Regeneration of Critical‐Sized Mandibular Defects Using 3D‐Printed Composite Scaffolds: A Quantitative Evaluation of New Bone Formation in In Vivo Studies

• Published in: Advanced healthcare materials Vol. 12; no. 21; pp. e2300128 - n/a
• Main Authors: Dalfino, Sophia, Savadori, Paolo, Piazzoni, Marco, Connelly, Stephen Thaddeus, Giannì, Aldo Bruno, Del Fabbro, Massimo, Tartaglia, Gianluca Martino, Moroni, Lorenzo
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01-08-2023; John Wiley and Sons Inc
• Subjects: 3D printing; Angiogenesis; Animal models; Animals; Biocompatible Materials - chemistry; Biological activity; Biomaterials; Biomedical materials; Biomolecules; Bone growth; Bone Regeneration; bone tissue engineering; Chemical composition; composites; Defects; In vivo methods and tests; Mandible; Mandible - surgery; mandibles; maxillofacial defects; Mechanical properties; Metastases; Osteogenesis; polymers; Printing, Three-Dimensional; Regeneration; Review; Reviews; Scaffolds; Stem cells; Surgical implants; Three dimensional composites; Three dimensional printing; Tissue Engineering; Tissue Scaffolds - chemistry; Vascularization; composites; mandibles; polymers; bone tissue engineering; maxillofacial defects; 3D printing
• ISSN: 2192-2640; 2192-2659; 2192-2659
• DOI: 10.1002/adhm.202300128

Mandibular tissue engineering aims to develop synthetic substitutes for the regeneration of critical size defects (CSD) caused by a variety of events, including tumor surgery and post‐traumatic resections. Currently, the gold standard clinical treatment of mandibular resections (i.e., autologous fibular flap) has many drawbacks, driving research efforts toward scaffold design and fabrication by additive manufacturing (AM) techniques. Once implanted, the scaffold acts as a support for native tissue and facilitates processes that contribute to its regeneration, such as cells infiltration, matrix deposition and angiogenesis. However, to fulfil these functions, scaffolds must provide bioactivity by mimicking natural properties of the mandible in terms of structure, composition and mechanical behavior. This review aims to present the state of the art of scaffolds made with AM techniques that are specifically employed in mandibular tissue engineering applications. Biomaterials chemical composition and scaffold structural properties are deeply discussed, along with strategies to promote osteogenesis (i.e., delivery of biomolecules, incorporation of stem cells, and approaches to induce vascularization in the constructs). Finally, a comparison of in vivo studies is made by taking into consideration the amount of new bone formation (NB), the CSD dimensions, and the animal model.
This review depicts the state of the art, in the last decade, on the regeneration of critical‐sized mandibular defects through composite or polymeric AM scaffolds. In particular, biomaterials, scaffolds structural properties, biomolecules and cellular components, along with vascularization strategies are correlated to NB data obtained from in vivo studies on small and large size animal models.