Three dimensionally printed bioactive ceramic scaffold osseoconduction across critical-sized mandibular defects

Christopher D. Lopez, J. Rodrigo Diaz-Siso, Lukasz Witek, Jonathan M. Bekisz, Bruce N. Cronstein, Andrea Torroni, Roberto L. Flores, Eduardo D. Rodriguez, Paulo Coelho

Research output: Contribution to journalArticle

Abstract

Background Vascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model. Methods Full-thickness mandibulectomy defects (12 mm) were created at the mandibular body of eight adult rabbits and replaced by 3D-printed ceramic scaffold made of 100% β-tricalcium phosphate, fit to defect based on computed tomography imaging. After 8 weeks, animals were euthanized, the mandibles were retrieved, and bone regeneration was assessed. Bone growth was qualitatively assessed with histology and backscatter scanning electron microscopy, quantified both histologically and with micro computed tomography and advanced 3D image reconstruction software, and compared to unoperated mandible sections (UMSs). Results Histology quantified scaffold with newly formed bone area occupancy at 54.3 ± 11.7%, compared to UMS baseline bone area occupancy at 55.8 ± 4.4%, and bone area occupancy as a function of scaffold free space at 52.8 ± 13.9%. 3D volume occupancy quantified newly formed bone volume occupancy was 36.3 ± 5.9%, compared to UMS baseline bone volume occupancy at 33.4 ± 3.8%, and bone volume occupancy as a function of scaffold free space at 38.0 ± 15.4%. Conclusions 3D-printed bioactive ceramic scaffolds can restore critical mandibular segmental defects to levels similar to native bone after 8 weeks in an adult rabbit, critical sized, mandibular defect model.

Original languageEnglish (US)
Pages (from-to)115-122
Number of pages8
JournalJournal of Surgical Research
Volume223
DOIs
StatePublished - Mar 1 2018

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Ceramics
Bone and Bones
Mandible
Rabbits
Histology
Tomography
Mandibular Reconstruction
Tissue Scaffolds
Bone Regeneration
Computer-Assisted Image Processing
Bone Development
Operative Time
Electron Scanning Microscopy
Length of Stay
Software
Morbidity
Delivery of Health Care

Keywords

  • 3D printing
  • Bone regeneration
  • Craniomaxillofacial
  • Osseoconduction
  • Reconstruction
  • Tissue engineering

ASJC Scopus subject areas

  • Surgery

Cite this

Three dimensionally printed bioactive ceramic scaffold osseoconduction across critical-sized mandibular defects. / Lopez, Christopher D.; Diaz-Siso, J. Rodrigo; Witek, Lukasz; Bekisz, Jonathan M.; Cronstein, Bruce N.; Torroni, Andrea; Flores, Roberto L.; Rodriguez, Eduardo D.; Coelho, Paulo.

In: Journal of Surgical Research, Vol. 223, 01.03.2018, p. 115-122.

Research output: Contribution to journalArticle

Lopez, Christopher D. ; Diaz-Siso, J. Rodrigo ; Witek, Lukasz ; Bekisz, Jonathan M. ; Cronstein, Bruce N. ; Torroni, Andrea ; Flores, Roberto L. ; Rodriguez, Eduardo D. ; Coelho, Paulo. / Three dimensionally printed bioactive ceramic scaffold osseoconduction across critical-sized mandibular defects. In: Journal of Surgical Research. 2018 ; Vol. 223. pp. 115-122.
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abstract = "Background Vascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model. Methods Full-thickness mandibulectomy defects (12 mm) were created at the mandibular body of eight adult rabbits and replaced by 3D-printed ceramic scaffold made of 100{\%} β-tricalcium phosphate, fit to defect based on computed tomography imaging. After 8 weeks, animals were euthanized, the mandibles were retrieved, and bone regeneration was assessed. Bone growth was qualitatively assessed with histology and backscatter scanning electron microscopy, quantified both histologically and with micro computed tomography and advanced 3D image reconstruction software, and compared to unoperated mandible sections (UMSs). Results Histology quantified scaffold with newly formed bone area occupancy at 54.3 ± 11.7{\%}, compared to UMS baseline bone area occupancy at 55.8 ± 4.4{\%}, and bone area occupancy as a function of scaffold free space at 52.8 ± 13.9{\%}. 3D volume occupancy quantified newly formed bone volume occupancy was 36.3 ± 5.9{\%}, compared to UMS baseline bone volume occupancy at 33.4 ± 3.8{\%}, and bone volume occupancy as a function of scaffold free space at 38.0 ± 15.4{\%}. Conclusions 3D-printed bioactive ceramic scaffolds can restore critical mandibular segmental defects to levels similar to native bone after 8 weeks in an adult rabbit, critical sized, mandibular defect model.",
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AU - Diaz-Siso, J. Rodrigo

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AU - Cronstein, Bruce N.

AU - Torroni, Andrea

AU - Flores, Roberto L.

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AU - Coelho, Paulo

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N2 - Background Vascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model. Methods Full-thickness mandibulectomy defects (12 mm) were created at the mandibular body of eight adult rabbits and replaced by 3D-printed ceramic scaffold made of 100% β-tricalcium phosphate, fit to defect based on computed tomography imaging. After 8 weeks, animals were euthanized, the mandibles were retrieved, and bone regeneration was assessed. Bone growth was qualitatively assessed with histology and backscatter scanning electron microscopy, quantified both histologically and with micro computed tomography and advanced 3D image reconstruction software, and compared to unoperated mandible sections (UMSs). Results Histology quantified scaffold with newly formed bone area occupancy at 54.3 ± 11.7%, compared to UMS baseline bone area occupancy at 55.8 ± 4.4%, and bone area occupancy as a function of scaffold free space at 52.8 ± 13.9%. 3D volume occupancy quantified newly formed bone volume occupancy was 36.3 ± 5.9%, compared to UMS baseline bone volume occupancy at 33.4 ± 3.8%, and bone volume occupancy as a function of scaffold free space at 38.0 ± 15.4%. Conclusions 3D-printed bioactive ceramic scaffolds can restore critical mandibular segmental defects to levels similar to native bone after 8 weeks in an adult rabbit, critical sized, mandibular defect model.

AB - Background Vascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model. Methods Full-thickness mandibulectomy defects (12 mm) were created at the mandibular body of eight adult rabbits and replaced by 3D-printed ceramic scaffold made of 100% β-tricalcium phosphate, fit to defect based on computed tomography imaging. After 8 weeks, animals were euthanized, the mandibles were retrieved, and bone regeneration was assessed. Bone growth was qualitatively assessed with histology and backscatter scanning electron microscopy, quantified both histologically and with micro computed tomography and advanced 3D image reconstruction software, and compared to unoperated mandible sections (UMSs). Results Histology quantified scaffold with newly formed bone area occupancy at 54.3 ± 11.7%, compared to UMS baseline bone area occupancy at 55.8 ± 4.4%, and bone area occupancy as a function of scaffold free space at 52.8 ± 13.9%. 3D volume occupancy quantified newly formed bone volume occupancy was 36.3 ± 5.9%, compared to UMS baseline bone volume occupancy at 33.4 ± 3.8%, and bone volume occupancy as a function of scaffold free space at 38.0 ± 15.4%. Conclusions 3D-printed bioactive ceramic scaffolds can restore critical mandibular segmental defects to levels similar to native bone after 8 weeks in an adult rabbit, critical sized, mandibular defect model.

KW - 3D printing

KW - Bone regeneration

KW - Craniomaxillofacial

KW - Osseoconduction

KW - Reconstruction

KW - Tissue engineering

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