bone scaffolds

[Image above] Paulo G. Coelho (right), examines the ceramic scaffold. Credit: NYU Langone Health

Usually, a broken or fractured bone will eventually heal itself as nature takes over. But in some cases, more severely damaged or diseased bones may require a complex solution such as a bone graft.

Bone grafting as a medical procedure has been around for centuries, but it does have limitations and risks, such as internal bleeding or infection. Over the years researchers have improved upon existing bone graft using materials such as sea coral, film coatings, or even porcine collagen.

A new study in regrowing damaged bone might eventually replace the bone graft as a procedure for repairing damaged bones.

A team of researchers and surgeons from the New York University School of Medicine and NYU College of Dentistry demonstrated a new method of growing bone using 3-D printed ceramic scaffolds. When implanted, the scaffolds dissolve as new bone growth takes over.

“Our three-dimensional scaffold represents the best implant in development because of its ability to regenerate real bone,” Dr. Leonard I. Linkow Professor at NYU Dentistry, professor of plastic surgery at NYU School of Medicine and study senior investigator Paulo G. Coelho says in an NYU news release.

The researchers used a gel ink and robocasting technology to print a three-dimensional scaffold onto a surface, and then superheat it to a hard ceramic form. To make the ceramic scaffold implant capable of being resorbed into the body, they used beta-tricalcium phosphate, a compound with a similar chemical makeup to real bone.

In testing the ceramic devices, the researchers found that six months after implantation, new bone grew into the scaffold lattice. And while the scaffold eventually dissolved, 77% resorbed into the test subjects’ bodies during that same period. Tests indicated that the new bone displayed the same strength as the original bone.

Contributing to the bone’s rapid growth was a coating of dipyridamole, a blood thinner the scientists used that is known to speed bone formation by more than 50%, according to the release. “…Because the implant is gradually resorbed, the drug is released a little at a time and locally into the bone, not into the whole body, thereby minimizing risks of abnormal bone growth, bleeding, or other side effects,” Director of the Clinical and Translational Science Institute, chief of the Division of Translational Medicine at NYU Langone Health, and study co-investigator Bruce N. Cronstein explains in the release.

Three-dimensional imaging on the left shows how bone, in green, replaced the bioactive ceramic scaffold, in purple, over a six-month period. Microscope images on the right show progressively increasing degrees of bone, stained pink, and lower amount of scaffold, in black, as time goes by in the body. Credit: Journal of Tissue Engineering and Regenerative Medicine

According to the scientists, their device is more representative of actual bone, unlike other implants that incorporate plastic—which offers bending properties but inadequate healing abilities.

Although the researchers conducted their initial study on skulls, limbs, and jaws of small animals, they plan to continue their studies on larger animals.

Their findings could dramatically improve existing bone graft technology and help those living with deformities.

“Our latest study results move us closer to clinical trials and potential bone implants for children living with skull deformations since birth, as well as for veterans seeking to repair damaged limbs,” Coelho says.

“We think that in terms of reconstruction, after accidents, for people who have injuries to their face or other bones, that this could be very useful,” Cronstein adds in a video. “In addition, for children with things like cleft palate or other sorts of problems, this could be very useful because the bone that results from growing on the scaffold (and the scaffold eventually is resorbed and goes away), but the bone that’s there is normal bone and presumably will continue to grow as the child ages.”

The paper, published in the Journal of Tissue Engineering and Regenerative Medicine, is “Form and Functional Repair of Long Bone Using 3D Printed Bioactive Scaffolds” (DOI: 10.1002/term.2733).

Watch the video below to learn more about this research.

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