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Injectable Scaffolds for Oral Tissue Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
J.L. Suárez-Franco, B.I. Cerda-Cristerna
The repair and regeneration of craniofacial tissues continue to be a challenge for clinicians and biomedical engineers. Reconstruction of pathologically damaged craniofacial tissues is often required because of tumors, traumas, or congenital malformations. There are constructive procedures for craniofacial tissue regeneration which are usually complex because the craniofacial region is a complex construct, consisting of bone, cartilage, soft tissue and neurovascular bundles. For instance, to reconstruct damaged craniofacial bones, surgical procedures are available. Autologous bone grafts have been considered the reference standard for bone regenerative therapies. Together with allogenic bone grafts, this type of bone graft material comprises more than 90% of grafts performed. However, these grafting procedures have numerous disadvantages, including hematomas, donor site morbidity, inflammation, infection and high cost (Morissette Martin et al. 2019).
Scaffold-Based Tissue Engineering for Craniofacial Deformities
Published in Atul Babbar, Ranvijay Kumar, Vikas Dhawan, Nishant Ranjan, Ankit Sharma, Additive Manufacturing of Polymers for Tissue Engineering, 2023
Jasmine Nindra, Mona Prabhakar
Craniofacial deformities include a large fraction of human bone defects, requiring interdisciplinary intervention by various specialists for surgical, nutritional, dental, speech, medical, and behavioral therapies that impose a substantial economic and societal burden. These deformities occur secondary to trauma, recession of bone due to tumor and cyst, or congenital defects and may affect both hard and soft tissues. The most prevalent congenital craniofacial defects are cleft lip and palate, which are caused by disturbance during embryonic development of hard and soft tissues of the oral cavity, resulting in non-fusion of the two palatine shelves (Martín-Del-Campo et al., 2019). Extensive surgical intervention using autologous bone grafting techniques is required for correction of these defects, which involves prolonged healing time at the donor and correction site, risk of infection, postoperative pain, and risk of graft failure. The child requiring craniofacial defect correction, along with their family, has to go through huge emotional as well as financial trauma that ultimately places financial burden on the healthcare system3. Due to the known challenges of extensive surgical interventions, the reconstructive surgeons have turned to scientists and engineers for alternate approaches of correction of these defects, in order to reduce severity of debilitating effects associated with surgery. It is quite impossible to completely eliminate surgery; however, the creation of high-end technologies improves surgical outcome by reducing the required number of surgical procedures. One such alternative technology to conventional autogenous bone graft techniques, which involves using scaffolds, stem cells, and signaling molecules to achieve therapeutic goals, is known as tissue engineering. This synergistic triad of functional biomaterials, bioactive molecules, and recruited stem cells improves life conditions of an affected individual by enhancing the self-repairment mechanism of affected tissues. Due to complexity of the maxillofacial region, it is necessary for the reconstruction procedures to maintain anatomic uniformity and appearance along with restoring tissue functions (Bhumiratana & Vunjak-Novakovic, 2012). Thus, to enhance mechanical, functional, and regenerative properties of grafts, tissue-engineered constructs are fabricated that imitate the original structure of matrix (scaffold), cells and bioactive molecules (Farré-Guasch et al., 2015). For adequate dimensional and structural properties, scaffold can be designed using additive manufacturing (AM) or 3D printing technologies customized according to individual patient needs. A recent advancement to AM is the 3D bioprinting technique, in which osteoinductive growth factors such as stem cells and adipose tissue cells are incorporated within or onto the printed scaffold6.
Introduction and Need for Additive Manufacturing in the Medical Industry
Published in Harish Kumar Banga, Rajesh Kumar, Parveen Kalra, Rajendra M. Belokar, Additive Manufacturing with Medical Applications, 2023
Industrial Revolution 4.0 is on the brink. Outstanding innovative technological developments in the twenty-first century are of an age turning towards digitalisation. Additive manufacturing (AM) is an overarching term for a variety of technologies [1]. Advances in AM in endless fields of application have come about in the last three decades [2]. AM technologies are also described as layered manufacturing, 3D printing, computer-automated manufacturing, rapid prototyping, or solid free-form technology [3]. This technology has been widely used in various engineering and biomedical fields [4,5]. AM has previously been used mostly to create scientific prototypes, but is now making inroads into the healthcare sector. This technique has opened the door to a modern era in precision medicine, and modern developments in molecular biology and gene profiling. Application of 3D printers for the production of customised pharmaceutical products and manufacture of personalised medicine enables stability and release profiles of multiple drugs. AM aims to exhibit the future of technology by manufacturing tailored products as a one-stop solution. With AM technologies pharmaceutical products are developed using computer-aided design (CAD) tools [7]. The object to be printed is rendered using CAD programming that transforms a drawn picture into a standard tessellation language (STL) file format suitable for 3D printers. A structure can be drawn in a layer-by-layer manner with the assistance of CAD drawing software. For example, some drugs have been found to be more effective in patients with hereditary differences, while some have been shown to have harmful effects on certain ethnic groups. Advances in the area of pharmacogenomics, according to how individual’s genetic profile influences their unique drug reaction, offer more detailed dose and drug selection details that can better support a single person depending on their genetic makeup. AM can be implemented in the healthcare sector on request to deliver medicine on demand [8]. Healthcare currently works on the principle in recent therapies of ‘one size fits all’. The setting forward of customised therapy, generally requiring the tailoring of treatments of a patient depending on their specific attributes, desires and expectations at all stages of care, has formulated the extraordinary area of personalised medicine. AM technology has been used to manufacture numerous formulations in pharmaceuticals, such as floating tablets, sustained release, patches and microneedles, that simplify the process of manufacturing complex dosage forms [9]. The conventional manufacturing process cannot be manipulated according to patient needs. 3D printing can strengthen the healthcare system, further enhancing medical compliance by tailoring the prescription to the patient. 3D printing is an AM process that enables the production of flexible and patient-specific scaffolds with high structural sophistication and design versatility. Recently, 3D printing has encountered a broad variety of uses in medicine, including craniofacial braces, dental moulds, crowns and implants. Recent advances in mechanical devices and software have greatly enhanced the precision, quality, speed and versatility of 3D printing methods. 3D printed items have often seen success clinically.
Validating 3D face morphing towards improving pre-operative planning in facial reconstruction surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2021
Z. Fishman, Jerry Liu, Joshua Pope, J.A. Fialkov, C.M. Whyne
Overall, the 3D face shape estimates using the 2017 Basel Face Model yielded sufficient clinical accuracy in many facial regions on average; however, the estimates’ standard deviation and maximum error should be improved for widespread applicability to better include any individual patient’s case above the average. Accurate 3D face shapes motivate the development of translational tools based on patient-specific 3D models to guide craniofacial reconstruction. Such estimated 3D face shapes can be used to generate computer-assisted designs that can be 3D printed into pre-operative practice models, drill guides, mesh contouring presses, or prosthetic production (Farkas et al. 1986; Dai et al. 2017). However, future morphable model estimation should include regional accuracy analysis, and consider the potential for biases related to race and sex, which may be addressed through the use of larger training datasets.
Computer-assisted surgery in medical and dental applications
Published in Expert Review of Medical Devices, 2021
Yen-Wei Chen, Brian W. Hanak, Tzu-Chian Yang, Taylor A. Wilson, Jenovie M. Hsia, Hollie E. Walsh, Huai-Che Shih, Kanako J. Nagatomo
Computer-assisted surgery, specifically surgical navigation systems in neurosurgery and other medical disciplines, affords many advantages to both surgeons and their patients, providing for safer, more efficacious, and often less invasive surgery through precise preoperative planning and intraoperative localization to minimize damage to adjacent tissues. Recently, computer-assisted surgical navigation systems have been integrated with robotics technology to yield navigation-assisted robotic surgery to further guide the surgeon to the anatomic target, enhancing the safety, accuracy, and precision of surgery in a minimally invasive manner. Three-dimensional modeling and the development of CAD/CAM systems have also added enhanced neurosurgical techniques. Through reverse engineering, these systems combine medical imaging with techniques in materials and process engineering to create physical replica for custom implants for patient-specific reconstruction in craniofacial, oral and maxillofacial surgery. Three-dimensional modeling can also be integrated with computer-assisted surgery systems.
The opportunity of using alloplastic bone augmentation materials in the maxillofacial region– Literature review
Published in Particulate Science and Technology, 2019
Simion Bran, Grigore Baciut, Mihaela Baciut, Ileana Mitre, Florin Onisor, Mihaela Hedesiu, Avram Manea
Some authors still consider the autogenous bone grafts to be the “golden standard” in alveolar ridge reconstruction and augmentation for oral implantology. Their main arguments are the predictability of the results and limited harvesting morbidity (Sakkas et al. 2017). Other studies suggest that results after using xenografts or alloplastic materials are similar to those obtained with autogenous bone grafts (Lutz et al. 2015). The choice between the two techniques is influenced by the surgeon’s preferences and expertise, the patient’s option, anatomical considerations, available alloplastic materials etc. It is obvious that there is no general “optimal solution” in such cases, only the best fitted solution for that certain case. Alloplastic bone augmentation materials provide obvious benefits: zero morbidity at donor site, available in unlimited quantities, increased patient acceptance and the existence of several shapes and sizes. Their usage to repair craniofacial defects has increased lately and will increase even more in the future (Profeta and Huppa 2016). Researchers are constantly trying to evaluate which of the currently available alloplastic materials are better, improve them and even come up with new materials (Lee and Volpicelli 2017). New alloplastic materials, in the form of granules, powder and even scaffolds are welcomed in this effort to offer better results in terms of new bone quantity and quality, healing times, production costs and finally increased patient satisfaction.