Additive Manufacturing for Guided Bone Regeneration: A Perspective for Alveolar Ridge Augmentation

Abstract

Three-dimensional (3D) printing has become an important tool in the field of tissue engineering and its further development will lead to completely new clinical possibilities. The ability to create tissue scaffolds with controllable characteristics, such as internal architecture, porosity, and interconnectivity make it highly desirable in comparison to conventional techniques, which lack a defined structure and repeatability between scaffolds. Furthermore, 3D printing allows for the production of scaffolds with patient-specific dimensions using computer-aided design. The availability of commercially available 3D printed permanent implants is on the rise; however, there are yet to be any commercially available biodegradable/bioresorbable devices. This review will compare the main 3D printing techniques of: stereolithography; selective laser sintering; powder bed inkjet printing and extrusion printing; for the fabrication of biodegradable/bioresorbable bone tissue scaffolds; and, discuss their potential for dental applications, specifically augmentation of the alveolar ridge.

Hyaluronic Acid/Bone Substitute Complex Implanted on Chick Embryo Chorioallantoic Membrane Induces Osteoblastic Differentiation and Angiogenesis, but not Inflammation

“…Some augmentation techniques are complex and involve invasive procedures not well tolerated by patients [4,5]. As a perspective for alveolar ridge augmentation, 3D printing allows for the production of biodegradable and bioresorbable bone scaffolds with patient-specific dimensions using computer-aided design [6,7].…”

In vitro and in vivo biocompatibility of calcium‐phosphate scaffolds three‐dimensional printed by stereolithography for bone regeneration

“…Employing a slurry system (Li, De Wijn, Layrolle, & de Groot, 2002), Wilson et al demonstrated ectopic bone formation and bone buds associated to materials harboring increased surface area implanted in nude mice (Wilson, de, van, Verbout, & Dhert, 2004). Thus, our results emphasized the emergent role of SLA-3D printing in challenging clinical applications such as large alveolar bone defects (Rider et al, 2018). Later, a simpler SLA 3D-printing manufacturing method was developed using and indirect SLA technique but this was not investigated in vivo (Li, Li, Lu, Wang, & Wang, 2007).…”

“…However, since this technique is based on subtractive manufacturing methods, these clinical reports highlight inherent limitations, such as delayed vascular penetration, slow bone formation, higher rates of bone resorption, possible immunogenicity and disease transmission (Delloye, Cornu, Druez, & Barbier, 2007;Greenwald, Boden, Goldberg, et al, 2001;Zamborsky, Svec, Bohac, Kilian, & Kokavec, 2016), and uncertain osseointegration and fragility (Moles et al, 2018). Therefore, additive manufacturing technologies by stereolithography (SLA) seem to be an excellent approach to process custom-made bone substitute scaffolds to overcome these limits (Rider et al, 2018;Roseti et al, 2017). Light process SLA is one of the most highly developed rapid prototyping techniques and is based upon ultraviolet lightinduced photopolymerization of photocurable resins (Barry et al, 2008).…”

An Introduction to 3D Bioprinting: Possibilities, Challenges and Future Aspects

“…Digital 3D images obtained from CT, MRI or ultrasound, are used to design a suitable scaffold with 3D slicing and CAD software; materials from printing are chosen depending upon the application, and can consist of polymers, ceramics, and bioactive components; cells are selected dependent on the application, a bioink can consist of singular or multiple cell types; post-fabrication 3D culture can be used for characterization, assessment and ultimately implantation. 3D printing is both time and cost effective, enabling fast adjustments and implementation of designs [13]. Designs can be made to match exact defect geometries, improving the union between implant and native tissue, thereby enhancing tissue integration [14].…”