Three-dimensional printing of biomaterials for bone tissue engineering: a review

Processing biomaterials into porous scaffolds for bone tissue engineering is a critical and a key step in defining and controlling their physicochemical, mechanical, and biological properties. Biomaterials such as polymers are commonly processed into porous scaffolds using conventional processing techniques, e.g., salt leaching. However, these traditional techniques have shown unavoidable limitations and several shortcomings. For instance, tissue-engineered porous scaffolds with a complex three-dimensional (3D) geometric architecture mimicking the complexity of the extracellular matrix of native tissues and with the ability to fit into irregular tissue defects cannot be produced using the conventional processing techniques. 3D printing has recently emerged as an advanced processing technology that enables the processing of biomaterials into 3D porous scaffolds with highly complex architectures and tunable shapes to precisely fit into irregular and complex tissue defects. 3D printing provides computer-based layer-by-layer additive manufacturing processes of highly precise and complex 3D structures with well-defined porosity and controlled mechanical properties in a highly reproducible manner. Furthermore, 3D printing technology provides an accurate patient-specific tissue defect model and enables the fabrication of a patient-specific tissue-engineered porous scaffold with pre-customized properties.     

浆料粘度对纳米羟基磷灰石/聚酰胺66复合支架孔结构与力学性能的影响

浆料粘度是热诱导相分离法制备支架材料的关键因素,采用不同粘度的纳米羟基磷灰石/聚酰胺66(n-HA/PA66)复合浆料制备了相应的n-HA/PA66多孔支架,并对不同粘度浆料制备支架材料的泡孔结构和力学性能等进行了对比研究。结果表明,浆料粘度对n-HA/PA66复合多孔支架的孔径、孔径分布、孔隙率、开孔率、力学强度等性能有显著的影响。随着浆料粘度的增大,制备支架的孔径、孔隙率、开孔率逐渐减小,而力学强度却逐渐增大。当浆料粘度为330Pa.s时,制备出的n-HA/PA66复合多孔支架综合性能最好,其孔径主要分布在200～500μm,平均孔径(324±67.1)μm,孔隙率为(75±1.6)%,开孔率为(59±2.5)%,抗压强度为(2.12±0.90)MPa,能够较好地满足骨组织工程支架材料对孔径、孔隙率和力学性能的要求。     

PLA-PEG共聚物三维多孔支架的制备及表征

将D,L-丙交酯(D,L-LA)与聚乙二醇(PEG)共聚制备了一系列共聚物,并用IR、GPC和1H-NMR对其进行了表征.在此基础上,采用溶剂浇铸-柱子沥滤技术和层叠技术制备了具有一定空间形状的三维多孔组织工程支架,并研究了致孔剂颗粒尺寸及其用量对多孔支架的孔径、孔隙率的影响.结果表明,PLA-PEG共聚物的分子量随着原料中PEG含量的增加而减小;以PLA-PEG共聚物为原料制备多孔支架时,孔径的大小与致孔剂颗粒尺寸有一定的对应关系,孔隙率随着致孔剂用量的增加而增加;采用层叠技术制备的具有一定形状的三维多孔支架符合组织工程对支架材料的一般要求.     

A novel porous scaffold fabrication technique for epithelial and endothelial tissue engineering

Porous scaffolds have the ability to minimize transport barriers for both two- (2D) and three-dimensional tissue engineering. However, current porous scaffolds may be non-ideal for 2D tissues such as epithelium due to inherent fabrication-based characteristics. While 2D tissues require porosity to support molecular transport, pores must be small enough to prevent cell migration into the scaffold in order to avoid non-epithelial tissue architecture and compromised function. Though electrospun meshes are the most popular porous scaffolds used today, their heterogeneous pore size and intense topography may be poorly-suited for epithelium. Porous scaffolds produced using other methods have similar unavoidable limitations, frequently involving insufficient pore resolution and control, which make them incompatible with 2D tissues. In addition, many of these techniques require an entirely new round of process development in order to change material or pore size. Herein we describe “pore casting,” a fabrication method that produces flat scaffolds with deterministic pore shape, size, and location that can be easily altered to accommodate new materials or pore dimensions. As proof-of-concept, pore-cast poly(ε-caprolactone) (PCL) scaffolds were fabricated and compared to electrospun PCL in vitro using canine kidney epithelium, human colon epithelium, and human umbilical vein endothelium. All cell types demonstrated improved morphology and function on pore-cast scaffolds, likely due to reduced topography and universally small pore size. These results suggest that pore casting is an attractive option for creating 2D tissue engineering scaffolds, especially when the application may benefit from well-controlled pore size or architecture.     

不同类型多孔结构生物材料支架制备及其性能优化

多孔支架是组织工程应用中的关键环节,类似细胞外基质的作用,支撑细胞的粘附和随后细胞向组织的衍化。虽然目前已采用多种制备技术研发出大量的多孔支架,但是多孔生物材料支架的制备和性能优化,仍然是组织工程支架领域的研究热点。结合实验室工作,综述了多种制备不同类型多孔结构生物材料支架的制备技术,主要包括颗粒和纤维堆积型支架、泡沫浸渍法支架和颗粒制孔支架等的制备技术,并阐述了这些制备技术对多孔结构支架的孔结构、贯通性和力学性能的改善效果。其目的旨在提供满足组织工程需求的多孔生物材料支架。     

Synthesis and characterization of photopolymerizable triblocks for 3D printing tissue engineering scaffolds

While previous research on polycaprolactone (PCL) and polyethylene glycol (PEG) triblock copolymers has focused on their use as hydrogels or with conventional scaffold fabrication methods, this work concentrates on producing viable photocurable resins from synthesized triblocks for use in a layer-by-layer 3D printer. After successful synthesis of PCL-PEG-PCL and PCL-PEG-PCL-diacrylate triblocks, they were combined with (hydroxyethyl)methacrylated polyethylene glycol (PEG-HEMA) and used as biomaterials in a dynamic masking 3D printing system to fabricate porous scaffolds. Diacrylation of the polymer (PCL-PEG-PCL-DA) revealed a substantial increase in mechanical strength and resulting compound resolved the re-dissolving issue significantly during the 3D printing process. Degradation tests were carried out by incubation in phosphate-buffered saline, and both biomaterials demonstrated their degradation resistance with steady pH levels and mass loss plateauing at 20% over a sixty day timeframe. Preliminary MG63 cell culture tests on the cross-linked 3D porous structures showed no significant cytotoxicity and MTT assay data verified cell proliferation on the photocured samples after three days. As a result, end-capping PCL-PEG-PCL with acrylates demonstrated advantages over PCL-PEG-PCL while keeping similar performance in degradation and biocompatibility. Overall results from this work demonstrate the suitability of the novel triblocks for use as biomaterials in tissue engineering scaffolds.     

骨组织工程用硅胶/掺锶β-磷酸三钙/硫酸钙复合多孔支架的制备与性能研究

以掺锶β-磷酸三钙/硫酸钙为原料,利用搅拌喷雾干燥法制备出掺锶β-磷酸三钙/硫酸钙复合小球,再将硅胶与制备的复合小球复合,通过在模具中堆垛聚集的方法,制备出硅胶/掺锶β-磷酸三钙/硫酸钙复合生物支架。采用XRD,SEM,FT-IR等方法分析制得复合多孔支架的成分、形貌以及结构特征,并研究复合生物支架的降解性、孔隙率、力学性能和细胞毒性等。结果表明:该复合多孔生物支架具有一定的不规则孔洞结构,小球与小球之间的孔隙约为0.2~1mm,而每个小球上也有大量的微孔,孔径在50~200μm之间,且平均孔隙率达到62%,基本能满足骨组织工程支架对孔隙率的要求;该复合多孔支架无细胞毒性,其降解周期约为80天,抗压强度约为0.1MPa,因此该支架在非承重骨组织修复方面具有良好的应用前景。     

Biodegradable polycaprolactone scaffold with controlled porosity obtained by modified particle-leaching technique

Scaffold with controlled porosity constitute a cornerstone in tissue engineering, as a physical support for cell adhesion and growth. In this work, scaffolds of polycaprolactone were synthesized by a modified particle leaching method in order to control porosity and pore interconnectivity; the aim is to observe their influence on the mechanical properties and, in the future, on cell adhesion and proliferation rates. Low molecular weight PEMA beads with an average size of 200 μm were sintered with various compression rates in order to obtain the templates (negatives of the scaffolds). Then the melt polycaprolactone was injected into the porous template under nitrogen pressure in a custom made device. After cooling and solidifying of the melt polymer, the porogen was removed by selective dissolution in ethanol. The porosity and morphology of the scaffold were studied as well as the mechanical properties. Porosities from 60% to 85% were reached; it was found that pore interconnectivity logically increases with increasing porosity, and that mechanical strength decreases with increasing porosity. Because of their interesting properties and interconnected structure, these scaffolds are expected to find useful applications as a cartilage or bone repair material.     

Fabrication of glycidyl methacrylate-modified silk fibroin/poly(L-lactic acid-co-ε-caprolactone)–polyethylene glycol diacrylate hybrid 3D nanofibrous scaffolds for tissue engineering

In order to provide a biomimetic natural extracellular matrix microenvironment with excellent mechanical capacity for tissue regeneration, a novel porous hybrid glycidyl methacrylate-modified silk fibroin/poly(L-lactic acid-co-ε-caprolactone)–polyethylene glycol diacrylate (SFMA/P(LLA-CL)–PEGDA) hybrid three-dimensional (3D) nanofibrous scaffolds was successfully fabricated through the combination of 3D nanofibrous platforms and divinyl PEGDA based photocrosslinking, and then further improved water resistance by ethanol vapor post-treatment. Scanning electron microscopy and micro-computed tomography results demonstrated significant PEGDA hydrogel-like matrices bonded nanofibers, which formed a 3D structure similar to that of “steel bar (nanofibers)‒cement (PEGDA)”, with proper pore size, high porosity, and high pore connectivity density. Meanwhile, the hybrid 3D nanofibrous scaffolds showed outstanding swelling properties as well as improved compressive and tensile properties. Furthermore, these hybrid 3D nanofibrous scaffolds could provide a biocompatible microenvironment, capable of inducing the material‒cell hybrid and regulating human umbilical vein endothelial cells proliferation. They thus present significant potential in tissue regeneration.     

Fabrication and evaluation of biomimetic scaffolds by using collagen–alginate fibrillar gels for potential tissue engineering applications

Pore architecture and its stable functionality under cell culturing of three dimensional (3D) scaffolds are of great importance for tissue engineering purposes. In this study, alginate was incorporated with collagen to fabricate collagen–alginate composite scaffolds with different collagen/alginate ratios by lyophilizing the respective composite gels formed via collagen fibrillogenesis in vitro and then chemically crosslinking. The effects of alginate amount and crosslinking treatment on pore architecture, swelling behavior, enzymatic degradation and tensile property of composite scaffolds were systematically investigated. The relevant results indicated that the present strategy was simple but efficient to fabricate highly interconnected strong biomimetic 3D scaffolds with nanofibrous surface. NIH3T3 cells were used as a model cell to evaluate the cytocompatibility, attachment to the nanofibrous surface and porous architectural stability in terms of cell proliferation and infiltration within the crosslinked scaffolds. Compared with the mechanically weakest crosslinked collagen sponges, the cell-cultured composite scaffolds presented a good porous architecture, thus permitting cell proliferation on the top surface as well as infiltration into the inner part of 3D composite scaffolds. These composite scaffolds with pore size ranging from 150 to 300 μm, over 90% porosity, tuned biodegradability and water-uptake capability are promising for tissue engineering applications.     

Porous Ti6Al4V scaffolds directly fabricated by 3D fibre deposition technique: Effect of nozzle diameter

3D porous Ti6Al4V scaffolds were successfully directly fabricated by a rapid prototyping technology: 3D fibre deposition. In this study, the rheological properties of Ti6Al4V slurry was studied and the flow rate was analyzed at various pressures and nozzle diameters. Scaffolds with different fibre diameter and porosity were fabricated. ESEM observation and mechanical tests were performed on the obtained porous Ti6Al4V scaffolds with regard to the porous structure and mechanical properties. The results show that these scaffolds have 3D interconnected porous structure and a compressive strength which depends on porosity at constant fibre diameters and on the fibre diameter at constant porosity. These Ti6Al4V scaffolds are expected to be constructs for biomedical applications.     

RGD-modified acellular bovine pericardium as a bioprosthetic scaffold for tissue engineering

Acellular biological tissues, including bovine pericardia (BP), have been proposed as natural biomaterials for tissue engineering. However, small pore size, low porosity and lack of extra cellular matrix (ECM) after native cell extraction directly restrict the seed cell adhesion, migration and proliferation and which is a vital problem for ABP’s application in the tissue engineered heart valve (TEHV). In the present study, we treated acellular BP with acetic acid, which increased the scaffold pore size and porosity and conjugated RGD polypeptides to ABP scaffolds. After 10 days of culture in vitro, the human mesenchymal stem cells (hMSCs) attached the best and proliferated the fastest on RGD-modified acellular scaffolds, and the cell has grown deep into the scaffold. In contrast, a low density of cells attached to the unmodified scaffolds, with few infiltrating into the acellular tissues. These findings support the potential use of modified acellular BP as a scaffold for tissue engineered heart valves.     

Novel 3D porous multi-phase composite scaffolds based on PCL,thermoplastic zein and ha prepared via supercritical CO2 foaming for bone regeneration

The aim of this study was the design of novel biodegradable porous scaffolds for bone tissue engineering (bTE) via supercritical CO₂ (scCO₂) foaming process. The porous scaffolds were prepared from a poly(ε-caprolactone)-thermoplastic zein multi-phase blend w/o interdispersed hydroxyapatite particles (HA) and the porous structure achieved via the scCO₂ foaming technology. The control of scaffolds porosity was obtained by modulating materials formulation and foaming temperature (T_F). The scaffolds were subjected to morphological, micro-structural and biodegradation analyses, as well as in vitro biocompatibility tests. Results demonstrated that both HA concentration and T_F significantly affected the micro-structural features of the scaffolds. In particular, scaffolds with porosity and pore size distribution, mechanical properties and biodegradability adequate for bTE were designed and produced by selecting a T_F equal to 100 °C for all the compositions used. The biocompatibility of these scaffolds was assessed in vitro by using osteoblast-like MG63 and human mesenchymal stem cells (hMSCs).     

Nanostructured bioactive glass coating on porous hydroxyapatite scaffold for strength enhancement

Many attempts have been focused on preparing highly porous scaffolds with appropriate mechanical strength. This paper has developed a new route to enhance the compressive strength of porous HA (hydroxyapatite) scaffold (porosity: ∼ 83%, mean pore size:∼ 800 μm). Briefly this route included nanostructure coating of bioactive glass on struts of porous HA. Coating microstructure consisted of the grains with the range between 91 and 320 nm and micron size pores that could be detected by SEM observation. This simple method improved the compressive strength of highly porous HA from 0.22 to 1.49 MPa. The obtained scaffolds provided good mechanical support while maintaining bioactivity so they could be used as tissue engineering scaffolds for low-load bearing applications.     

Evaluation of channel-like porous-structured titanium in mechanical properties and osseointegration

The porous titanium with a channel-like pore structure fabricated by infiltration casting followed by selectively dissolving the precursor woven three dimensional(3 D) structure technique was comprehensively investigated by means of mechanical tests, in vitro and in vivo evaluation. Such porous structure exhibited superiority in compressive, tensile strength and osseointegration. At 40% porosity, the average compressive and tensile strength reached about 145 MPa and 85 MPa, which was superior to that of other porous titanium, e.g., Selective Laser Melting or powder sintered ones, and was comparable to that of the human cortical bone. Without any bioactive surface treatment, this porous titanium exhibited good cell adhesion, rapid cell proliferation and excellent osseointegration. Based on the study, the 0.4 mm pore size resulted in the most rapid cell proliferation and the maximal BV/TV ratio and trabecular bone number of the new bone that ingrew into the porous titanium. To balance the excellent osseointegration and adequate mechanical properties, the optimal structural parameters were 0.4 mm pore size with40% porosity. This porous titanium is very promising for orthopedic applications where compressive and tensile load-bearing is extremely important.     

A casting based process to fabricate 3D alginate scaffolds and to investigate the influence of heat transfer on pore architecture during fabrication

The fabrication of 3-dimensional (3D) tissue scaffolds is a competitive approach to engineered tissues. An ideal tissue scaffold must be highly porous, biocompatible, biodegradable, easily processed and cost-effective, and have adequate mechanical properties. A casting based process has been developed in this study to fabricate 3D alginate tissue scaffolds. The alginate/calcium gluconate hydrogel was quenched in a glass mold and freeze dried to form a highly porous tissue scaffold whose tiny pores retain the shape of the ice crystals during quenching. Knowing that the water in the alginate hydrogel would form ice crystals if frozen and that different cooling conditions may dramatically influence the pore architecture, the speed and direction of the heat transfer in freeze drying hydrogel were examined with regard to pore size and orientation. The pore architecture at the different locations of the fabricated scaffolds was characterized using scanning electron microscopy. The fabricated scaffolds consist of pores that are highly interconnected, with a diameter about 200 µm (average diameter of a capillary) to permit blood vessel penetration. It also has been found that the pore size, orientation, and uniformity are significantly affected by the condition of heat transfer during freeze drying. Tailoring the pore architecture of the scaffolds is feasible by controlling heat transfer. This study provides an insight on pore architecture formation and control by altered process parameters.     

Influence of pore size on tensile strength, permeability and porosity of hyaluronan-collagen scaffolds

Recent investigations have shown the importance of scaffold pore size on the realisation of tissue engineered cartilage which promotes cell adhesion, proliferation and differentiation. The objective of this study was to investigate the influence of pore size on the mechanical properties, the permeability and the porosity of hyaluronan-collagen scaffolds. Hyaluronan-collagen scaffolds with three different mean pore sizes (302.5, 402.5 and 525 microm) have been produced according to a standardised protocol. The maximum stress at rupture, the Young's Moduli, permeability and porosity of the scaffolds were investigated. The permeability was determined both empirically and mathematically. Increased pore sizes indicated a larger stress at rupture as well as increased Young's Moduli. Porosity and permeability were raised by increasing pore sizes. The mathematically calculated permeability showed the same trend. The results indicate a higher mechanical stability for scaffolds with larger pores. The experimental and mathematical experiments both show increased permeability and fluid mobility for larger pores in scaffolds. Morphological changes resulting from the alteration of pore size led to non-correlation between the calculated and the experimental permeability.     

Personalised bone tissue engineering scaffold with controlled architecture using fractal tool paths in layered manufacturing

The scaffolds for bone tissue engineering should consider the functional requirements such as the external shape of the replacement, porosity for vessel and nutrient conduit, and stiffness in order to avoid stress shielding and to stimulate growth of the new tissue. Layered manufacturing (LM) has shown great promise in fabricating such porous bone scaffold. The present work proposes a biomimetic design and LM of patient- and site-specific controlled porosity scaffolds for optimised mechanical properties for repair and regeneration of bone. Correlation models between porosity and modulus for bone, and known biomaterials processable by LM are used to estimate the site-specific porosity requirements in the scaffold model. A novel method for generating a tool path using space-filling fractal curves eliminates representation difficulties associated with LM of porous objects. A representative study of a hydroxyapatite scaffold for a cortical bone defect site in human femur is presented to illustrate the methodology.     

Scaffold development using 3D printing with a starch-based polymer

Rapid prototyping (RP) techniques have been utilised by tissue engineers to produce three-dimensional (3D) porous scaffolds. RP technologies allow the design and fabrication of complex scaffold geometries with a fully interconnected pore network. Three-dimensional printing (3DP) technique was used to fabricate scaffolds with a novel micro- and macro-architecture. In this study, a unique blend of starch-based polymer powders (cornstarch, dextran and gelatin) was developed for the 3DP process. Cylindrical scaffolds of five different designs were fabricated and post-processed to enhance the mechanical and chemical properties. The scaffold properties were characterised by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), porosity analysis and compression tests.     

Design of porous polymeric scaffolds by gas foaming of heterogeneous blends

One of the challenges in tissue engineering scaffold design is the realization of structures with a pre-defined multi-scaled porous network. Along this line, this study aimed at the design of porous scaffolds with controlled porosity and pore size distribution from blends of poly(ε-caprolactone) (PCL) and thermoplastic gelatin (TG), a thermoplastic natural material obtained by de novo thermoplasticization of gelatin. PCL/TG blends with composition in the range from 40/60 to 60/40 (w/w) were prepared by melt mixing process. The multi-phase microstructures of these blends were analyzed by scanning electron microscopy and dynamic mechanical analysis. Furthermore, in order to prepare open porous scaffolds for cell culture and tissue replacement, the TG and PCL were selectively extracted from the blends by the appropriate combination of solvent and extraction parameters. Finally, with the proposed combination of gas foaming and selective polymer extraction technologies, PCL and TG porous materials with multi-scaled and highly interconnected porosities were designed as novel scaffolds for new-tissue regeneration.