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3D-printed "hyperelastic bone" scaffolds accelerate bone regeneration in critical-sized bone defects

Sumanas Jordan, MD, PhD, Yu-hui Huang, MS, Adam Jakus, PhD, Zari Dumanian, BS, Linping Zhao, PhD, Ramille Shah, PhD, Pravin Patel, MD
The Ohio State University
2018-02-15

Presenter: Sumanas Jordan

Affidavit:
Dr. Jordan contributed to the design and implementation of the project as outlined below. She designed the study groups, performed the surgeries, and participated in the interpretation of the results. She provided critical revision of this abstract. It will be also be presented at the upcoming PSRC.

Director Name: Albert Chao

Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial

BACKGROUND: Autologous bone grafts remain the gold standard for craniofacial reconstruction despite limitations of donor site availability and morbidity. A myriad of commercial bone substitutes and allografts are available, yet no product has gained widespread use due to inferior outcomes. The ideal bone substitute is both osteoconductive and osteoinductive with the ability to be vascularized by and integrated with surrounding tissues. Irregular three-dimensional craniofacial defects may benefit from malleable or customizable substrates. "Hyperelastic Bone" (HB) is 3D-printed synthetic scaffold, composed of 90%weight hydroxyapatite (HA) and 10%weight poly(lactic-co-glycolic acid) (PLGA), with inherent bioactivity and porosity to allow tissue integration. This study examines the capacity of HB for bone regeneration in a critical-sized calvarial defect.

METHODS: Eight-millimeter calvarial defects in adult male rats were treated with HB, 3D-printed PLGA without HA (F-PLGA), autologous bone (positive control), or left untreated (negative control). Animals were sacrificed at 8 or 12 weeks, and calvarial specimens were analyzed by cone beam computed tomography (CBCT), microCT, histology, and SEM.

RESULTS: The mineralized bone volume to total tissue volume fraction (BV/TV) for the HB cohort was 73.8% and 68.2% of positive control at 8 and 12 weeks, respectively. F-PLGA performed similarly to the negative control. Histology of HB scaffolds revealed fibrous tissue at 8 weeks and new bone formation surrounding struts by 12 weeks.

CONCLUSIONS
3D-printed hyperelastic bone induced bone formation in a rat model without exogenous growth factors or cells. HB has the potential to be a customizable, inexpensive, bone substitute with comparable efficacy to autologous grafts.

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