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We elucidate here process-structure-property relationships in implantable biomaterials processed by rapid prototyping approaches that are based on the principle of additive manufacturing. The conventional methods of fabrication of biomedical devices including freeze casting and sintering are limited because of difficulties in adaptation at the host site and mismatch in micro/ macrostructure, mechanical and physical properties with the host tissue. Moreover, additive manufacturing has the advantage of fabricating patient-specific designs, which can be obtained from the computed tomography scan of the defect site. The discussion here comprises two partsthe first part briefly describes the evolution and underlying reasons that have led to 3D printing of scaffolds for tissue regeneration. The second part focuses on biocompatibility and mechanical properties of 3D scaffolds, fabricated by different approaches. The article concludes with a discussion on functionally graded scaffolds and vascularisation of 3D porous scaffolds that are envisaged to meet the requirements of the biomedical industry. In general, the mechanical properties of 3D printed scaffolds are governed by pore architecture, pore volume and percentage porosity. To ensure long-term endurance and the ability to withstand abrupt impact, it is important that the fabricated materials have a good combination of strength and energy absorption capability. While scaffolds with high interconnected porosity are preferred for tissue regeneration, such structures lack adequate mechanical strength and energy absorption capability. These mutually opposing requirements of high porosity and mechanical strength in conjunction with high energy absorption have hindered the application of 3D scaffolds as biomedical devices. In this regard, functionally graded 3D structures with high strength and energy absorption are potentially attractive for biomedical devices.

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Three-dimensional (3D) printing is considered an ideally suitable method to fabricate patient specific implantable devices. The approach enabled to produce a porous scaffold with tailored physical, mechanical, and biological properties because of the flexibility to tune the scaffold architecture. The objective of the study described was to elucidate the determining role of cell-laid extracellular matrix (ECM) in impacting biological response. In this regard, to mimic the natural ECM environment or the attributes of the native tissue, a natural ECM analogue surface was produced on the 3D printed and sintered hydroxyapatite (HA) scaffold surface by the mineralized ECM of the osteoblast. This involved the growth of osteoblast on 3D printed scaffolds, followed by differentiation to deposit the mineralized ECM on the biomaterial surface. The cells were removed from the mineralized matrix using freeze-thaw cycles to obtain a decellularized extracellular matrix (dECM) on the biomaterial surface. Subsequently, seeding of osteoblast on dECM-ornamented HA scaffolds led to 3D growth with enhanced expression of prominent proteins, actin and vinculin. Based on preliminary observations of present study, it was underscored that HA scaffolds-ornamented with dECM provided an optimized microenvironment conducive to the growth of 3D structural tissue and favorably promoted biological functionality because of the availability of an environment that promoted cell-cell and cell-scaffold interaction. The primary advantage of dECM is that it enabled constructive remodeling and promoted the formation of tissue in lieu of less functional tissue. The study opens-up a new path for printing of 3D structures suitable to treat segmental bone defects. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1343-1351, 2016.