3D‑printed Ti6Al4V scaffolds combined with pulse electromagnetic fields enhance osseointegration in osteoporosis

Abstract

The loosening and displacement of prostheses after dental implantation and arthroplasty is a substantial medical burden due to the complex correction surgery. Three-dimensional (3D)-printed porous titanium (pTi) alloy scaffolds are characterized by low stiffness, are beneficial to bone ingrowth, and may be used in orthopedic applications. However, for the bio-inert nature between host bone and implants, titanium alloy remains poorly compatible with osseointegration, especially in disease conditions, such as osteoporosis. In the present study, 3D-printed pTi scaffolds with ideal pore size and porosity matching the bone tissue, were combined with pulse electromagnetic fields (PEMF), an exogenous osteogenic induction stimulation, to evaluate osseointegration in osteoporosis. In vitro, external PEMF significantly improved osteoporosis-derived bone marrow mesenchymal stem cell proliferation and osteogenic differentiation on the surface of pTi scaffolds by enhancing the expression of alkaline phosphatase, runt-related transcription factor-2, osteocalcin, and bone morphogenetic protein-2. In vivo, Microcomputed tomography analysis and histological evaluation indicated the external PEMF markedly enhanced bone regeneration and osseointegration. This novel therapeutic strategy has potential to promote osseointegration of dental implants or artificial prostheses for patients with osteoporosis.

Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review

“…Finally, both PEMF and SFM appear to increase the osteoblast function in terms of upregulation of genes related to osteogenic differentiation, with a concomitant deposition of mineralized ECM [34,35,37,[40][41][42]49].…”

“…Finally, two publications, analyzing PEMF effects both in vivo and in vitro, can be described partially in this section for their in vitro results [34,36]. Two different research groups corroborated the positive effect of pulsed stimulation on cell growth independently on the used models (BM-MSC from osteoporotic rabbits [34] and osteoblast-like MC3T3-E1 cells [36]) and at very different exposure times and peak intensities of PEMF (4-7 days/1 mT and 6-12 weeks/2 mT, respectively).…”

“…The authors also evaluated the effects of PEMF on osteoblast and osteocyte functionality by assessing circulating levels of osteoblast-related factors such as osterix (OSX), OCN, RUNX-2 and bone-resorbing cytokines (i.e., serum TRAcP5b and CTX-1) showing a PEMF-dependent increase in their level [49]. In addition, Ye et al [34] found that PEMF stimulation (1 mT 2 h/day) led to increased bone formation, measured by microcomputed tomography and histomorphometry, on the porous surface of Ti implants placed in the femurs of osteoporotic rabbits after 6 and 12 weeks. Conversely, Akca et al [52] found that peri-implant bone volume of osteoporotic rabbits receiving PEMF stimulation 4 h/day was not improved by the treatment and was similar to the peri-implant bone of osteoporotic animals not receiving stimulation.…”

Applicative Assessment of a Selective Laser Melting 3D-Printed Ti–6Al–4 V Plate with a Honeycomb Structure in the Reconstruction of a Mandibular Defect of a Beagle Dog

“…Therefore, three-dimensional (3D) printing technology may help to solve many bone defect repair problems. 5,7,8 In addition, a curtain frame, such as the 3D honeycomb structure, maintains the porosity and the continuity of pores, which allows cell migration and promotes new bone formation. 9 Currently, 3D-printed surgical plates have been widely used to restore the mandible defect and exhibit better mechanical properties than the conventional reconstruction plate.…”

“…Three-dimensional (3D) printing technology has the advantages of high precision, fast construction speed, and individualized repair of defects, which also can combine with the osteoconductive modification technology of the material surface. Therefore, three-dimensional (3D) printing technology may help to solve many bone defect repair problems. ,, In addition, a curtain frame, such as the 3D honeycomb structure, maintains the porosity and the continuity of pores, which allows cell migration and promotes new bone formation …”