Clinical Application of 3D-Printed Patient-Specific Polycaprolactone/Beta Tricalcium Phosphate Scaffold for Complex Zygomatico-Maxillary Defects

Abstract

(1) Background: In the present study, we evaluated the efficacy of a 3D-printed, patient-specific polycaprolactone/beta tricalcium phosphate (PCL/β-TCP) scaffold in the treatment of complex zygomatico-maxillary defects. (2) Methods: We evaluated eight patients who underwent immediate or delayed maxillary reconstruction with patient-specific PCL implants between December 2019 and June 2021. The efficacy of these techniques was assessed using the volume and density analysis of computed tomography data obtained before surgery and six months after surgery. (3) Results: Patients underwent maxillary reconstruction with the 3D-printed PCL/β-TCP scaffold based on various reconstructive techniques, including bone graft, fasciocutaneous free flaps, and fat graft. In the volume analysis, satisfactory volume conformity was achieved between the preoperative simulation and actual implant volume with a mean volume conformity of 79.71%, ranging from 70.89% to 86.31%. The ratio of de novo bone formation to total implant volume (bone volume fraction) was satisfactory with a mean bone fraction volume of 23.34%, ranging from 7.81% to 66.21%. Mean tissue density in the region of interest was 188.84 HU, ranging from 151.48 HU to 291.74 HU. (4) Conclusions: The combined use of the PCL/β-TCP scaffold with virtual surgical simulation and 3D printing techniques may replace traditional non-absorbable implants in the future owing to its accuracy and biocompatible properties.

Clinical application of 3D‐printed biodegradable lumbar interbody cage (polycaprolactone/β‐tricalcium phosphate) for posterior lumbar interbody fusion

“…The use of PCL blended with β‐TCP showed good osseointegration, biosafety, and appropriate rate of degradation, thereby reducing the irritation of acidic degradation product to the adjacent tissues and the occurrence of osteolytic and inflammatory reactions. This viewpoint has been also confirmed by other clinical and preclinical studies concerning PCL/ β‐TCP scaffold 33,34 …”

Current Applications of Polycaprolactone as a Scaffold Material for Heart Regeneration

“…For example, during tooth extraction, 3D PCL scaffolds inserted into the tooth socket have allowed for improved alveolar ridge preservation and bone healing during clinical trials . Further, PCL scaffolds have been utilized for treatment of facial fracture to promote bone healing. − In one study, 3D-printed, patient-specific PCL scaffolds were fabricated for complex maxillary defects, , thus highlighting the advanced biofabrication that can leveraged with PCL. Cosmetically, PCL-based material has been utilized as a soft tissue filler in various applications such as correction of nasolabial folds, dorsal hand volume loss due to aging and facial lifting. , 3D PCL scaffolds have further been used in clinical rhinoplasty procedures, with 98.0% of patients showing no postoperative infection-related foreign body reaction or distinct abnormal reaction .…”

“…159 Further, PCL scaffolds have been utilized for treatment of facial fracture to promote bone healing. 160−163 In one study, 3D-printed, patient-specific PCL scaffolds were fabricated for complex maxillary defects, 160,161 thus highlighting the advanced biofabrication that can leveraged with PCL. Cosmetically, PCL-based material has been utilized as a soft tissue filler in various applications such as correction of nasolabial folds, 164 dorsal hand volume loss due to aging 165 and facial lifting.…”

3D-Printing for Critical Sized Bone Defects: Current Concepts and Future Directions

“…A PLA-BG scaffold was found to have favorable biomechanical properties such as elastic modulus and compressive strength, while a combination of bioactive glass and poly(propylene fumarate) fabricated by Kleinfehn et al resulted in a functionalized scaffold through catechol molecule tethering and increased bioglass concentrations [ 74 , 181 ]. Combining the polymer polycaprolactone (PCL) with β-TCP in the complex reconstruction of zygomatic-maxillary defects, CT assessment of the volume and density of bone formation indicated a satisfactory ratio of new bone formation to implant volume [ 182 ]. Furthermore, there is interest in the use of self-healing elastomers, which rely on the use of photo elastomer inks containing both thiol and disulfide groups to interact for photocuring capacity [ 183 ].…”