ABSTRACT
Fabricating three-dimensional (3D) scaffolds is attractive due to various advantages for tissue engineering, such as cell migration, proliferation, and adhesion. Since cell growth depends on transmitting nutrients and cell residues, naturally vascularized scaffolds are superior for tissue engineering. Vascular passages help the inflow and outflow of liquids, nutrients, and waste disposal from the scaffold and cell growth. Porous scaffolds can be prepared by plant tissue decellularization which allows for the cultivation of various cell lines depending on the intended application. To this end, researchers decellularize plant tissues by specific chemical and physical methods. Researchers use plant parts depending on their needs, for example, decellularizing the leaves, stems, and fruits. Plant tissue scaffolds are advantageous for regenerative medicine, wound healing, and bioprinting. Studies have examined various plants such as vegetables and fruits such as orchid, parsley, spinach, celery, carrot, and apple using various materials and techniques such as sodium dodecyl sulfate, Triton X-100, peracetic acid, deoxyribonuclease, and ribonuclease with varying percentages, as well as mechanical and physical techniques like freeze-thaw cycles. The process of data selection, retrieval, and extraction in this review relied on scholarly journal publications and other relevant papers related to the subject of decellularization, with a specific emphasis on plant-based research. The obtained results indicate that, owing to the cellulosic structure and vascular nature of the decellularized plants and their favorable hydrophilic and biological properties, they have the potential to serve as biological materials and natural scaffolds for the development of 3D-printing inks and scaffolds for tissue engineering.
ABSTRACT
This study investigates the safety and efficacy of 3D-printed polycaprolactone/hydroxyapatite (PCL/HA) scaffolds for patient-specific cranioplasty surgeries, employing liquid deposition modeling (LDM) technology. This research is pioneering as it explores the impact of gamma radiation on PCL/HA scaffolds and utilizes printing ink with the highest content of HA known in the composite. The mechanical, morphological, and macromolecular stability of the gamma-sterilized scaffolds were verified before implantation. Subsequent research involving animal subjects was conducted to explore the effects of sterilized implants. Eventually, three clinical cases were selected for the implantation studies as part of a phase 1 non-randomized open-label clinical trial. It was shown that a 25 kGy gamma-ray dose for sterilizing the printed implants did not alter the required geometrical precision of the printed implants. The implants exhibited well-distributed HA and strength comparable to cancellous bone. Gamma radiation reduced hydrophobicity and water uptake capacity without inducing pyrogenic or inflammatory responses. Personalized PCL/HA substitutes successfully treated various craniomaxillofacial defects, including trauma-induced facial asymmetry and congenital deformities. HA nanoparticles in the ink stimulated significant osteoconductive responses within three months of implantation. Moreover, the results revealed that while larger implants may exhibit a slower bone formation response in comparison to smaller implants, they generally had an acceptable rate and volume of bone formation. This clinical trial suggests the application of a sterilized PCL/HA composite for craniomaxillofacial surgery is safe and could be considered as a substitute for autologous bone.
