Successful bone tissue engineering depends on the scaffold's ability to allow nutrient diffusion to and waste removal from the regeneration site, as well as provide an appropriate mechanical environment. Since bone is highly vascularized, scaffolds that provide greater mass transport may support increased bone regeneration. Permeability encompasses the salient features of three-dimensional porous scaffold architecture effects on scaffold mass transport. We hypothesized that higher permeability scaffolds will enhance bone regeneration for a given cell seeding density. We manufactured poly-e-caprolactone scaffolds, designed to have the same internal pore design and either a low permeability (0.688 · 10 /N-s), respectively. Scaffolds were seeded with bone morphogenic protein-7-transduced human gingival fibroblasts and implanted subcutaneously in immune-compromised mice for 4 and 8 weeks. Micro-CT evaluation showed better bone penetration into high permeability scaffolds, with blood vessel infiltration visible at 4 weeks. Compression testing showed that scaffold design had more influence on elastic modulus than time point did and that bone tissue infiltration increased the mechanical properties of the high permeability scaffolds at 8 weeks. These results suggest that for polycaprolactone, a more permeable scaffold with regular architecture is best for in vivo bone regeneration. This finding is an important step toward the end goal of optimizing a scaffold for bone tissue engineering.

Objectives To determine the potential of integrated image-based Computer Aided Design (CAD) and 3D printing approach to engineer scaffolds for head and neck cartilaginous reconstruction for auricular and nasal reconstruction. Study Design Proof of concept revealing novel methods for bioscaffold production with in vitro and in vivo animal data. Setting Multidisciplinary effort encompassing two academic institutions. Subjects and Methods DICOM CT images are segmented and utilized in image-based computer aided design to create porous, anatomic structures. Bioresorbable, polycaprolactone scaffolds with spherical and random porous architecture are produced using a laser-based 3D printing process. Subcutaneous in vivo implantation of auricular and nasal scaffolds was performed in a porcine model. Auricular scaffolds were seeded with chondrogenic growth factors in a hyaluronic acid/collagen hydrogel and cultured in vitro over 2 months duration. Results Auricular and nasal constructs with several microporous architectures were rapidly manufactured with high fidelity to human patient anatomy. Subcutaneous in vivo implantation of auricular and nasal scaffolds resulted in excellent appearance and complete soft tissue ingrowth. Histologic analysis of in vitro scaffolds demonstrated native appearing cartilaginous growth respecting the boundaries of the scaffold. Conclusions Integrated image-based computer-aided design (CAD) and 3D printing processes generated patient-specific nasal and auricular scaffolds that supported cartilage regeneration.

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Objective The mechanical properties of normal auricular cartilage provide a benchmark against which to characterize changes in auricular structure/function due to genetic defects creating phenotypic abnormalities in collage subtypes. Such properties also provide inputs/targets for auricular reconstruction scaffold design. Several studies report the biomechanical properties for septal, costal, and articular cartilage. However, analogous data for auricular cartilage is lacking. Therefore, our aim in this study was to characterize both whole ear and auricular cartilage mechanics by mechanically testing specimens and fitting the results to nonlinear constitutive models. Study Design Mechanical testing of whole ears and auricular cartilage punch biopsies. Methods Whole human cadaveric ear and auricular cartilage punch biopsies from both porcine and human cartilage were subjected to whole ear helix down compression and quasi-static unconfined compression tests. Common hyperelastic constitutive laws (widely used to characterize soft tissue mechanics) were evaluated for their ability to represent the stress-strain behavior of auricular cartilage. Results Load displacement curves for whole ear testing exhibited compliant linear behavior until after significant displacement where nonlinear stiffening occurred. All five commonly used 2-term hyperelastic soft tissue constitutive models successfully fit both human and porcine nonlinear elastic behavior (mean R2 fit greater than 0.95). Conclusion Auricular cartilage exhibits nonlinear strain stiffening elastic behavior that is similar to other soft tissues in the body. The whole ear exhibits compliant behavior with strain stiffening at high displacement. The constants from the hyperelastic model fits provide quantitative baselines for both human and porcine (a commonly used animal model for auricular tissue engineering) auricular mechanics.

Image-based computer-aided design and 3D printing offers an exciting new avenue for the tissue-engineered auricle. In early pilot work, creation of spherical micropores within the scaffold architecture appears to impart greater chondrogenicity of the bioscaffold. This advantage could be related to differences in permeability allowing greater cell migration and nutrient flow, differences in surface area allowing different cell aggregation, or a combination of both factors. The ability to design an anatomically correct scaffold that maintains its structural integrity while also promoting auricular cartilage growth represents an important step towards clinical applicability of this new technology.