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.     

An approach to architecture 3D scaffold with interconnective microchannel networks inducing angiogenesis for tissue engineering

The angiogenesis of 3D scaffold is one of the major current limitations in clinical practice tissue engineering. The new strategy of construction 3D scaffold with microchannel circulation network may improve angiogenesis. In this study, 3D poly(d,l-lactic acid) scaffolds with controllable microchannel structures were fabricated using sacrificial sugar structures. Melt drawing sugar-fiber network produced by a modified filament spiral winding method was used to form the microchannel with adjustable diameters and porosity. This fabrication process was rapid, inexpensive, and highly scalable. The porosity, microchannel diameter, interconnectivity and surface topographies of the scaffold were characterized by scanning electron microscopy. Mechanical properties were evaluated by compression tests. The mean porosity values of the scaffolds were in the 65–78% and the scaffold exhibited microchannel structure with diameter in the 100–200 μm range. The results showed that the scaffolds exhibited an adequate porosity, interconnective microchannel network, and mechanical properties. The cell culture studies with endothelial cells (ECs) demonstrated that the scaffold allowed cells to proliferate and penetrate into the volume of the entire scaffold. Overall, these findings suggest that the fabrication process offers significant advantages and flexibility in generating a variety of non-cytotoxic tissue engineering scaffolds with controllable distributions of porosity and physical properties that could provide the necessary physical cues for ECs and further improve angiogenesis for tissue engineering.     

The morphology,mechanical properties and ageing behavior of porous injection molded starch-based blends for tissue engineering scaffolding

One important parameter in the tissue engineering of hard tissues is the scaffold. A scaffold is a support in which cells are seeded and that should create the adequate environment for the cells to attach and proliferate. Furthermore the scaffold should allow the flow of an appropriate culture media, providing nutrients to the cells and simultaneously removing the metabolites resulting from the cells activity. One of the possibilities is to obtain solid foamed structures that will enable the cells to attach, spread into the inner surfaces and start to produce extracellular matrix. Ideally, if the scaffold is produced from a biodegradable material, it should degrade at a pace that is in phase with the formation of the new tissue.In this work it was studied the production of porous structures from biodegradable polymers for use as scaffolds for bone tissue engineering. Two materials were studied, starch compounded with poly(ethylene-vinyl-alcohol) (SEVA-C) and starch with poly(lactic acid) (SPLA). The porous structures were obtained by injection molding with a blowing agent to control the porosity, interconnectivity and degradation rate. In previous attempts, the current starch compounds proved to be very difficult to process by this method. This study includes the characterization of the mechanical properties, water absorption and of the degradation kinetics of the 3-D porous structures.Two starch-based biodegradable 3D porous structures were successfully processed in conventional injection molding and the foaming was obtained by means of the use of a blowing agent. The mechanical properties are very promising as well as the improved degradation kinetics when compared with the synthetic polymers alone, although the degree of porosity and of interconnectivity needs to be improved in further work.     

Three-dimensional printing of multilayered tissue engineering scaffolds

The field of tissue engineering has produced new therapies for the repair of damaged tissues and organs, utilizing biomimetic scaffolds that mirror the mechanical and biological properties of host tissue. The emergence of three-dimensional printing (3DP) technologies has enabled the fabrication of highly complex scaffolds that offer a more accurate replication of native tissue properties and architecture than previously possible. Of strong interest to tissue engineers is the construction of multilayered scaffolds that target distinct regions of complex tissues. Musculoskeletal and dental tissues in particular, such as the osteochondral unit and periodontal complex, are composed of multiple interfacing tissue types, and thus benefit from the usage of multilayered scaffold fabrication. Traditional 3DP technologies such as extrusion printing and selective laser sintering have been used for the construction of scaffolds with gradient architectures and mixed material compositions. Additionally, emerging bioprinting strategies have been used for the direct printing and spatial patterning of cells and chemical factors, capturing the complex organization found in the body. To better replicate the varied and gradated properties of larger tissues, researchers have created scaffolds composed of multiple materials spanning natural polymers, synthetic polymers, and ceramics. By utilizing high-precision 3DP techniques and judicious material selection, scaffolds can thus be designed to address the regeneration of previously challenging musculoskeletal, dental, and other heterogeneous target tissues. These multilayered 3DP strategies show great promise in the future of tissue engineering.     

β-CaSiO_3/丝素蛋白复合支架材料结构与性能的研究

利用冷冻干燥法制备了β-CaSiO_3/丝素蛋白复合支架材料,经XRD和FTIR分析表明复合支架中丝素的结构主要以β-折叠为主;SEM分析显示材料孔隙分布均匀,孔连通性较好,孔径尺寸约为100～300μm.对支架的孔隙率和机械强度等性能进行了表征,研究表明复合支架的孔隙率为83%～87%,机械强度有较大提高.应用模拟体液浸泡实验研究了复合支架的体外生物活性,并用XRD、FESEM和EDS对试样表面进行了表征;结果显示,样品经模拟体液浸泡3天后,表面都能沉积出类骨羟基磷灰石(HA)层,β-CaSiO_3的加入能加快复合支架表面沉积类骨HA的速度.研究结果显示β-CaSiO_3/丝素蛋白复合支架材料有望作为强度较好的生物活性硬组织修复材料.     

A biomimetic three-dimensional woven composite scaffold for functional tissue engineering of cartilage

Tissue engineering seeks to repair or regenerate tissues through combinations of implanted cells, biomaterial scaffolds and biologically active molecules. The rapid restoration of tissue biomechanical function remains an important challenge, emphasizing the need to replicate structural and mechanical properties using novel scaffold designs. Here we present a microscale 3D weaving technique to generate anisotropic 3D woven structures as the basis for novel composite scaffolds that are consolidated with a chondrocyte-hydrogel mixture into cartilage tissue constructs. Composite scaffolds show mechanical properties of the same order of magnitude as values for native articular cartilage, as measured by compressive, tensile and shear testing. Moreover, our findings showed that porous composite scaffolds could be engineered with initial properties that reproduce the anisotropy, viscoelasticity and tension-compression nonlinearity of native articular cartilage. Such scaffolds uniquely combine the potential for load-bearing immediately after implantation in vivo with biological support for cell-based tissue regeneration without requiring cultivation in vitro.     

Design and 3D Printing of Scaffolds and Tissues

A growing number of three-dimensional(3D)-print- ing processes have been applied to tissue engineering. This paper presents a state-of-the-art study of 3D-printing technologies for tissue-engineering applications, with particular focus on the development of a computer-aided scaffold design system; the direct 3D printing of functionally graded scaffolds; the modeling of selective laser sintering(SLS) and fused deposition modeling(FDM) processes; the indirect additive manufacturing of scaffolds, with both micro and macro features; the development of a bioreactor; and 3D/4D bioprinting. Technological limitations will be discussed so as to highlight the possibility of future improvements for new 3D-printing methodologies for tissue engineering.     

Biopolymer deposition for freeform fabrication of hydrogel tissue constructs

Three-dimensional (3D) tissue scaffolds play a vital role as extra-cellular matrices onto which cells can attach, grow, and form new tissue. Among available biomaterials, hydrogels, such as alginate, fibrin, and chitosan, have promising potential in tissue engineering applications because of their structural similarities to macromolecular-based human tissues, their biocompatibility, low toxicity, and availability. The presentation will report our recent research on development of a novel multi-nozzle biopolymer deposition system for freeform fabrication of biopolymer-based tissue scaffolds and cell-embedded tissue constructs. The process of the biopolymer deposition is conducted in a biocompatible environment which allows the construction of scaffolds with bioactive compounds and living cells. The system configuration and the process for fabrication of bioactive scaffolds through the biopolymer depositions system under different nozzle system will be described. Results of study on deposition feasibility and 3D structural formability of alginate-based tissue scaffolds will be reported. A semi-empirical model, developed based on the Poiseulle's equation for non-Newtonian fluids to predict the deposition flow rate and the deposition geometry, along with comparison of experimental data will be presented. Deposition of cell embedded tissue scaffold as well as the cell viability will be introduced. Results of effect of the process parameters on the structural, mechanical and cellular tissue engineering properties for freeform fabricated 3D alginate tissue scaffolds will also be presented.     

骨软骨组织工程仿生梯度支架研究进展

骨软骨缺损是导致关节发病和残疾的重要原因,骨软骨组织工程是修复骨软骨缺损的方法之一。骨软骨组织工程方法涉及仿生梯度支架的制造,该支架需模仿天然骨软骨组织的生理特性（例如从软骨表面到软骨下骨之间的梯度过渡）。在许多研究中骨软骨仿生梯度支架表现为离散梯度或连续梯度,用于模仿骨软骨组织的特性,例如生物化学组成、结构和力学性能。连续型骨软骨梯度支架的优点是其每层之间没有明显的界面,因此更相似地模拟天然骨软骨组织。到目前为止,骨软骨仿生梯度支架在骨软骨缺损修复研究中已经取得了良好的实验结果,但是骨软骨仿生梯度支架与天然骨软骨组织之间仍然存在差异,其临床应用还需要进一步研究。本文首先从骨软骨缺损的背景、微尺度结构与力学性能、骨软骨仿生梯度支架制造相关的材料与方法等方面概述了离散和连续梯度支架的研究进展。其次,由于3D打印骨软骨仿生梯度支架的方法能够精确控制支架孔的几何形状和力学性能,因此进一步介绍了计算仿真模型在骨软骨组织工程中的应用,例如采用仿真模型优化支架结构和力学性能以预测组织再生。最后,提出了骨软骨缺损修复相关的挑战以及骨软骨组织再生未来研究的展望。例如,连续型骨软骨仿生梯度支架需要更相似地模拟天然骨软骨组织单元的结构,即力学性能和生化性能的过渡更加自然地平滑。同时,虽然大多数骨软骨仿生梯度支架在体内外实验中均取得了良好的效果,但临床研究和应用仍然需要进行进一步深入研究。     

A novel approach via combination of electrospinning and FDM for tri-leaflet heart valve scaffold fabrication

In this paper, a novel combination method of electrospinning and rapid prototyping (RP) fused deposition modeling (FDM) is proposed for the fabrication of a tissue engineering heart valve (TEHV) scaffold. The scaffold preparation consisted of two steps: tri-leaflet scaffold fabrication and heart valve ring fabrication. With the purpose of mimicking the anisotropic mechanical properties of the natural heart valve leaflet, electrospun thermoplastic polyurethane (ES-TPU) was introduced as the tri-leaflet scaffold material. ES-TPU scaffolds can be fabricated to have a well-aligned fiber network, which is important for applications involving mechanically anisotropic soft tissues. We developed ES-TPU scaffolds as heart valve leaflet materials under variable speed conditions and measured fiber alignment by fast Fourier transform (FFT). By using FFT to assign relative alignment values to an electrospun matrix, it is possible to systematically evaluate how different processing variables affect the structure and material properties of a scaffold. TPU was suspended at certain concentrations and electrospun from 1,1,1,3,3,3-hexafluoro-2-propanol onto rotating mandrels (200–3000 rpm). The scaffold morphological property and mechanical anisotropic property are discussed in the paper as a function of fiber diameter and mandrel RPM. The induction of varying degrees of anisotropy imparted distinctive material properties to the electrospun scaffolds. A dynamic optimum design of the heart valve ring graft was constructed by FDM. Fabrication of a 3D heart valve ring was constructed using pro-engineer based on optimum hemodynamic analysis and was converted to an STL file format. The model was then created from PCL which was sewed and glued with electrospun nanofibrous leaflets. This proposed method was proven as a promising fabrication process in fabricating a specially designed graft with the correct physical and mechanical properties.     

Alternative tissue engineering scaffolds based on starch: processing methodologies, morphology, degradation and mechanical properties

An ideal tissue engineering scaffold must be designed from a polymer with an adequate degradation rate. The processing technique must allow for the preparation of 3-D scaffolds with controlled porosity and adequate pore sizes, as well as tissue matching mechanical properties and an appropriate biological response.

This communication revises recent work that has been developed in our laboratories with the aim of producing 3-D polymeric structures (from starch-based blends) with adequate properties to be used as scaffolds for bone tissue engineering applications. Several processing methodologies were originally developed and optimised. Some of these methodologies were based on conventional melt-based processing routes, such as extrusion using blowing agents (BA) and compression moulding (combined with particulate leaching). Other developed technologies included solvent casting and particle leaching and an innovative in situ polymerization method.

By means of using the described methodologies, it is possible to tailor the properties of the different scaffolds, namely their degradation, morphology and mechanical properties, for several applications in tissue engineering. Furthermore, the processing methodologies (including the blowing agents used in the melt-based technologies) described above do not affect the biocompatible behaviour of starch-based polymers. Therefore, scaffolds obtained from these materials by means of using one of the described methodologies may constitute an important alternative to the materials currently used in tissue engineering.     

Glass,Ceramic, Polymeric,and Composite Scaffolds with Multiscale Porosity for Bone Tissue Engineering

Porosity affects performance of scaffolds for bone tissue engineering both in vitro and in vivo. Macropores (i.e., pores with a diameter >100 μm) are essential for cellular infiltration; micropores (i.e., pores with a diameter of 1–10 μm) promote cell adhesion and facilitate nutrient absorption. Scaffolds containing both macropores and micropores exploit the advantages of both pore sizes and have excellent osteogenic properties. Nanopores (i.e., pores with a diameter of 1–50 nm) can be included as well, to improve cell–material interactions by further enhancing the surface area of the scaffold. This article reviews fabrication techniques and properties of scaffolds with multiscale porosity, focusing on glass, ceramic, polymeric, and composite scaffolds. After discussing the structure of bone and how it inspired scaffolds for bone tissue engineering, pore nomenclature is introduced. Then, the techniques used to induce multiscale porosity, the nature of the pores created, and the effects of scaffold porosity on mechanical properties and biological activity of the scaffolds are discussed. The review concludes by providing an outlook for this field, including advancements that are made possible by computational modeling and artificial intelligence.     

3D Bioplotting of Gelatin/Alginate Scaffolds for Tissue Engineering:Influence of Crosslinking Degree and Pore Architecture on Physicochemical Properties

Gelatin/Alginate hydrogels were engineered for bioplotting in tissue engineering. One major drawback of hydrogel scaffolds is the lack of adequate mechanical properties. In this study, using a bioplotter, we constructed the scaffolds with different pore architectures by deposition of gelatin/alginate hydrogels layerby-layer. The scaffolds with different crosslinking degree were obtained by post-crosslinking methods.Their physicochemical properties, as well as cell viability, were assessed. Different crosslinking methods had little influence on scaffold architecture, porosity, pore size and distribution. By contrast, the water absorption ability, degradation rate and mechanical properties of the scaffolds were dramatically affected by treatment with various concentrations of crosslinking agent(glutaraldehyde). The crosslinking process using glutaraldehyde markedly improved the stability and mechanical strength of the hydrogel scaffolds. Besides the post-processing methods, the pore architecture can also evidently affect the mechanical properties of the scaffolds. The crosslinked gelatin/alginate scaffolds showed a good potential to encapsulate cells or drugs.     

A review on powder-based additive manufacturing for tissue engineering: selective laser sintering and inkjet 3D printing

Since most starting materials for tissue engineering are in powder form, using powder-based additive manufacturing methods is attractive and practical. The principal point of employing additive manufacturing (AM) systems is to fabricate parts with arbitrary geometrical complexity with relatively minimal tooling cost and time. Selective laser sintering (SLS) and inkjet 3D printing (3DP) are two powerful and versatile AM techniques which are applicable to powder-based material systems. Hence, the latest state of knowledge available on the use of AM powder-based techniques in tissue engineering and their effect on mechanical and biological properties of fabricated tissues and scaffolds must be updated. Determining the effective setup of parameters, developing improved biocompatible/bioactive materials, and improving the mechanical/biological properties of laser sintered and 3D printed tissues are the three main concerns which have been investigated in this article.     

A novel approach via combination of electrospinning and FDM for tri-leaflet heart valve scaffold fabrication

In this paper, a novel combination method of electrospinning and rapid prototyping (RP) fused deposition modeling (FDM) is proposed for the fabrication of a tissue engineering heart valve (TEHV) scaffold. The scaffold preparation consisted of two steps: tri-leaflet scaffold fabrication and heart valve ring fabrication. With the purpose of mimicking the anisotropic mechanical properties of the natural heart valve leaflet, electrospun thermoplastic polyurethane (ES-TPU) was introduced as the tri-leaflet scaffold material. ES-TPU scaffolds can be fabricated to have a well-aligned fiber network, which is important for applications involving mechanically anisotropic soft tissues. We developed ES-TPU scaffolds as heart valve leaflet materials under variable speed conditions and measured fiber alignment by fast Fourier transform (FFT). By using FFT to assign relative alignment values to an electrospun matrix, it is possible to systematically evaluate how different processing variables affect the structure and material properties of a scaffold. TPU was suspended at certain concentrations and electrospun from 1,1,1,3,3,3-hexafluoro-2-propanol onto rotating mandrels (200―3000 rpm). The scaffold morphological property and mechanical anisotropic property are discussed in the paper as a function of fiber diameter and mandrel RPM. The induction of varying degrees of anisotropy imparted distinctive material properties to the electrospun scaffolds. A dynamic optimum design of the heart valve ring graft was constructed by FDM. Fabrication of a 3D heart valve ring was constructed using pro-engineer based on optimum hemodynamic analysis and was converted to an STL file format. The model was then created from PCL which was sewed and glued with electrospun nanofibrous leaflets. This proposed method was proven as a promising fabrication process in fabricating a specially designed graft with the correct physical and mechanical properties.     

Novel 3D scaffold with enhanced physical and cell response properties for bone tissue regeneration,fabricated by patterned electrospinning/electrospraying

Developing three dimensional scaffolds mimicking the nanoscale structure of native extracellular matrix is a key parameter in tissue regeneration. In this study, we aimed to introduce a novel 3D structures composed of nanofibers (NF) and micro particles (MP) and compare their efficiency with 2D nanofibrous scaffold. The conventional nanofibrous PCL scaffolds are 2D mats fabricated by the electrospinning technique, whereas the NF/MP and patterned NF/MP PCL scaffolds are three dimensional structures fabricated by a modified electrospinning/electrospraying technique. The mentioned method was carried out by varying the electrospinning solution parameters and use of a metal mesh as the collector. Detailed fabrication process and morphological properties of the fabricated structures is discussed and porosity, pore size and PBS solution absorption value of the prepared structures are reported. Compared with the 2D structure, 3D scaffolds possessed enhanced porosity and pore size which led to the significant increase in their water uptake capacity. In vitro cell experiments were carried out on the prepared structures by the use of MG-63 osteosarcoma cell line. The fabricated 3D structures offered significantly increased cell attachment, spread and diffusion which were confirmed by SEM analysis. In vitro cytocompatibility assessed by MTT colorimetric assay indicated a continuous cell proliferation over 21 days on the innovative 3D structure, while on 2D mat cell proliferation stopped at early time points. Enhanced osteogenic differentiation of the seeded MG-63 cells on 3D scaffold was confirmed by the remarkable ALP activity together with increased and accelerated calcium deposition on this structure compared to 2D mat. Massive and well distributed bone minerals formed on patterned 3D structure were shown by EDX analysis. In comparison between NF/MP quasi-3D and Patterned NF/MP 3D scaffolds, patterned structures proceeded in all of the above properties. As such, the innovative Patterned NF/MP 3D scaffold could be considered as a proper bone graft substitute for bone tissue regeneration.     

A review on powder-based additive manufacturing for tissue engineering: selective laser sintering and inkjet 3D printing

Abstract

Since most starting materials for tissue engineering are in powder form, using powder-based additive manufacturing methods is attractive and practical. The principal point of employing additive manufacturing (AM) systems is to fabricate parts with arbitrary geometrical complexity with relatively minimal tooling cost and time. Selective laser sintering (SLS) and inkjet 3D printing (3DP) are two powerful and versatile AM techniques which are applicable to powder-based material systems. Hence, the latest state of knowledge available on the use of AM powder-based techniques in tissue engineering and their effect on mechanical and biological properties of fabricated tissues and scaffolds must be updated. Determining the effective setup of parameters, developing improved biocompatible/bioactive materials, and improving the mechanical/biological properties of laser sintered and 3D printed tissues are the three main concerns which have been investigated in this article.     

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.     

Gravity Drawing of Micro‐ and Nanofibers for Additive Manufacturing of Well‐Organized 3D‐Nanostructured Scaffolds

This work introduces a gravity fiber drawing (GFD) method of making single filament nanofibers from polymer solutions and precise alignment of the fibers in 3D scaffolds. This method is advantageous for nanofiber 3D alignment in contrast to other known methods. GFD provides a technology for the fabrication of freestanding filament nanofibers of well‐controlled diameter, draw ratio, and 3D organization with controllable spacing and angular orientation between nanofibers. The GFD method is capable of fabricating complex 3D scaffolds combining fibers with different diameters, chemical compositions, mechanical properties, angular orientations, and multilayer structures in the same construct. The scaffold porosity can be as high as 99% to secure transport of nutrients and space for cell infiltration and differentiation in tissue engineering and 3D cell culture applications.     

聚乳酸/聚乙二醇/羟基磷灰石多孔骨支架的3D打印制备及其生物相容性

聚乳酸(PLA)是一种应用广泛的生物高分子材料,但在应用过程中存在韧性、亲水性、生物活性差等缺点。用聚乙二醇(PEG)和羟基磷灰石(HA)对PLA进行改性。通过熔融共混制备不同质量比的PLA/PEG/HA复合3D打印线材,并通过分析PLA/PEG/HA线材的力学性能、结晶性能、热性能、流变性能等,筛选更适合熔融沉积成型(FDM)的3D打印成型线材,进而利用3D打印制备精度高的力学性能试样及生物相容性好、细胞可增殖和分化的生物多孔支架。结果表明:PEG的添加提高了PLA的韧性,降低了PLA的熔点。HA的添加则提高PLA/PEG/HA复合材料的弹性模量和冷结晶温度,同时HA也可以改善复合材料的加工性能。SEM与荧光标记结果表明多孔支架与细胞具有良好的生物相容性。生物支架对体外细胞的成功培养,为进一步发掘生物多孔支架在动物体内、生物医学及定制化应用方面提供了潜在可能。