In the rapidly advancing field of bioprinting, the potential to print bone tissue is both a fascinating and promising development. During a live session, Professor Risto Kontio from the University of Helsinki shared his insights and experiences in this innovative area, focusing on the progress and challenges of printing bone tissue.
The Promise of Bioprinting
Bioprinting holds immense potential, especially in the reconstruction of large bone defects in the facial skeleton, such as those resulting from tumor ablation surgery. Professor Kontio emphasized that the integration of 3D CAD/CAM techniques with tissue engineering is crucial for successful bioprinting. This technology allows for the creation of patient-specific models that replicate the exact anatomy of the patient, including both micro and macro structures.
State of Research in Bone Tissue Printing
As of October 2020, research in bone tissue printing is divided into two main lines: printing cells and biomaterials simultaneously, and printing a 3D scaffold first, which is then seeded with cells and other bioactive materials. The majority of current CAD/CAM applications focus on surgical guides, models for surgery planning, and custom implants. However, the bioprinting of bone tissue, although still in its early stages, shows great promise.
Translational and Clinical Studies
Various studies have demonstrated the potential of tissue engineering technology combined with CAD/CAM for bone growth in mandibular and calvarial defects. For instance, Grayson and colleagues successfully created a mandibular condyle scaffold using CAD technology, while another study in Helsinki used a combination of materials to repair mandibular defects in a minipig model. Despite these advancements, clinical studies remain scarce, with most being case reports rather than large-scale trials.
Challenges and Key Factors
One of the primary challenges in bone regeneration is ensuring adequate vascularization and nutrition for the cells. Research has shown that the rapid development of new blood vessels (neovascularization) is essential for the success of printed bone tissue. Without sufficient vascularization, the risk of resorption is high, leading to the loss of the implanted bone.
Clinical Applications and Future Directions
In clinical practice, a stable structure and proper coverage of the implanted scaffold are crucial for successful integration with the native bone. Professor Kontio shared examples of successful reconstructions using titanium scaffolds filled with tricalcium phosphate, bone grafts, and bone morphogenetic proteins. These patient-specific implants have been used to reconstruct maxillary defects with promising results.
Audience Engagement and Expert Insights
During the session, Professor Kontio addressed several audience questions, providing valuable insights into the current state and future prospects of bioprinting. He confirmed that mature bone can be printed directly without needing a cartilage phase, and emphasized the importance of vascularization in reducing resorption rates. When asked about the possibility of bioprinting teeth, Professor Kontio optimistically suggested that it could become a reality within the next decade, potentially revolutionizing implantology.
Conclusion
Bioprinting bone tissue is an exciting frontier in regenerative medicine and implantology. While significant challenges remain, particularly in ensuring vascularization and integration with native bone, ongoing research and technological advancements hold the promise of making bioprinted bone a viable option for reconstructive surgery. As Professor Kontio highlighted, the future of bioprinting is bright, and we may soon see breakthroughs that could transform the field of dental and maxillofacial surgery.
For those interested in continuing the discussion and learning more, Professor Kontio and other experts are available for further conversations on the EAO’s “Tell Me More About” after-discussion chat channel.