This case study pivots the role of 3D resorbable scaffolds in the field

of bone and tissue engineering in which bone loss or broken bones

are assisted by putting a scaffold which helps the bone heal itself. It
widely discusses how these scaffolds can be printed using a cryogenic
build plate to attain highly compressible nature with multi scale
porosity that mimics the extra cellular matrix (ECM) necessary for
bone grafting studies.
Typically, these bone grafts can be classified into 3 types i.e.
Autograft which is performed using the patient’s own tissue.
Sometimes this is done by using the tissue material from another
patient or even from a different species of animal named as
xenograft. Often these grafts are performed from the iliac crest, the
hipbone but as this requires additional surgery and thus is
inconvenient. Therefore, this is an active field of research, and the
search of the perfect bone material is ongoing. The best option is to
have a synthetic bio scaffold which is easily available with no chances
of infection. These rules out the need for additional surgeries and
thus prevent donor site morbidities. Poor integration and eventual
mechanical failure are some limitations which is an interesting field
of research and will soon be overcome. Now, we do not have bio
scaffold which possess all osteogenic properties and the
vascularization ability as ECM. There are numerous applications in
which such scaffolds can be used.
These scaffolds are widely used in maxillofacial surgeries where
there is a need to augment the jaw to place implants to curb
dentures and chances of infection and disease. This field of
periodontal augmentation is crucial for maxillofacial surgeons and
dentists to tackle the infections such as cysts which reach the jaw
characterised by a large opening inside the jaw with a narrow neck
through thus the scaffolds used here should have special properties
by which it can enter the narrow opening and then subsequently fill
the entire space. Yet another application is in the field of cranial
surgeries where defects may range from small burr holes to large
dentures and sometimes the defect enlarges as the surgeon wishes
to resect part of the original tissue so the sturdiest challenge here is
to find a match as the exact size of the defect. Today it has become
necessary to develop a polymeric scaffold that integrates well and
gets resolved as the body lays down its own natural bone. This
should also demonstrate multi-scale porosity with a customised
distribution so that it mimics the natural bone and supports tissue
ingrowth and efficient nutrient transfer. The structure should be
resorbable to integrate functional groups, cells as well as drugs & the
growth factors.
Cryo gel 3D bioprinting is a procedure in which the printer is a
custom made where the gel is maintained at a relatively high
temperature when it is fluid so it can be extruded in a syringe
arrangement. The build plate is kept in cryogenic temperature (i.e.,
nitrogen temperature) so that it is self-supporting. The surrounding
temperature is kept cold as well with the vapour generated from the
liquid nitrogen which prevents the frosting of the cells. The needle
extrudes out the gel which freezes onto the cold build plate. The
structure of build plate is a cylindrical disc with crossheads, struts
etc. which provides the microporosity into which the cells can
infiltrate easily. Natural polymers like gelatine, Carboxymethyl chitin
(CMC)are the materials used for the scaffolds as they biodegrade
well and have good biocompatibility to mimic the bone ECM. Nano
Hydroxyapatite is added to build multi scale porosity by using the
process of freeze-drying in which the frozen scaffold is subjected to
lyophilization. Thereafter it is partially crosslinked which has a degree
of elasticity which supports its insertion into narrow openings. This is
the compressible nature of the scaffolds with complete recovery
between cycles without any permanent set. The molecular
interactions show the chemical nature of the scaffold material which
interacts well with Calcium and thus would assist in the subsequent
mineralisation after implantation. The optimisation of the properties
such as uptake of water, blood, extracellular fluid, and the nutrients
depends on the degree of crosslinking although its not possible to
reach the natural extent of the bone. As the concentration of
crosslinker increases pore percentage also increases. But still, they
have reasonably good mechanical extent for low load bearing
applications which accumulate and grow on the surface as well as
penetrate through the open pores into the bulk of the sample. This
shows the efficiency with which the 3D tissue engineering can be
achieved.
The functional aspects associated with the bone cells with osteolytic
and osteoblastic actions can be denoted by various markers. Besides
the SOAS-2 osteosarcoma cell line which mimics the bone cell line
also can expand the stem cells. We also have human umbilical cord
derived mesenchymal stem cells which are obtained after approvals
and used in these experiments which shows that the scaffolds exhibit
good proliferation and attachment properties. To summarize in this
case study, we have seen that specialised conditions can help
achieve various structures using biocompatible and bioresorbable
materials. The shape can be obtained through CT or MRI scans
utilizing the power of 3D bioprinting and when it’s combined with
lyophilisation it gives rise to overall 3D shape with multi scale
porosity. This helps in the penetration of cells, attachment,
proliferation, and their functionality which is demonstrated by the
alkaline phosphatase levels and the level of mineralization. This in
fact helps the surgeon load these bio scaffolds into appropriate
defects due to compressive, or spongy nature that makes them
particularly valuable.