Alveolar bone reconstruction using a 3D bioprinting PCL beta‐TCP scaffold with rhBMP‐2

Abstract

Background: Insufficient bone volume is one of the major challenges encountered by dentists after dental implant placement. Recently, there are many studies on going about three‐dimensional bone grafts materials. Three‐dimensional bone graft material can overcome the weakness of conventional particulate bone grafting materials. Customized three‐dimensional polycaprolactone (3D PCL) scaffold implant fabricated with a 3D bio‐printing system to facilitate rapid alveolar bone regeneration. Aim/Hypothesis: This study aimed to evaluate a customized polycaprolactone (PCL) scaffold and PCL β‐tricalcium phosphate (β‐TCP) scaffold with human bone morphogenetic protein‐2 (rhBMP‐2) fabricated using a three‐dimensional (3D) bioprinting system for alveolar bone reconstruction in large animal model. Material and Methods: Scaffold characteristics – The PCL scaffolds were designed by CAD CAM and manufactured using a 3D bioprinting system. Four types of scaffolds were produced + PCL alone (PCL), PCL and β‐TCP blend (PCL TCP), PCL with rhBMP‐2 (PCL BMP), and PCL and β‐TCP blend with rhBMP‐2 (PCL TCP BMP). Animal experiments – Four adult, male beagle dogs were used. Both the mandibular second and third premolars were extracted and a three month healing period was allowed. A standardized rectangular bone defect, 10.0 × 5.0 × 5.0 mm size was created on the alveolar ridge using a surgical bur. After surgery, the animals were examined by computed tomography (CT) under general anesthesia. After 2 weeks, surgical re‐entry was performed to implant the 3D fabricated scaffolds. The 3D scaffolds were fixed with a fixation screw and all defect sites were covered with a resorbable membrane. 12 weeks later, beagles were sacrificed and micro CT examination and Histology & histomorphometric analysis were performed. Results: Histologically, There was no noticeable new bone formation inside of scaffold. Instead little new bone formation was observed in the space between the scaffold and alveolar bone. Histomorphometrically, the new bone area of PCL BMP TCP group was significantly higher than that of PCL BMP group (_I_P_i_ < 0.05). And BMP groups were higher than non‐BMP groups in new bone ratio and bone volume, but there was no significant difference. Interestingly, Micro‐CT analysis revealed that remained scaffold ratio of TCP groups were lower than non‐TCP groups. It showed TCP groups have higher absorptive tendency than non – TCP groups although there was no significant difference. Conclusions and Clinical Implications: PCL is easy to manipulate for fabrication of customized scaffolds and it also has excellent mechanical strength. The PCL TCP composite scaffolds combined with rhBMP‐2 were suitable to allow new bone formation. It can be concluded that TCP has ability to continually release rhBMP‐2 as a reservoir. And rhBMP‐2 can accelerate and promote new bone formation. For general use of PCL scaffold as bone graft materials, strategies for the direct bone contact to PCL is needed in further study. [ABSTRACT FROM AUTHOR] Copyright of Clinical Oral Implants Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)