Selective laser melting (SLM) is one methodology to realize additive manufacturing and is mainly used to join metal powder in a layer-by-layer manner to produce a solid three-dimensional (3D) object. For bone tissue engineering purposes, scaffolds can readily be designed as 3D data model and realized with titanium known for its excellent osseointegration behavior. The microarchitecture, that is, design with submillimeter features, of additively manufactured scaffolds is in many cases a lattice structure. This study aimed to apply SLM that allows a high degree of microarchitectural freedom to generate lattice structures and to determine the optimal distance between rods and the optimal diameter of rods for osteoconduction (bone ingrowth into scaffolds) and bone regeneration. For the biological readout, diverse SLM-fabricated titanium implants were placed in the calvarium of rabbits and new bone formation and defect bridging were determined after 4 weeks of healing. The results from the middle section of the defects show that with a lattice microarchitecture, the optimal distance between titanium rods is around 0.8 mm and the optimal rod dimension is between 0.3 and 0.4 mm to optimize defect bridging and bone regeneration.
The treatment of fractures of the proximal tibia is complex and makes great demands on the implants used. Our study aimed to identify what levels of primary stability could be achieved with various forms of osteosynthesis in the treatment of diaphyseal fractures of the proximal tibia. Pairs of human tibiae were investigated. An unstable fracture was simulated by creating a defect at the metaphyseal-diaphyseal junction. Six implants were tested in a uniaxial testing device (Instron) using the quasi-static and displacement-controlled modes and the force-displacement curve was recorded. The movements of each fragment and of the implant were recorded video-optically (MacReflex, Qualysis). Axial deviations were evaluated at 300 N. The results show that the nailing systems tolerated the highest forces. The lowest axial deviations in varus and valgus were also found for the nailing systems; the highest axial deviations were recorded for the buttress plate and the less invasive stabilising system (LISS). In terms of rotational displacement the LISS was better than the buttress plate. In summary, it was found that higher loads were better tolerated by centrally placed load carriers than by eccentrically placed ones. In the case of the latter, it appears advantageous to use additive procedures for medial buttressing in the early phase.
Additive manufacturing of bone tissue engineering scaffolds will become a key element for personalized bone tissue engineering in the near future. Several additive manufacturing processes are based on extrusion where the deposition of the filament will result in a three-dimensional lattice structure. Recently, we studied diverse lattice structures for bone tissue engineering realized by laser sintering of titanium. In this work, we used lithography-based ceramic manufacturing of lattice structures to produce scaffolds from tricalcium phosphates (TCP) and compared them in vivo to congruent titanium scaffolds manufactured with the identical computer-aided design data to look for material-based differences in bony healing. The results show that, during a 4-week period in a noncritical-size defect in a rabbit calvarium, both scaffolds with the identical microarchitecture performed equally well in terms of bony regeneration and bony bridging of the defect. A significant increase in both parameters could only be achieved when the TCP-based scaffolds were doped with bone morphogenetic protein-2. In a critical-size defect in the calvarial bone of rabbits, however, the titanium scaffold performed significantly better than the TCP-based scaffold, most likely due to its higher mechanical stability. We conclude that titanium and TCP-based scaffolds of the same microarchitecture perform equally well in terms of bone regeneration, provided the microarchitecture meets the mechanical demand at the site of implantation.
Selective laser melting (SLM) was used to manufacture smart programmed structures with customized properties made of biocompatible NiTi shape-memory alloy. A series of helixes was produced with systematically varied SLM process parameters Laser Exposure Time and Laser Power in order to specifically change the thermo-mechanical material properties of the 3D-structures. This innovation opens up the possibility to adjust the NiTi phase transformation temperature during the manufacturing process. This controllable property determines which of the two crystallographic phases martensite or austenite is present at a certain operating temperature and allows the mechanical properties to be adjusted: martensitic devices are soft and pseudo-plastic due to the shape-memory effect, whereas austenitic structures are pseudo-elastic. In a further step, the SLM process parameters were locally varied within 4Dprinted twin-helixes. As a result, the phases, respectively the mechanical properties of a single component were adjusted at different locations. The ratio of elastic to plastic deformation and the spring constant of the helix can be locally controlled. This allows, for example, the spatio-temporal programming of 3D-printed surgical instruments or implants that are stimuliresponsive.
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