Abstract
Objective This study sought to compare the biocompatibility of a three-dimensional (3D)-printed titanium implant with a conventional machined titanium product, as well as the effect of such implant applied with recombinant human Bone Morphogenetic Protein Type 2 (rhBMP-2) for guided bone regeneration.Methodology Disk-shaped titanium specimens fabricated either by the conventional machining technique or by the 3D-printing technique were compared by MC3T3-E1 cells cytotoxicity assay. New bone formation was evaluated using a rapid prototype titanium cap applied to the calvaria of 10 rabbits, which were divided into two groups: one including an atelopeptide collagen plug on one side of the cap (group I) and the other including a plug with rhBMP-2 on the other side (group II). At six and 12 weeks after euthanasia, rabbits calvaria underwent morphometric analysis through radiological and histological examination.Results Through the cytotoxicity assay, we identified a significantly higher number of MC3T3-E1 cells in the 3D-printed specimen when compared to the machined specimen after 48 hours of culture. Moreover, morphometric analysis indicated significantly greater bone formation at week 12 on the side where rhBMP-2 was applied when evaluating the upper portion immediately below the cap.Conclusion The results suggest that 3D-printed titanium implant applied with rhBMP-2 enables new bone formation.
Highlights
Maxillofacial bone defects may account for several reasons, including trauma, malformation, tumors, or infectious diseases
The disks and caps used in the animal experiment were designed with the Autodesk Meshmixer software (San Rafael, CA, USA): the 3D-printed titanium implant in a 2-mm thick disk shape of 5mm diameter and the cap-shaped rapid prototype (RP) in a hemispherical shape according to the size of the trephine bur, with 9mm of diameter, 4.5mm of height, and 0.8mm of thickness (Figure 1)
MC3T3-E1 cell counts between the titanium plate and the RP titanium disk (3D print) specimen were significantly different after 48 hours (p< 0.05)
Summary
Maxillofacial bone defects may account for several reasons, including trauma, malformation, tumors, or infectious diseases. Considering the aforementioned titanium materials, the most widely known method for 3D printing is the powder bed fusion (PBF), such as selective laser sintering (SLS), direct metal laser sintering (DMLS), selective laser melting (SLM), and electron beam melting (EBM) – among which the DMLS method with titanium and titanium alloy has been a useful manufacturing technique.. Considering the aforementioned titanium materials, the most widely known method for 3D printing is the powder bed fusion (PBF), such as selective laser sintering (SLS), direct metal laser sintering (DMLS), selective laser melting (SLM), and electron beam melting (EBM) – among which the DMLS method with titanium and titanium alloy has been a useful manufacturing technique.8 This is due to its reproducibility, customization, controllable surface geometry, cost-effectiveness, and relatively good resolution (~20mm), sparing interest on its application to implantable and prosthetic devices. Being the representative technology of the fourth industrial revolution, three-dimensional (3D) printing is characterized by its custom design output. Printouts can be obtained through various materials and different types of printing – such as bioprinting, which combines 3D biomaterial scaffolds, cells, and signaling molecules to regenerate tissue. Bone-regeneration scaffold requires biocompatibility, mechanical properties, and structure for cell survivability. and the most common titanium materials in recent years are Titanium alloy Ti6Al4V (Ti-64) and commercially pure titanium (CP–Ti) are the most common titanium materials used in guided bone regeneration in recent years. Depending on the laser power or layer thickness, each 3D printing method has different properties. Considering the aforementioned titanium materials, the most widely known method for 3D printing is the powder bed fusion (PBF), such as selective laser sintering (SLS), direct metal laser sintering (DMLS), selective laser melting (SLM), and electron beam melting (EBM) – among which the DMLS method with titanium and titanium alloy has been a useful manufacturing technique. This is due to its reproducibility, customization, controllable surface geometry, cost-effectiveness, and relatively good resolution (~20mm), sparing interest on its application to implantable and prosthetic devices.
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