Three-dimensional bio-printing and bone tissue engineering: technical innovations and potential applications in maxillofacial reconstructive surgery

Background Bone grafting has been considered the gold standard for hard tissue reconstructive surgery and is widely used for large mandibular defect reconstruction. However, the midface encompasses delicate structures that are surrounded by a complex bone architecture, which makes bone grafting using traditional methods very challenging. Three-dimensional (3D) bioprinting is a developing technology that is derived from the evolution of additive manufacturing. It enables precise development of a scaffold from different available biomaterials that mimic the shape, size, and dimension of a defect without relying only on the surgeon’s skills and capabilities, and subsequently, may enhance surgical outcomes and, in turn, patient satisfaction and quality of life. Review This review summarizes different biomaterial classes that can be used in 3D bioprinters as bioinks to fabricate bone scaffolds, including polymers, bioceramics, and composites. It also describes the advantages and limitations of the three currently used 3D bioprinting technologies: inkjet bioprinting, micro-extrusion, and laser-assisted bioprinting. Conclusions Although 3D bioprinting technology is still in its infancy and requires further development and optimization both in biomaterials and techniques, it offers great promise and potential for facial reconstruction with improved outcome

Architecture and microstructure of cortical bone in reconstructed canine mandibles after bone transport distraction osteogenesis

Reconstruction of the canine mandible using bone transport distraction osteogenesis has been shown to be a suitable method for correcting segmental bone defects produced by cancer, gunshots, and trauma. Although the mechanical quality of the new regenerate cortical bone seems to be related to the mineralization process, several questions regarding the microstructural patterns of the new bony tissue remain unanswered. The purpose of this study was to quantify any microstructural differences that may exist between the regenerate and control cortical bone. Five adult American foxhound dogs underwent unilateral bone transport distraction of the mandible to repair bone defects of 30-35 mm. Animals were killed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical cortical samples were extracted from the superior, medial, and inferior aspects of the lingual and buccal plates of the reconstructed aspect of the mandible, and 21 specimens were collected similarly from the contralateral aspect of the mandible. Specimens were evaluated using histomorphometric and micro-computed tomographic techniques to compare their microstructure. Except for differences in haversian canal area, histomorphometric analyses suggested no statistical differences in microstructure between regenerate and control cortical bone. Morphological evaluation suggested a consistent level of anisotropy, possibly related to the distraction vector. After 12 weeks' consolidation, bone created during bone transport distraction osteogenesis was comparable to native bone in microstructure, architecture, and mechanical properties. It is proposed that, after enough time, the properties of the regenerate bone will be identical to that of native bone. © Springer Science+Business Media, LLC 2010