without the need for external growth factors, demonstrating the exciting potential of this novel strategy for the generation of osteochondral tissue constructs for cartilage engineering applications.

TISSUE ENGINEERING PERFUSABLE CANCER MODELS

The effect of fluid flow on cancer progression is currently not well understood, highlighting the need for perfused tumor models to close this gap in knowledge. Enabling biological processes at the cellular level to be modeled with high spatiotemporal control, microfluidic tumor models have demonstrated applicability as platforms to study cell-cell interactions, effect of interstitial flow on tumor migration and the role of vascular barrier function. To account for the multi-scale nature of cancer growth and invasion, macroscale models are also necessary. The consideration of fluid dynamics within tumor models at both the micro- and macroscopic levels may greatly improve our ability to more fully mimic the tumor microenvironment.

Articular chondrocyte redifferentiation in 3D co-cultures with mesenchymal stem cells

In this work, we evaluated the ability of 3D co-cultures with mesenchymal stem cells (MSCs) to redifferentiate monolayer expanded articular chondrocytes (ACs) and produce cartilaginous extracellular matrix at varying stages of the dedifferentiation process and further examined the dependency of this effect on the culture medium composition. Primary bovine ACs were expanded in monolayers for up to nine population doublings to obtain seven cell stocks with gradually increasing levels of dedifferentiation. Culture expanded ACs were then seeded as monocultures and co-cultures with rabbit bone marrow-derived MSCs (30:70 ratio of ACs-to-MSCs) on porous scaffolds. Parallel cultures were established for each cell population in serum-containing growth medium and serum-free induction medium supplemented with dexamethasone and TGF-β3. After 3 weeks, all groups were analyzed for DNA content, glycosaminoglycan (GAG) and hydroxyproline (HYP) production, and chondrogenic gene expression. Significant enhancements in cellularity, GAG content and GAG/HYP ratio, and chondrogenic phenotype were observed in the induction medium compared to growth medium at all levels of AC expansion. Furthermore, primary co-cultures showed similarly enhanced chondrogenesis compared to monocultures in both culture media, whereas passaged ACs benefitted from co-culturing only in the induction medium. We conclude that co-cultures of ACs and MSCs can produce superior in vitro engineered cartilage in comparison to pure AC cultures, due to both heterotypic cellular interactions and decreased need for monolayer expansion of biopsied chondrocytes. While the initial level of AC dedifferentiation affected the quality of the engineered constructs, co-culture benefits were realized at all stages of AC expansion when suitable chondroinductive culture medium was used.

Synthesis, physicochemical characterization, and cytocompatibility of bioresorbable, dual-gelling injectable hydrogels

Injectable, dual-gelling hydrogels were successfully developed through the combination of physical thermogellation at 37 °C and favorable amine:epoxy chemical cross-linking. Poly(N-isopropylacrylamide)-based thermogelling macromers with a hydrolyzable lactone ring and epoxy pendant groups and a biodegradable diamine-functionalized polyamidoamine cross-linker were synthesized, characterized, and combined to produce nonsyneresing and bioresorbable hydrogels. Differential scanning calorimetry and oscillatory rheometry demonstrated the rapid and dual-gelling nature of the hydrogel formation. The postgelation dimensional stability, swelling, and mechanical behavior of the hydrogel system were shown to be easily tuned in the synthesis and formulation stages. The leachable products were found to be cytocompatible under all conditions, while the degradation products demonstrated a dose- and time-dependent response due to solution osmolality. Preliminary encapsulation studies showed mesenchymal stem cell viability could be maintained for 7 days. The results suggest that injectable and thermally and chemically cross-linkable hydrogels are promising alternatives to prefabricated biomaterials for tissue engineering applications, particularly for cell delivery.

A factorial analysis of the combined effects of hydrogel fabrication parameters on the in vitro swelling and degradation of oligo(poly(ethylene glycol) fumarate) hydrogels

In this study, a full factorial approach was used to investigate the effects of poly(ethylene glycol) (PEG) molecular weight (MW; 10,000 vs. 35,000 nominal MW), crosslinker-to-macromer carbon-carbon double bond ratio (DBR; 40 vs. 60), crosslinker type (PEG-diacrylate (PEGDA) vs. N,N'-methylene bisacrylamide (MB)), crosslinking extent of incorporated gelatin microparticles (low vs. high), and incubation medium composition (with or without collagenase) on the swelling and degradation characteristics of oligo[(poly(ethylene glycol) fumarate)] (OPF) hydrogel composites as indicated by the swelling ratio and the percentage of mass remaining, respectively. Each factor consisted of two levels, which were selected based on previous in vitro and in vivo studies utilizing these hydrogels for various tissue engineering applications. Fractional factorial analyses of the main effects indicated that the mean swelling ratio and the mean percentage of mass remaining of OPF composite hydrogels were significantly affected by every factor. In particular, increasing the PEG chain MW of OPF macromers significantly increased the mean swelling ratio and decreased the mean percentage of mass remaining by 5.7 ± 0.3 and 17.2 ± 0.6%, respectively. However, changing the crosslinker from MB to PEGDA reduced the mean swelling ratio and increased the mean percentage of mass remaining of OPF composite hydrogels by 4.9 ± 0.2 and 9.4 ± 0.9%, respectively. Additionally, it was found that the swelling characteristics of hydrogels fabricated with higher PEG chain MW or with MB were more sensitive to increases in DBR. Collectively, the main and cross effects observed between factors enables informed tuning of the swelling and degradation properties of OPF-based hydrogels for various tissue engineering applications. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 3477-3487, 2014.

Cell-derived polymer/extracellular matrix composite scaffolds for cartilage regeneration, Part 1: investigation of cocultures and seeding densities for improved extracellular matrix deposition

This study investigated the coculture of chondrocytes and mesenchymal stem cells (MSCs) on electrospun fibrous polymer scaffolds to produce polymer/extracellular matrix (ECM) hybrid constructs with the objective of reducing the number of chondrocytes necessary to produce ample cartilage-like ECM within the scaffolds. To generate these hybrid constructs, electrospun poly(ɛ-caprolactone) fibrous scaffolds were seeded at both high and low initial densities with five different ratios of chondrocytes to MSCs: 1:0, 1:1, 1:3, 1:5, and 0:1, and cultured for 7, 14, and 21 days. Glycosaminoglycan production and distribution within the three coculture groups was similar to quantities generated by chondrocyte-only controls. Conversely, as the concentration of chondrocytes was increased, the collagen content of the constructs also increased at each time point, with a 1:1 chondrocyte to MSC ratio approximating the collagen production of chondrocytes alone. Histological staining suggested that cocultured constructs mimicked the well-distributed ECM patterns of chondrocyte generated constructs, while improving greatly over the restricted distribution of matrix within MSC-only constructs. These results support the capacity of cocultures of chondrocytes and MSCs to generate cartilaginous matrix within a polymeric scaffold. Further, the inclusion of MSCs in these cocultures enables the reduction of chondrocytes needed to produce cell-generated ECM.