Tackling Inequalities in Oral Health: Bone Augmentation in Dental Surgery through the 3D Printing of Poly(ε-caprolactone) Combined with 20% Tricalcium Phosphate

Abstract

The concept of personalized medicine and overcoming healthcare inequalities have become extremely popular in recent decades. Polymers can support cost reductions, the simplicity of customized printing processes, and possible future wide-scale expansion. Polymers with β-tricalcium phosphate (TCP) are well known for their synergy with oral tissues and their ability to induce osteoconductivity. However, poor information exists concerning their properties after the printing process and whether they can maintain an unaffected biological role. Poly(ε-caprolactone) (PCL) polymer and PCL compounded with TCP 20% composite were printed with a Prusa Mini-LCD-®3D printer. Samples were sterilised by immersion in a 2% peracetic acid solution. Sample analyses were performed using infrared-spectroscopy and statical mechanical tests. Biocompatibility tests, such as cell adhesion on the substrate, evaluations of the metabolic activity of viable cells on substrates, and F-actin labelling, followed by FilaQuant-Software were performed using a MC3T3-E1 pre-osteoblasts line. PCL+β-TCP-20% composite is satisfactory for commercial 3D printing and appears suitable to sustain an ISO14937:200937 sterilization procedure. In addition, the proper actin cytoskeleton rearrangement clearly shows their biocompatibility as well as their ability to favour osteoblast adhesion, which is a pivotal condition for cell proliferation and differentiation.

Multipotent Mesenchymal Cells Homing and Differentiation on Poly(ε-caprolactone) Blended with 20% Tricalcium Phosphate and Polylactic Acid Incorporating 10% Hydroxyapatite 3D-Printed Scaffolds via a Commercial Fused Deposition Modeling 3D Device

“…The dimensions of the test specimen for biological assays featured a thickness of 1 mm, while the diameter adhered to the standard dimensions of wells in multiwell plates, namely 11.5 mm in diameter. Consistent with our earlier research on PCL + 20% β-TCP [23], PLLA + 10% HA (synthetic hydroxyapatite) and PCL + 20% β-TCP were 3D-printed using a Prusa Mini LCD ® 3D printer (Prusa Research a.s., Prague, Czech Republic), featuring a 0.2 mm nozzle size and printing temperatures of 175 • C or 110 • C, respectively. No additional post-printing procedures were conducted.…”

“…These findings underscore the impact of even a modest proportion of HA in modifying the material's mechanical characteristics. Conversely, in our prior analysis of PCL + 20% β-TCP [23], the composite exhibited statistically negligible alterations in behavior compared to pure PCL, registering values of 0.3-0.4 GPa and 13-15 MPa. It is worth noting that the PCL + 20% β-TCP composite underwent ISO 14937-200935 sterilization using a 2% peracetic acid solution without significant changes [23], in accordance with Italian national law n.…”

“…Simultaneously, there is a need to minimize costs and facilitate broad integration into the everyday procedures of medical practitioners. This dual approach would help reduce expenses and make the treatment accessible across all social strata, even in technologically less advanced nations [23]. In a previous study [23], we demonstrated that a PCL compound supplemented up to 20% with β-TCP is suitable for commercial 3D printing using fused deposition modelling (FDM) and can withstand sterilization procedures according to ISO14937:200935 with a peracetic acid solution; it can also support osteoblasts' homing and growth.…”

“…This dual approach would help reduce expenses and make the treatment accessible across all social strata, even in technologically less advanced nations [23]. In a previous study [23], we demonstrated that a PCL compound supplemented up to 20% with β-TCP is suitable for commercial 3D printing using fused deposition modelling (FDM) and can withstand sterilization procedures according to ISO14937:200935 with a peracetic acid solution; it can also support osteoblasts' homing and growth. In this work, we combined PLLA with up to 10% HA, and in line with what was previously done with the PCL + 20% β-TCP, compared to pure PCL, we showcased its printability through a commercial 3D printer.…”

Bone Regeneration: Overview and Future Trends

“…Therefore, the aim for future research and clinical studies should address the use of the largely available material, such as resorbable biopolymers, that can be easily printed by the Fused Deposition Modeling technique (FDM) [ 17 ]. In the mentioned study, the authors showed the capacity of ceramic biopolymers in terms of cell proliferation and maturation, which is one of the most important milestones for medical grade classification.…”