Mechanobiologically-optimized non-resorbable artificial bone for patient-matched scaffold-guided bone regeneration

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Orthopedic Surgery

Background:

• Critical-sized bone defects pose significant clinical challenges.
• Current treatments using bioresorbable scaffolds and metal plates have limitations, including mechanical instability, stress shielding, and interference with imaging and radiotherapy.
• Mandibular reconstruction, especially in ovine models, is complicated by high mechanical stresses.

Purpose of the Study:

• To evaluate a novel, permanent, 3D-printed scaffold for long-term reconstruction of segmental mandibular defects.
• To assess the efficacy of a patient-matched, numerically optimized polyetherketone gyroid scaffold combined with a ceramic-hydrogel composite in ovine models.

Main Methods:

• Utilized a permanent, patient-matched, numerically optimized, 3D-printed, thermally toughened, plasma-treated, and laser-sintered polyetherketone gyroid scaffold.
• Integrated a resorbable ceramic lattice infused with a stem cell-laden hydrogel as an osteoinductive reservoir.
• Reconstructed ovine segmental mandibulectomy defects and assessed long-term clinical performance.

Main Results:

• Achieved long-term reconstruction of ovine segmental mandibulectomy defects.
• Demonstrated durable clinical performance of the novel scaffold system.
• The scaffold provided a stable and effective solution for challenging mandibular defects.

Conclusions:

• The permanent, 3D-printed polyetherketone scaffold offers a translatable alternative to conventional bone grafting and metal plate fixation.
• This approach addresses the mechanical and biological challenges in critical-sized bone defect reconstruction.
• The study highlights a promising strategy for improving outcomes in mandibular reconstruction.