Three-dimensional (3D) printing is a promising technology that can use a patient's image data to create complex and personalized constructs precisely. It has made great progress over the past few decades and has been widely used in medicine including medical modeling, surgical planning, medical education and training, prosthesis and implants. Three-dimensional (3D) bioprinting is a powerful tool that has the potential to fabricate bioengineered constructs of the desired shape layer-by-layer using computer-aided deposition of living cells and biomaterials. Advances in 3D printed implants and future tissue-engineered constructs will bring great progress to the field of otolaryngology. By integrating 3D printing into tissue engineering and materials, it may be possible for otolaryngologists to implant 3D printed functional grafts into patients for reconstruction of a variety of tissue defects in the foreseeable future. In this review, we will introduce the current state of 3D printing technology and highlight the applications of 3D printed prosthesis and implants, 3D printing technology combined with tissue engineering and future directions of bioprinting in the field of otolaryngology.
The regenerated silk fibroin microhydrogel with thixotropic property could be bioprinted and then ripened to a tough hydrogel because of the change in “the second network” of the microhydrogel.
The
regeneration of functional epithelial lining is critical for artificial
grafts to repair tracheal defects. Although silk fibroin (SF) scaffolds
have been widely studied for biomedical application (e.g., artificial
skin), its potential for tracheal substitute and epithelial regeneration
is still unknown. In this study, we fabricated porous three-dimensional
(3D) silk fibroin scaffolds and cocultured them with primary human
tracheobronchial epithelial cells (HBECs) for 21 days in vitro. Examined by scanning electronic microscopy (SEM) and calcein-AM
staining with inverted phase contrast microscopy, the SF scaffolds
showed excellent properties of promoting cell growth and proliferation
for at least 21 days with good viability. In vivo, the porous 3D SF scaffolds (n = 18) were applied
to repair a rabbit anterior tracheal defect. In the control group
(n = 18), rabbit autologous pedicled trachea wall
without epithelium, an ideal tracheal substitute, was implanted in situ. Observing by endoscopy and computed tomography
(CT) scan, the repaired airway segment showed no wall collapse, granuloma
formation, or stenosis during an 8-week interval in both groups. SEM
and histological examination confirmed the airway epithelial growth
on the surface of porous SF scaffolds. Both the epithelium repair
speed and the epithelial cell differentiation degree in the SF scaffold
group were comparable to those in the control group. Neither severe
inflammation nor excessive fibrosis occurred in both groups. In summary,
the porous 3D SF scaffold is a promising biomaterial for tracheal
repair by successfully supporting tracheal wall contour and promoting
tracheal epithelial regeneration.
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