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3D printing bone grafts
A Review of 3D Printed Bone Implants
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3D printed implants made from a mixture of bone powder and plastic could be ideal for bone replacement
Many people require surgery to replace the bones of the skull and face - usually a fragment of the patient's own legs is used during this procedure.
However, the results often leave much to be desired, not to mention possible complications. Fortunately, there is a lot of research being done on alternative methods of making bones that are ideal for a particular site. We are talking about 3D printing of partially plastic structures on which living cells can be placed. However, the difficulty is to stimulate the cells to form bone tissue - for this, scientists from Johns Hopkins University used bone powder.
Scientists have been working on 3D printing plastic implants – in this case, polycaprolactone, a biodegradable material with a low melting point (80-100 degrees). This plastic provides the necessary strength, but is not able to stimulate cell growth - so the researchers used it in combination with powdered bone material obtained from cows. It is bone powder that contains structural proteins that allow stem cells to form bone tissue. In addition, according to scientists, the powder makes the plastic rougher, which helps to fix cells and enhance growth factors.
To evaluate the potential of the composite material, the scientists tested various combinations of bone powder and polycaprolactone. The material with the maximum bone content, 85%, was not suitable for 3D printing at all - the structures simply fell apart. As for the other combinations that were printed, they were evaluated in terms of their ability to stimulate cell growth. For this, stem cells extracted from the patient's adipose tissue during liposuction were used in the construction.
After three weeks, the scientists evaluated the results - the greatest progress towards transformation into bone tissue was shown by an implant with a bone powder content of 70%. Samples with a bone content of 30% also showed good results in all tests, although not as impressive - so the researchers decided to conduct an experiment in real conditions.
During the experiment, scientists transplanted 3D-printed bone implants into the skulls of mice, in which holes were made that were unable to heal on their own.
After some time, the mice underwent computed tomography, which showed that the material with a content of 30% and 70% bone powder led to much faster bone development compared to pure polycaprolactone implants.
Experiments with various combinations are still ongoing - scientists intend to determine their advantages and disadvantages, as well as to conduct tests with human bones and other improvements that, in particular, can stimulate the formation of new blood vessels.
Tags: 3D printing, implant, Johns Hopkins University, polycaprolactone, 3D printer
Biomaterial for 3D printing of temporary human bones created Photo: Adam E. Jakus
Attempts to create materials for 3D printing of temporary human bones (osteoregenerative biomaterials) have been made repeatedly. Unfortunately, they still suffer from a number of shortcomings. Among them are the inability to quickly and accurately reproduce a new bone, high cost and limited production capabilities, and the complexity of processing during a surgical operation.
The new biomaterial is devoid of all these shortcomings. If all tests are successful, then in a few years people will be able to get strong, superelastic and cheap artificial bones that will biodegrade in the body in a few years (they are gradually replaced by natural bone tissue). The most interesting thing is that the material extrusion process at room temperature, theoretically, allows printing bones even on home printers.
As the scientists write, the new material HB (from hyperelastic “bone”) consists of 90% by weight of hydroxyapatite and 10% of polycaprolactone.
Hydroxylapatite Ca 10 (PO 4 ) 6 (OH) 2 is the main mineral constituent of natural human bones. In most bones, it is about 50% of the total mass, and in tooth enamel - 96%. In medicine, a synthetic analog has long been used in traumatology, orthopedics, and bone surgery as a filler that replaces parts of a lost bone. In dentistry, it is also used in toothpastes as a remineralizing element that strengthens tooth enamel.
But polycaprolactone (PCL) is not found in biological materials. It is a biodegradable polyester, which is used in industry for the production of polyurethanes. It is made into biodegradable bags. In medicine, PCL is also used as a suture material and as a self-absorbable long-acting thermal implant (filler), which has the ability to stimulate the growth of fibrous tissue and replenish volume due to its own components. Many tablets are produced in PCL capsules, they are absorbed in the body. In addition, PCL is used in mass 3D printing as a material for prototyping. By its properties, viscous PCL is similar to a natural resin like gutta-percha.
Experiments have shown that artificial bones of this composition can be quickly printed at room temperature at a speed of up to 275 cm 3 /hour by extrusion, that is, by forcing a viscous melt of material or a thick paste through a forming hole. A special solvent is used to create a viscous mixture that is loaded into the printer.
Printing an implant with conventional extrusion at room temperature is a big advantage because other bone implants are created at high temperature using lasers, explains Ramille Shah, lead author and research team leader at Northwestern University ( USA). During the experiments, the researchers themselves used a commercially available 3D-Bioplotter System printer manufactured by EnvisionTec. This device can be purchased for between $250,000 and $300,000.
Of course, in the household, such a printer would be too expensive. But every hospital or surgical center can afford it. In principle, even private individuals can buy such printers and print new bones for themselves or pets if necessary (of course, it is advisable to turn to a professional surgeon for the operation).
EnvisionTEC 3D-Bioplotter
Artificial bones demonstrate good mechanical properties: strain to failure from 32% to 67%, elastic modulus from 4 to 11 MPa. Thus, it is an elastic and durable material.
It is also characterized by high absorbency (porosity 50%), supports the viability and spread of living cells. Tests have shown that the material does not interfere with the formation of bone marrow cells from mesenchymal stem cells.
So far, the biocompatibility of HB has only been tested in laboratory animals, but these experiments have shown great promise. Subcutaneous implants in mice did not cause rejection within 7-35 days. In rats, a bone graft was placed in the posterolateral part of the spine (posterior lateral fusion) for 8 weeks, and new bone formation was recorded. We also conducted an experiment on a primate with skull damage (4 weeks).
During all experiments, HB did not cause a negative reaction of the immune system. At the same time, normal vascularization (formation of blood vessels) was noted, the artificial bone quickly integrated into the surrounding tissues, quickly ossified and supported the growth of new bone tissue without additional intervention.
