Current and future perspectives on biomaterials for segmental mandibular defect repair

Maruf, D S Abdullah Al; Parthasarathi, Krishnan; Cheng, Kai; Mukherjee, Payal; McKenzie, David R.; Crook, Jeremy Micah; Wallace, Gordon G.; Clark, Jonathan R.

doi:10.1080/00914037.2022.2052729

Cited by 9 publications

(10 citation statements)

References 148 publications

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“…Traditional methods are becoming increasingly difficult to meet the requirements of precise mandibular reconstruction because of the 3D anatomical structure and complex function of the face. The latest research mentioned the use of biomaterials for mandibular defects, allogeneic transplantation of facial tissue, and drug-induced rapid distraction osteogenesis ( De Paz et al, 2021 ; Al Maruf et al, 2022 ; Shen et al, 2022 ), providing a new idea for the study of mandibular defects. In summary, combined with the bibliometric analysis, among the various methods of reconstruction in the field of mandibular defects, we consider that accurate mandibular reconstruction and tissue engineering bone regeneration technologies are research hotspots and frontiers in this field.…”

Section: Discussionmentioning

confidence: 99%

Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021

Li¹,

Li²,

Tang

et al. 2023

Front. Bioeng. Biotechnol.

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Background: Mandibular defects can result from congenital deformities, trauma, tumor resection, and osteomyelitis. The shape was irregular because the lower jaw was radians. This involves teeth and jaw functions; therefore, the difficulty of bone repair is greater than that in other body parts. Several standard treatments are available, but they result in various problems, such as difficulties in skin flap transplantation and possible zone dysfunction, artificial material boneless combining ability, and a long treatment period. This study aimed to introduce the present status of research on mandibular defects to analyze the current introduction and predict future research trends through a bibliometric study.Methods: From 2001 to 2021, publications on mandibular defects were collected for bibliometric visualization using VOSviewer, CiteSpace, and Scimago Graphica software based on the Web of Science Core Collection.Results: This study analyzed 4,377 articles, including 1,080 published in the United States, 563 in China, and 359 in Germany, with an increase in the number of articles published over the past 20 years. Wikesjoe and Ulf Mai E had the most publications (p = 36) and citations (citations = 1,553). Shanghai Jiaotong University published the highest number of papers among the research institutions (p = 88). The most productive journal was Journal of Oral and Maxillofacial Surgery, and the cited literature was primarily classified as dentistry, dermatology, and surgery. Cluster Analysis of Co-occurrence Keywords revealed that highest number of core words were mandibular defects, mandibular reconstruction, and bone regeneration. The highest cited words were head and neck cancer, accuracy, and osteogenic differentiation. High-frequency terms of Cluster Analysis of References were osteosynthesis plate, tissue engineering, and rapid distraction rate.Conclusion: Over the past 20 years, the number of studies on mandibular defects has gradually increased. New surgical procedures are increasingly being used in clinical practice. Current frontier topics mainly focus on areas such as computer-aided design, 3D printing of osteotomy and reconstruction guide plates, virtual surgical planning, and bone tissue engineering.

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Section: Discussionmentioning

confidence: 99%

Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021

Li¹,

Li²,

Tang

et al. 2023

Front. Bioeng. Biotechnol.

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“…Although autologous bone flaps are effective in restoring bone continuity, long and complex operations are required and are associated with substantial donor site morbidity. For some cases autologous bone is not suitable for replicating the complex 3D geometries, as in the facial region of the skull. − Bone tissue engineering provides a feasible alternative by enabling the design and manufacture of tissue scaffolds, which support tissue regeneration via cell adhesion and nutrient transport. − Unlike free flaps, tissue scaffolds can be additively manufactured so that they are patient specific, enabling the scaffold to match the actual size and shape of the defect. − Scaffold architecture, biomaterials selection, additive manufacturing, implantation, and performance evaluation are crucial steps that need to be carefully planned and implemented to ensure optimal experimental and clinical outcomes. For oral cancer patients, there are additional challenges that are not often encountered in long bone defects, such as oral microflora, postoperative radiotherapy, and cantilever loading.…”

Section: Introductionmentioning

confidence: 99%

A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects

Xin,

Ferguson,

Wan

et al. 2024

ACS Biomater. Sci. Eng.

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The present work describes a preclinical trial (in silico, in vivo and in vitro) protocol to assess the biomechanical performance and osteogenic capability of 3D-printed polymeric scaffolds implants used to repair partial defects in a sheep mandible. The protocol spans multiple steps of the medical device development pipeline, including initial concept design of the scaffold implant, digital twin in silico finite element modeling, manufacturing of the device prototype, in vivo device implantation, and in vitro laboratory mechanical testing. First, a patient-specific one-body scaffold implant used for reconstructing a critical-sized defect along the lower border of the sheep mandible ramus was designed using on computed-tomographic (CT) imagery and computer-aided design software. Next, the biomechanical performance of the implant was predicted numerically by simulating physiological load conditions in a digital twin in silico finite element model of the sheep mandible. This allowed for possible redesigning of the implant prior to commencing in vivo experimentation. Then, two types of polymeric biomaterials were used to manufacture the mandibular scaffold implants: poly ether ether ketone (PEEK) and poly ether ketone (PEK) printed with fused deposition modeling (FDM) and selective laser sintering (SLS), respectively. Then, after being implanted for 13 weeks in vivo, the implant and surrounding bone tissue was harvested and microCT scanned to visualize and quantify neotissue formation in the porous space of the scaffold. Finally, the implant and local bone tissue was assessed by in vitro laboratory mechanical testing to quantify the osteointegration. The protocol consists of six component procedures: (i) scaffold design and finite element analysis to predict its biomechanical response, (ii) scaffold fabrication with FDM and SLS 3D printing, (iii) surface treatment of the scaffold with plasma immersion ion implantation (PIII) techniques, (iv) ovine mandibular implantation, (v) postoperative sheep recovery, euthanasia, and harvesting of the scaffold and surrounding host bone, microCT scanning, and (vi) in vitro laboratory mechanical tests of the harvested scaffolds. The results of microCT imagery and 3-point mechanical bend testing demonstrate that PIII-SLS-PEK is a promising biomaterial for the manufacturing of scaffold implants to enhance the bone-scaffold contact and bone ingrowth in porous scaffold implants. MicroCT images of the harvested implant and surrounding bone tissue showed encouraging new bone growth at the scaffold-bone interface and inside the porous network of the lattice structure of the SLS-PEK scaffolds.

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“…The immediate and long-term goals typically differ, with osteogenic strategies employed to support bone growth that ultimately achieves the desired mechanical stability and in the case of injury, regenerative capacity. Various biomaterials including polycaprolactone (PCL), polyether ether ketone (PEEK), polyetherketone ketone (PEKK), ceramics, metals, polymethylmethacrylate (PMMA), polyglycolic acid (PGA), and polylactic acid (PLA) hydrogels have been extensively researched for bone regeneration [ 4 ]. An ideal biomaterial must be safe, biocompatible, cytocompatible (non-cytotoxic or do not cause harm to the cells), bioinert (when implanted, has minimal interaction with its surrounding tissue), bioactive (has a biological effect), biostable, and biodegradable [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Osteoinduction requires the scaffold to provide structural support for progenitor cells and a biological environment that favours osteogenic differentiation, proliferation, and mineralization [ 11 ]. Significant progress in the field of biomaterials has been evident over recent decades [ 4 ]. However, segmental mandibular defects of the mandible are a particularly challenging clinical scenario because of the microorganism-rich environment, minimal soft tissue cover, the consistent requirement for adjuvant radiotherapy, complex geometry, specialised anatomical structures (teeth), and high-stress axial and non-axial (cantilever) loading [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Significant progress in the field of biomaterials has been evident over recent decades [ 4 ]. However, segmental mandibular defects of the mandible are a particularly challenging clinical scenario because of the microorganism-rich environment, minimal soft tissue cover, the consistent requirement for adjuvant radiotherapy, complex geometry, specialised anatomical structures (teeth), and high-stress axial and non-axial (cantilever) loading [ 4 ]. For critical sized bone defects, the medium to long-term mechanical characteristics of scaffolds is particularly important, as it may take months for bone to grow across oral cancer-related mandibular defects that are commonly 6–10 cm in length without osteoinduction.…”

Section: Introductionmentioning

confidence: 99%

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Hydrogel: A Potential Material for Bone Tissue Engineering Repairing the Segmental Mandibular Defect

et al. 2022

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Free flap surgery is currently the only successful method used by surgeons to reconstruct critical-sized defects of the jaw, and is commonly used in patients who have had bony lesions excised due to oral cancer, trauma, infection or necrosis. However, donor site morbidity remains a significant flaw of this strategy. Various biomaterials have been under investigation in search of a suitable alternative for segmental mandibular defect reconstruction. Hydrogels are group of biomaterials that have shown their potential in various tissue engineering applications, including bone regeneration, both through in vitro and in vivo pre-clinical animal trials. This review discusses different types of hydrogels, their fabrication techniques, 3D printing, their potential for bone regeneration, outcomes, and the limitations of various hydrogels in preclinical models for bone tissue engineering. This review also proposes a modified technique utilizing the potential of hydrogels combined with scaffolds and cells for efficient reconstruction of mandibular segmental defects.

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Current and future perspectives on biomaterials for segmental mandibular defect repair

Cited by 9 publications

References 148 publications

Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021

Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021

A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects

Hydrogel: A Potential Material for Bone Tissue Engineering Repairing the Segmental Mandibular Defect

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