Evaluation of a self-fitting, shape memory polymer scaffold in a rabbit calvarial defect model.

Self-fitting scaffolds prepared from biodegradable poly(ε-caprolactone)-diacrylate (PCL-DA) have been developed for the treatment of craniomaxillofacial (CMF) bone defects. As a thermoresponsive shape memory polymer (SMP), with the mere exposure to warm saline, these porous scaffolds achieve a conformal fit in defects. This behavior was expected to be advantageous to osseointegration and thus bone healing. Herein, for an initial assessment of their regenerative potential, a pilot in vivo study was performed using a rabbit calvarial defect model. Exogenous growth factors and cells were excluded from the scaffolds. Key scaffold material properties were confirmed to be maintained following gamma sterilization. To assess scaffold integration and neotissue infiltration along the defect perimeter, non-critically sized (d = 8 mm) bilateral calvarial defects were created in 12 New Zealand white rabbits. Bone formation was assessed at 4 and 16 weeks using histological analysis and micro-CT, comparing defects treated with an SMP scaffold (d = 9 mm x t = 1 or 2 mm) to untreated defects (i.e. defects able to heal without intervention). To further assess osseointegration, push-out tests were performed at 16 weeks and compared to defects treated with poly(ether ether ketone) (PEEK) discs (d = 8.5 mm x t = 2 mm). The results of this study confirmed that the SMP scaffolds were biocompatible and highly conducive to bone formation and ingrowth at the perimeter. Ultimately, this resulted in similar bone volume and surface area versus untreated defects and superior performance in push-out testing versus defects treated with PEEK discs. STATEMENT OF SIGNIFICANCE: Current treatments of craniomaxillofacial (CMF) bone defects include biologic and synthetic grafts but they are limited in their ability to form good contact with adjacent tissue. A regenerative engineering approach using a biologic-free scaffold able to achieve conformal fitting represents a potential "off-the-shelf" surgical product to heal CMF bone defects. Having not yet been evaluated in vivo, this study provided the preliminary assessment of the bone healing potential of self-fitting PCL scaffolds using a rabbit calvarial defect model. The study was designed to assess scaffold biocompatibility as well as bone formation and ingrowth using histology, micro-CT, and biomechanical push-out tests. The favorable results provide a basis to pursue establishing self-fitting scaffolds as a treatment option for CMF defects.

Hydrolytic degradation of PCL-PLLA semi-IPNs exhibiting rapid, tunable degradation.

Accelerating the rate of polyester hydrolytic degradation is of interest for numerous biomedical applications. Poly(ε-caprolactone) (PCL) and poly(L-lactic acid) (PLLA) have been extensively studied as thermoplastic homo- and copolymers as well as PCL-PLLA blends. PCL-PLLA semi-interpenetrating networks (semi-IPN) prepared with thermoplastic PLLA embedded in a cross-linked PCL diacrylate (PCL-DA) network were previously shown to exhibit uniquely accelerated degradation behavior that increased with PLLA content. Herein, their properties before and during degradation were further investigated to reveal the origin of this behavior and to better understand the semi-IPNs' degradation mechanism. Initially, semi-IPNs exhibited restricted spherulite size and irregularity, as well as a phase-separated morphology and PLLA-rich surface. Under accelerated conditions (1 M NaOH, 37 °C), degradation was revealed to be initiated in PLLA regions. It was also found that the PCL-DA crosslinking and PCL-PLLA phase separation played the largest roles in degradation rates and that semi-IPNs underwent faster rates of degradation than an analogous blend largely due to the reduced crystallinity of PCL-DA. Non-accelerated conditions (PBS [pH = 7.4], 37 °C) up to 56 weeks, which had never before been studied for polyester semi-IPNs, revealed similar trends in degradation rates.

Hydrolytic Degradation and Erosion of Polyester Biomaterials.

Strategies to refine the degradation behavior of polyester biomaterials, particularly to overcome the limitations of slow hydrolytic degradation, would broaden their utility. Herein, we examine the complexities of polyester degradation behavior, its assessment and strategies for refinement. The factors governing polyester degradation are strikingly complex. In addition to the half-life of the hydrolytically-labile bond, a series of interdependent material properties must be considered. Thus, methods used to characterize such material properties, both before and during degradation, must be carefully selected. Assessment of degradation behavior is further complicated by the variability of reported test protocols and the need for accelerated rather than real-time in vitro testing conditions. Ultimately, through better control of degradation behavior and correlation of in vitro, simulated degradation to that observed in vivo, the development of superior devices prepared with polyester biomaterials may be achieved.

Porous Poly(ε-caprolactone)-Poly(l-lactic acid) Semi-Interpenetrating Networks as Superior, Defect-Specific Scaffolds with Potential for Cranial Bone Defect Repair.

The treatment of irregular cranial bone defects is currently limited due to the graft resorption that can occur when an ill-fitting interface exists between an autograft and the surrounding tissue. A tissue engineering scaffold able to achieve defect-specific geometries could improve healing. This work reports a macroporous, shape memory polymer (SMP) scaffold composed of a semi-interpenetrating network (semi-IPN) of thermoplastic poly(l-lactic acid) (PLLA) within cross-linked poly(ε-caprolactone) diacrylate (PCL-DA) that is capable of conformal fit within a defect. The macroporous scaffolds were fabricated using a fused salt template and were also found to have superior, highly controlled properties needed for regeneration. Specifically, the scaffolds displayed interconnected pores, improved rigidity, and controlled, accelerated degradation. Although slow degradation rates of scaffolds can limit healing, the unique degradation behavior observed could prove promising. Thus, the described SMP semi-IPN scaffolds overcome two of the largest limitations in bone tissue engineering: defect "fit" and tailored degradation.

PCL-PLLA Semi-IPN Shape Memory Polymers (SMPs): Degradation and Mechanical Properties.

Thermoresponsive shape memory polymers (SMPs) based on poly(ε-caprolactone) (PCL) whose shape may be actuated by a transition temperature (T trans ) have shown utility for a variety of biomedical applications. Important to their utility is the ability to modulate mechanical and degradation properties. Thus, in this work, SMPs are formed as semi-interpenetrating networks (semi-IPNs) comprised of a cross-linked PCL diacrylate (PCL-DA) network and thermoplastic poly(l-lactic acid) (PLLA). The semi-IPN uniquely allows for requisite crystallization of both PCL and PLLA. The influence of PLLA (PCL:PLLA wt% ratio) and PCL-DA molecular weight (n) on film properties are investigated. PCL-PLLA semi-IPNs are able to achieve enhanced mechanical properties and accelerated rates of degradation.