Additive manufacturing - an antidote to bottlenecks in tissue engineering and regenerative medicine

Tissue engineering and regenerative medicine (TERM) has advanced by leveraging innovations in biomaterials, cell biology, and drug delivery, but its potential remains to be fully realized due to limitations in manufacturing complex cellular constructs. The complexity of cellular and extracellular matrix (ECM) organization poses a formidable challenge to replicate using conventional fabrication methods. Additive manufacturing (AM) enables the translation of design intent into controlled three-dimensional (3D) constructs with defined geometry, internal architecture, and spatially organized components. Beyond merely fabricating complex structures, its value lies in addressing structural, spatial, reproducibility, personalization, and translational limitations. However, printability does not guarantee biological function. By exploring AM of soft matter (hydrogels) as a practical manufacturing framework for TERM, this review first identifies the core manufacturing bottlenecks in classical TERM (Section 2), then evaluates how AM addresses structural fidelity, spatial patterning, digital reproducibility, and personalization (Section 3). Using osteochondral units, skin, and vascular grafts as representative testbeds (Section 4), we critically analyze current limitations-including bioink tradeoffs, resolution-scale constraints, and regulatory barriers (Section 5)-and outline the functional validation, standardization, and digital-AI integration needed for clinical implementation (Section 6). The review concludes that AM's translational impact will depend less on geometric complexity than on demonstrating tissue maturation, host integration, and regulatory compliance within viable clinical workflows.