Orbital floor repair using patient specific osteoinductive implant made by stereolithography

Autor: Geoff Richards, Lai Yuxiao, Ruud R.M. Bos, Tanja Smidt, David Eglin, Mike A. Geven, Christoph M. Sprecher, Tingting Tang, Vincent A. Stadelmann, Dominic Gehweiler, Dirk W. Grijpma, Ling Qin, Viktor Varjas, Mauro Alini, Peng Jiang, Olivier Guillaume, Peter Varga, Stephan Zeiter, Huipin Yuan
Přispěvatelé: Biomaterials Science and Technology, TechMed Centre
Rok vydání: 2019
Předmět:
Stereolithography
02 engineering and technology
Fibrous tissue
Surgical planning
law.invention
LINKED POLY(TRIMETHYLENE CARBONATE)
law
Poly(trimethylene carbonate)
IN-VIVO
Biological evaluation
Bone morphogenesis
Titanium
0303 health sciences
MECHANICAL-PROPERTIES
Prostheses and Implants
Patient specific
021001 nanoscience & nanotechnology
Mechanics of Materials
0210 nano-technology
Orbit
RESORBABLE MESH
Materials science
FEASIBILITY
Patient specific implant
Biophysics
chemistry.chemical_element
Bioengineering
Sheep model
Orbital floor
BLOWOUT FRACTURES
Hydroxyapatite
Biomaterials
03 medical and health sciences
parasitic diseases
COMPOSITES
Animals
Humans
RECONSTRUCTION
TECHNOLOGY
030304 developmental biology
22/2 OA procedure
technology
industry
and agriculture
Plastic Surgery Procedures
Surgical Mesh
Durapatite
chemistry
DEGRADATION BEHAVIOR
Ceramics and Composites
Implant
Biomedical engineering
Zdroj: Biomaterials, 233:119721. ELSEVIER SCI LTD
Biomaterials, 233:119721. Elsevier
ISSN: 1878-5905
0142-9612
Popis: The orbital floor (OF) is an anatomical location in the craniomaxillofacial (CMF) region known to be highly variable in shape and size. When fractured, implants commonly consisting of titanium meshes are customized by plying and crude hand-shaping. Nevertheless, more precise customized synthetic grafts are needed to meticulously reconstruct the patients’ OF anatomy with better fidelity. As alternative to titanium mesh implants dedicated to OF repair, we propose a flexible patient-specific implant (PSI) made by stereolithography (SLA), offering a high degree of control over its geometry and architecture. The PSI is made of biodegradable poly(trimethylene carbonate) (PTMC) loaded with 40 wt % of hydroxyapatite (called Osteo-PTMC). In this work, we developed a complete work-flow for the additive manufacturing of PSIs to be used to repair the fractured OF, which is clinically relevant for individualized medicine. This work-flow consists of (i) the surgical planning, (ii) the design of virtual PSIs and (iii) their fabrication by SLA, (iv) the monitoring and (v) the biological evaluation in a preclinical large-animal model. We have found that once implanted, titanium meshes resulted in fibrous tissue encapsulation, whereas Osteo-PMTC resulted in rapid neovascularization and bone morphogenesis, both ectopically and in the OF region, and without the need of additional biotherapeutics such as bone morphogenic proteins. Our study supports the hypothesis that the composite osteoinductive Osteo-PTMC brings advantages compared to standard titanium mesh, by stimulating bone neoformation in the OF defects. PSIs made of Osteo-PTMC represent a significant advancement for patients whereby the anatomical characteristics of the OF defect restrict the utilization of traditional hand-shaped titanium mesh.
Databáze: OpenAIRE
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