Abstract

One of the most common hereditary craniofacial anomalies in humans are cleft lip and cleft alveolar bone with or without cleft palate. Current clinical practice, the augmentation of the persisting alveolar bone defect by using autologous bone grafts, has considerable disadvantages motivating to an intensive search for alternatives. We developed a novel therapy concept based on 3D printing of biodegradable calcium phosphate-based materials and integration of osteogenic cells allowing fabrication of patient-specific, tissue-engineered bone grafts. Objective of the present study was the in vivo evaluation of implants in a rat alveolar cleft model. Scaffolds were designed according to the defect’s geometry with two different pore designs (60° and 30° rotated layer orientation) and produced by extrusion-based 3D plotting of a pasty calcium phosphate cement. The scaffolds filled into the artificial bone defect in the palate of adult Lewis rats, showing a good support. Half of the scaffolds were colonized with rat mesenchymal stromal cells (rMSC) prior to implantation. After 6 and 12 weeks, remaining defect width and bone formation were quantified histologically and by microCT. The results revealed excellent osteoconductive properties of the scaffolds, a significant influence of the pore geometry (60° > 30°), but no enhanced defect healing by pre-colonization with rMSC.

Highlights

  • During embryologic development of the craniomaxillofacial anatomy, tissue fusion is essential

  • 3D Printing of Bone Grafts study was “The application of a 3D plotted bone graft into an artificial maxillary bone defect leads to a significant reduction of the defect width after 12 weeks.”

  • The study hypothesis was, that “The application of a 3D plotted bone graft into an artificial maxillary bone defect leads to a significant reduction of the defect width after 12 weeks.”

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Summary

Introduction

During embryologic development of the craniomaxillofacial anatomy, tissue fusion is essential. In cases of maxillofacial and cleft reconstructions, the following rates of complications in the donor site region are summarized by a review of Boehm et al (2018): acute (45.7%) and chronic (1.5%) gait disturbance, acute (17.8%) and chronic nerve changes (1.4%), hypertrophic/painful scar (9.1%), chronic pain (3.1%), hematoma (2.2%), seroma (2.0%), infection (1.0%) and iliac crest fracture (1.2%). Against this background, it is of great clinical interest to evaluate biomaterials regarding their potential to be an alternative for the autologous bone grafts. The bone grafts should have the following characteristics: osteoconductivity, mechanical stability, promotion of vascular ingrowth and stem cell recruitment, and progressive resorption during the replacement by native tissue (Hutmacher et al, 2007; Kim et al, 2017)

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