Maxillofacial bone defects caused by congenital malformations, trauma, tumors, and inflammation can severely affect functions and aesthetics of maxillofacial region. Despite certain successful clinical applications of biomaterial scaffolds, ideal bone regeneration remains a challenge in maxillofacial region due to its irregular shape, complex structure, and unique biological functions. Scaffolds that address multiple needs of maxillofacial bone regeneration are under development to optimize bone regeneration capacity, costs, operational convenience. etc. In this review, we first highlight the special considerations of bone regeneration in maxillofacial region and provide an overview of the biomaterial scaffolds for maxillofacial bone regeneration under clinical examination and their efficacy, which provide basis and directions for future scaffold design. Latest advances of these scaffolds are then discussed, as well as future perspectives and challenges. Deepening our understanding of these scaffolds will help foster better innovations to improve the outcome of maxillofacial bone tissue engineering. 

Biomaterial scaffolds in maxillofacial bone tissue engineering: A review of recent advances

A Collagen(Col)/nano-hydroxyapatite (nHA) biological composite bone scaffold with double multi-level interface reinforcement

Numerous developments in additive manufacturing have endowed triply periodic minimal surface (TPMS) structures with excellent mechanical properties, providing possibilities for the wide application prospects of such scaffolds in repairing bone defects. However, current studies mainly focus on the basic mechanical and biomedical properties of TMPS with relatively large scale and low precision made from conventional materials such as stainless powder. Therefore, challenges exist in manufacturing ceramic-based TPMS bone scaffolds that stratify the precision requirements for human bones at the micron scale and further investigating their dynamic mechanical properties. Herein, we successfully design and fabricate two TPMS scaffolds named TPMS-B and TPMS-C with microstructures similar to that of human bone utilizing advanced 3D-printing technology. The experiments reveal that TPMS-C outperforms conventional porous scaffold (Normal-A) and TPMS-B for certain parameters such as specific strength and specific energy absorption. Moreover, the numerical simulation analysis illustrates that structural asymmetry and discontinuous boundaries are the main causes of completely destructive disparities in TPMS-C when exposed to given loads. Meanwhile, the cytocompatibility and osteogenic differentiation of the three scaffolds are verified. The objective of this work is to reveal the mechanical properties and failure analysis of novel 3D-printing materials that can be used to fabricate advanced TPMS bone scaffolds for bone defects treatment. 

Mechanical properties and failure analysis of 3D-printing micron-scale ceramic-based triply periodic minimal surface scaffolds under quasi-static-compression and low-speed impact loads

To investigate the feasibility of the 3D printed scaffold for periapical bone defects.In this study, antimicrobial peptide KSL-W-loaded PLGA sustainable-release microspheres (KSL-W@PLGA) were firstly prepared followed by assessing the drug release behavior and bacteriostatic ability against Enterococcus faecalis and Porphyromonas gingivalis. After that, we demonstrated that KSL-W@PLGA/collagen (COL)/silk fibroin (SF)/nano-hydroxyapatite (nHA) (COL/SF/nHA) scaffold via 3D-printing technique exhibited significantly good biocompatibility and osteoconductive property. The scaffold was characterized as to pore size, porosity, water absorption expansion rate and mechanical properties. Moreover, MC3T3-E1 cells were seeded into sterile scaffold materials and investigated by CCK-8, SEM and HE staining. In the animal experiment section, we constructed bone defect models of the mandible and evaluated its effect on bone formation. The Japanese white rabbits were killed at 1 and 2 months after surgery, the cone beam computerized tomography (CBCT) and micro-CT scanning, as well as HE and Masson staining analysis were performed on the samples of the operation area, respectively. Data analysis was done using ANOVA and LSD tests. (α = 0.05).We observed that the KSL-W@PLGA sustainable-release microspheres prepared in the experiment were uniform in morphology and could gradually release the antimicrobial peptide (KSL-W), which had a long-term antibacterial effect for at least up to 10 days. HE staining and SEM showed that the scaffold had good biocompatibility, which was conducive to the adhesion and proliferation of MC3T3-E1 cells. The porosity and water absorption of the scaffold were (81.96 ± 1.83)% and (458.29 ± 29.79)%, respectively. Histological and radiographic studies showed that the bone healing efficacy of the scaffold was satisfactory.The KSL-W@PLGA/COL/SF/nHA scaffold possessed good biocompatibility and bone repairing ability, and had potential applications in repairing infected bone defects. Clinical significance The 3D printed scaffold not only has an antibacterial effect, but can also promote bone tissue formation, which provides an alternative therapy option in apical periodontitis. 

https://bmcoralhealth.biomedcentral.com/counter/pdf/10.1186/s12903-022-02362-4

3D printed scaffold for repairing bone defects in apical periodontitis

The application of three-dimensional printing technology in the medical field has great potential for bone defect repair, especially personalized and biological repair. As a green manufacturing process that does not involve liquefication through heating, low-temperature deposition manufacturing (LDM) is a promising type of rapid prototyping manufacturing and has been widely used to fabricate scaffolds in bone tissue engineering. The scaffolds fabricated by LDM have a multi-scale controllable pore structure and interconnected micropores, which are beneficial for the repair of bone defects. At the same time, different types of cells or bioactive factor can be integrated into three-dimensional structural scaffolds through LDM. Herein, we introduced LDM technology and summarize its applications in bone tissue engineering. We divide the scaffolds into four categories according to the skeleton materials and discuss the performance and limitations of the scaffolds. The ideas presented in this review have prospects in the development and application of LDM scaffolds.

Low-temperature deposition manufacturing technology: a novel 3D printing method for bone scaffolds

The three-dimensional (3D) printing technology combined with bone tissue engineering has become one of the major methods for mandibular reconstruction. However, the key factor retarding mandible re...

Effects of Fiber Cross-Angle Structures on the Mechanical Property of 3D Printed Scaffolds and Performance of Seeded MC3T3-E1 Cells

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Effects of Fiber Cross-Angle Structures on the Mechanical Property of 3D Printed Scaffolds and Performance of Seeded MC3T3-E1 Cells