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Recently, efforts towards the development of patient-specific 3D printed scaffolds for bone tissue engineering from bioactive ceramics have continuously intensified. For reconstruction of segmental defects after subtotal mandibulectomy a suitable tissue engineered bioceramic bone graft needs to be endowed with homogenously distributed osteoblasts in order to mimic the advantageous features of vascularized autologous fibula grafts, which represent the standard of care, contain osteogenic cells and are transplanted with the respective blood vessel. Consequently, inducing vascularization early on is pivotal for bone tissue engineering. The current study explored an advanced bone tissue engineering approach combining an advanced 3D printing technique for bioactive resorbable ceramic scaffolds with a perfusion cell culture technique for pre-colonization with mesenchymal stem cells, and with an intrinsic angiogenesis technique for regenerating critical size, segmental discontinuity defects in vivo applying a rat model. To this end, the effect of differing Si-CAOP (silica containing calcium alkali orthophosphate) scaffold microarchitecture arising from 3D powder bed printing (RP) or the Schwarzwalder Somers (SSM) replica fabrication technique on vascularization and bone regeneration was analyzed in vivo. In 80 rats 6-mm segmental discontinuity defects were created in the left femur.
Over the last decade there have been increasing efforts to develop three-dimensional (3D) scaffolds for bone tissue Engineering from bioactive ceramics with 3D printing emerging as a promising technology. The overall objective of the present study was to generate a tissue engineered synthetic bone graft with homogenously distributed osteoblasts and mineralizing bone Matrix in vitro, thereby mimicking the advantageous properties of autogenous bone grafts and facilitating usage for reconstructing segmental discontinuity defects in vivo . To this end, 3D scaffolds were developed from a silica-containing calcium alkali orthophosphate, using, fi rst, a replica technique – the Schwartzwalder – Somers method – and, second, 3D printing, (i.e. rapid prototyping). The mechanical and physical scaffold properties and their potential to facilitate homogenous colonization by osteogenic cells and extracellular bone matrix formation throughout the porous scaffold architecture were examined.
Osteoblastic cells were dynamically cultured for 7 days on both scaffold types with two different concentrations of 1.5 and 3 × 10⁹ cells/l. The amount of cells and bone matrix formed and osteogenic marker expression were evaluated using hard tissue histology, immunohistochemical and histomorphometric analysis. 3D-printed scaffolds (RPS) exhibited more micropores, greater compressive strength and silica release. RPS seeded with 3 × 10⁹ cells/l displayed greatest cell and extracellular Matrix formation, mineralization and osteocalcin expression. In conclusion, RPS displayed superior mechanical and biological properties and facilitated generating a tissue engineered synthetic bone graft in vitro, which mimics the advantageous properties of autogenous bone grafts, by containing homogenously distributed terminally differentiated osteoblasts and mineralizing bone matrix and therefore is suitable for subsequent in vivo implantation for regenerating segmental discontinuity bone defects.
Silicate bioceramics possess an excellent bioactivity; however, shaping them into complex geometries is still challenging. Therefore, this paper aims to present a new strategy for the shaping of a bioglass-ceramic with controlled geometry and properties starting from a glass powder combined with a preceramic polymer, i.e. a silicon resin, and reactive fillers. The powder-based three-dimensional (3D)-printing of wollastonite (CaSiO3)-based silicate bioceramic parts was demonstrated in this work. The resin plays a dual role, as it not only acts as a non-sacrificial binder for the filler powders in the printing process but it also reacts with the fillers to generate the desired bioceramic phases. The mechanical and physical properties, i.e. ball-on-three-balls test, density, porosity and morphology, were evaluated in 3D-printed discs. These samples possessed a total porosity around 64 vol% and a biaxial flexural strength around 6 MPa. The raw materials used in this work also enabled the 3D-printing of scaffolds possessing a designed multi-scale porosity, suitable bioceramic phase assemblage and a compressive strength of 1 MPa (for cylindrical scaffolds with total porosity ~80 vol%). Solubility in TRIS/HCl and in vitro assays, i.e. viability, cytotoxicity and apoptosis assays, were also performed. In vitro tests indicated good cell viability and no cytotoxicity effect on the cells.
Calcium alkaline phosphate scaffolds for bone regeneration 3D-fabricated by additive manufacturing
(2012)
Calcium alkaline phosphate granulates can be used for substitution of several bone defects but for the reconstruction of large skeletal parts in the maxillofacial and orthopaedic fields fitted scaffolds are preferable. Within the additive manufacturing methods, the 3D printing process offers exciting opportunities to generate defined porous scaffolds. We used a R1 printer from ProMetal Company, USA, for producing scaffolds directly from a ceramic powder. For this direct free form fabrication technology the powder has to possess a lot of specific properties both for the generation of a stable green body and also for the subsequent sintering preparation. For this printing process we prepared different granules in a fluidized bed process containing Ca2KNa(PO4)2 as main crystalline phase. Granules were characterized by different methods and several sieve fractions were used for preparing disc like and cylindrical parts. The suitability of granules for this printing process was determined by porosity and strength of produced bodies. Next to granules' performance both of these properties can be directly influenced by 3D printing process parameters. With knowledge of suitable process parameters scaffolds with different porosity in a respective desired design can be created. In this study, cylindrical scaffolds with graded porosity were produced for bone regeneration of segmental defects in maxillofacial surgery and dental implantology by tissue engineering.
Solubility and ingrowth behaviour of degradable and figuline calcium alkaline phosphate cements
(2012)
The thrust of the investigations presented here is to point out the degradation behaviour in vitro and the ingrowth behaviour in vivo of four different calcium alkaline phosphate cements. Two of the figuline and mouldable composites consist of the crystalline phase Ca2KNa(PO4)2 and two of the crystalline phase Ca10[K/Na](PO4)2 each containing 2wt% medium gel strength porcine gelatin. Furthermore A-TCP was added to both Ca10[K/Na](PO4)2 cements as a hardening supporting reactant. The testing material groups differ in small amorphous portions containing either silica phosphate (GB9), magnesium potassium phosphate (GB14) or diphosphates (401545 and 401545(70)). The respective composites show a monomodal particle size distribution (d50~7µm; span~4) and an average total porosity around 28vol%.For the solubility studies cylindrical samples (d=6mm; h=12mm) were stored in a 0.1mol TRIS buffer solution and incubated at 37°C for maximum 50 weeks. The storage solution was analysed and renewed every week. The results are plotted cumulative. For the in vivo studies critical size defects were dissected to mandibles in a sheep model in which a 1cm³ area of the bottom of the mandibles was surgically resected and replaced with the figuline cements whereas the mouldability allows the reconstruction of the original outer contour without draining off even when replacing upside down.
Biocompatible materials such as porous bioactive calcium phosphate ceramics or titanium are regularly applied in dental surgery: ceramics are used to support the local bone regeneration in a given defect, afterwards titanium implants replace lost teeth. The current gold standard for bone reconstruction in implant dentistry is the use of autogenous bone grafts. But the concept of guided bone regeneration (GBR) has become a predictable and well documented surgical approach using biomaterials (bioactive calcium phosphate ceramics) which qualify as bone substitutes for this kind of application as well. We applied high resolution synchrotron microtomography and subsequent 3d image analysis in order to investigate bone formation and degradation of the bone substitute material in a three-dimensional manner, extending the knowledge beyond the limits of classical histology. Following the bone regeneration, titanium-based implants to replace lost teeth call for high mechanical precision, especially when two-piece concepts are used in order to guaranty leak tightness. Here, synchrotron-based radiography in comparison with classical laboratory radiography yields high spatial resolution in combination with high contrast even when exploiting micro-sized features in these kind of highly attenuating objects. Therefore, we could study micro-gap formation at interfaces in two-piece dental implants with the specimen under different mechanical load. We could prove the existence of micro-gaps for implants with conical connections as well as to study the micromechanical behavior of the mating zone of conical implants during loading. The micro-gap is a potential issue of failure, i. e. bacterial leakage which can induce an inflammatory process.