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- Abteilung für Funktionswerkstoffe der Medizin und der Zahnheilkunde (18) (remove)
Aim of this thesis was the development of functionalizable hydrogel coatings for melt electrowritten PCL scaffolds and of bioprintable hydrogels for biofabrication.
Hydrogel coatings of melt electrowritten scaffolds enabled to control the surface hydrophilicity, thereby allowing cell-material interaction studies of biofunctionalized scaffolds in minimal protein adhesive environments. For this purpose, a hydrophilic star- shaped crosslinkable polymer was used and the coating conditions were optimized. Moreover, newly developed photosensitive scaffolds facilitated a time and pH independent biofunctionalization.
Bioprintable hydrogels for biofabrication were based on the allyl-functionalization of gelatin (GelAGE) and modified hyaluronic acid-products, to enable hydrogel crosslinking by means of the thiol-ene click chemistry. Optimization of GelAGE hydrogel properties was achieved through an in-depth analysis of the synthesis parameters, varying Ene:SH ratios, different crosslinking molecules and photoinitiators. Homogeneity of thiol-ene crosslinked networks was compared to free radical polymerized hydrogels and the applicability of GelAGE as bioink for extrusion-based bioprinting was investigated. Purely hyaluronic acid-based bioinks were hypothesized to maintain mechanical- and rheological properties, cell viabilities and the processability, upon further decreasing the overall hydrogel polymer and thiol content.
Hydrogel coatings: Highly structured PCL scaffolds were fabricated with MEW and subjected to coatings with six-armed star-shaped crosslinkable polymers (sP(EO-stat-PO)). Crosslinking results from the aqueous induced hydrolysis of reactive isocyanate groups (NCO) of sP(EO-stat-PO) and increased the surface hydrophilicity and provided a platform for biofunctionalizations in minimal protein adhesive environments. Not only the coating procedure was optimized with respect to sP(EO-stat-PO) concentrations and coating durations, instead scaffold pre-treatments were developed, which were fundamental to enhance the final hydrophilicity to completely avoid unspecific protein adsorption on sP(EO-stat-PO) coated scaffolds. The sP(EO-stat-PO) layer thickness of around 100 nm generally allows in vitro studies not only in dependence on the scaffold biofunctionalization but also on the scaffold architecture. The hydrogel coating extent was assessed via an indirect quantification of the NCO-hydrolysis products. Knowledge of NCO-hydrolysis kinetics enabled to achieve a balance of sufficiently coated scaffolds while maintaining the presence of NCO-groups that were exploited for subsequent biofunctionalizations. However, this time and pH dependent biofunctionalization was restricted to small biomolecules. In order to overcome this limitation and to couple high molecular weight biomolecules another reaction route was developed. This route was based on the photolysis of diazirine moieties and enabled a time and pH independent scaffold biofunctionalization with streptavidin and collagen type I. The fibril formation ability of collagen was used to obtain different collagen conformations on the scaffolds and a preliminary in vitro study demonstrated the applicability to investigate cell-material interactions.
The herein developed scaffolds could be applied to gain deeper insights into the fundamentals of cellular sensing. Especially the complexity by which cells sense e.g. collagen remain to be further elucidated. Therefore, different hierarchies of collagen-like conformations could be coupled to the scaffolds, e.g. gelatin or collagen-derived peptide sequences, and the activation of DDR receptors in dependence on the complexity of the coupled substances could be determined. Due to the strong streptavidin-biotin bond, streptavidin functionalized scaffolds could be applied as a versatile platform to allow immobilization of any biotinylated molecules.
Gelatin-based bioinks: First the GelAGE products were synthesized with respect to molecular weight distributions and amino acid composition integrity. A detailed study was conducted with varying molar ratios of reactants and synthesis durations and implied that gelatin degradation was most dominant for high alkaline synthesis conditions with long reaction times. Gelatin possesses multiple functionalizable groups and the predominant functionalization of amine groups was confirmed via different model substances and analyses. Polymer network homogeneity was proven for the GelAGE system compared to free radical polymerized hydrogels with GelMA. A detailed analysis of hydrogel compositions with varying functional group ratios and UV- or Vis-light photoinitiators was executed. The UV-initiator concentration is restricted due to cytotoxicity and potential cellular DNA damages upon UV-irradiation, whereas the more cytocompatible Vis- initiator system enabled mechanical stiffness tuning over a wide range by controlling the photoinitiator concentration at constant Ene:SH ratios and polymer weight percentages. Versatility of the GelAGE bioink for different AM techniques was proved by exploiting the thermo-gelling behavior of differently degraded GelAGE products for stereolithography and extrusion-based printing. Moreover, the viability of cell-laden GelAGE constructs was demonstrated for extrusion-based bioprinting. By applying different multifunctional thiol-macromolecular crosslinkers the mechanical and rheological properties improved concurrently to the processability. Importantly, lower thiol-crosslinker concentrations were required to yield superior mechanical strengths and physico-chemical properties of the hydrogels as compared to the small bis-thiol-crosslinker. Extrusion-based bioprinting with distinct encapsulated cells underlined the need for individual optimization of cell-laden hydrogel formulations.
Not only the viability of encapsulated cells in extrusion-based bioprinted constructs should be assessed, instead other parameters such as cell morphology or production of collagen or glycosaminoglycans should be considered as these represent some of the crucial prerequisites for cartilage Tissue Engineering applications. Moreover, these studies should be expanded to the stereolithographic approach and ultimately the versatility and cytocompatibility of formulations with macromolecular crosslinkers would be of interest. Macromolecular crosslinkers allowed reducing polymer weight percentages and amounts of thiol groups and are thus expected to contribute to increased cytocompatibility, especially in combination with the more cytocompatible Vis-initiator system, which remains to be elucidated.
Hyaluronic acid-based bioinks: Different molecular weight hyaluronic acid (HA) products were synthesized to bear ene- (HAPA) or thiol-functionalities (LHASH) to enable pure HA thiol-ene crosslinked hydrogels. Depending on the molecular weight of modified HA products, polymer weight percentages and Ene:SH ratios, a wide range of mechanical stiffness was covered. However, the manageability of high molecular weight HA (HHAPA) product solutions (HHAPA + LHASH) was restricted to 5.0 wt.-% as a consequence of the high viscosity. Based on the same HA thiol component (LHASH), hybrid hydrogels of HA with GelAGE were compared to pure HA hydrogels. Although the overall polymer weight percentage of HHAPA + LHASH hydrogels was significantly lowered compared to hybrid hydrogels (GelAGE + LHASH), similar mechanical and physico-chemical properties of pure HA hydrogels were determined with maintained Ene:SH ratios. Low viscous low molecular weight HA precursor solutions (LHAPA + LHASH) prevented the applicability for extrusion-based bioprinting, whereas the non-thermoresponsive HHAPA + LHASH system could be bioprinted with only one-fourth of the polymer content of hybrid formulations. The high viscous behavior of HHAPA + LHASH solutions, lower polymer weight percentages, decreased printing pressures and consequently declined shear stress during printing, were hypothesized to contribute to high cell viabilities in extrusion-based bioprinted constructs compared to the hybrid bioink.
The low molecular weight HA precursor formulation (LHAPA + LHASH) was not applicable for extrusion-based printing, but this system has potential for other AM techniques such as stereolithography. Similar to the GelAGE system a more detailed study on the functions of encapsulated cells would be useful to further develop this system. Moreover, the initiation with the Vis-initiator should be conducted.
Despite advances in cartilage repair strategies, treatment of focal chondral lesions remains an important challenge to prevent osteoarthritis. Articular cartilage is organized into several layers and lack of zonal organization of current grafts is held responsible for insufficient biomechanical and biochemical quality of repair-tissue. The aim was to develop a zonal approach for cartilage regeneration to determine whether the outcome can be improved compared to a non-zonal strategy. Hydrogel-filled polycaprolactone (PCL)-constructs with a chondrocyte-seeded upper-layer deemed to induce hyaline cartilage and a mesenchymal stromal cell (MSC)-containing bottom-layer deemed to induce calcified cartilage were compared to chondrocyte-based non-zonal grafts in a minipig model. Grafts showed comparable hardness at implantation and did not cause visible signs of inflammation. After 6 months, X-ray microtomography (µCT)-analysis revealed significant bone-loss in both treatment groups compared to empty controls. PCL-enforcement and some hydrogel-remnants were retained in all defects, but most implants were pressed into the subchondral bone. Despite important heterogeneities, both treatments reached a significantly lower modified O’Driscoll-score compared to empty controls. Thus, PCL may have induced bone-erosion during joint loading and misplacement of grafts in vivo precluding adequate permanent orientation of zones compared to surrounding native cartilage.
Calcium phosphate cements (CPC) represent valuable synthetic bone grafts, as they are self-setting, biocompatible, osteoconductive and in their composition similar to the inorganic phase of human bone. Due to their long shelf-life, neutral setting and since water is sufficient for setting, hydroxyapatite (HA) forming cements are processed in different paste formulations. Those comprise dual setting, Ca2+ binding and premixed cement systems. With dual setting formulations, both dissolution and precipitation of the cement raw powder occur simultaneously to the polymerization of water-soluble monomers to form a hydrogel. Chelating agents are able to form complexes with Ca2+ released from the raw powder. Premixed systems mostly contain the raw powder of the cement and a non-aqueous binder liquid which delays the setting reaction until application in the moist physiological environment. In the present work, two of those reaction mechanisms allowed the development of HA based cement applications.
Drillable cements are of high clinical interest, as the quality of screw and plate osteosynthesis techniques can be improved by cement augmentation. A drillable, dual setting composite from HA and a poly(2-hydroxyethyl methacrylate) hydrogel was analyzed with respect to the influence of monomer content and powder-to-liquid ratio on setting kinetics and mechanical outcome. While the conversion to HA and crystal growth were constantly confined with increased monomer amount, a minimum concentration of 50 % was required to see impressive ameliorations including a low bending modulus and high fracture energy at improved bending strength. Increasing the liquid amount enabled injection of the paste as well as drilling after 10 min of pre-setting.
While classic bone wax formulations have drawbacks such as infection, inflammation, hindered osteogenesis and a lack of biodegradability, the as-presented premixed formulation is believed to exhibit outmatching properties. It consisted of HA raw powders and a non-aqueous, but water-miscible carrier liquid from poly(ethylene glycol) (PEG). The bone wax was proved to be cohesive and malleable, it withstood blood pressure conditions and among deposition in an aqueous environment, PEG was exchanged such that porous, nanocrystalline HA was formed. Incorporation of a model antibiotic proved the suitability of the novel bone wax formulation for drug release purposes.
Prefabricated laminates from premixed carbonated apatite forming cement and poly(ε-caprolactone) fiber mats with defined pore architecture were presented as a potential approach for the treatment of 2-dimensional, curved cranial defects. They are flexible until application and were produced in a layer-by-layer approach from both components such that the polymer scaffold prevents the cement from flowing. It was demonstrated that solution electrospinning with a patterned collector for the fabrication of perforated fiber mats was suitable, as high fiber volume contents in combination with an appropriate interface enabled the successful fabrication of mechanically reinforced laminates. Mild immersion of the scaffolds under alkaline conditions additionally improved the interphase followed by an increase in bending-strength.
Since few years, magnesium phosphate cements (MPC) have attracted increasing attention for bone replacement. Compared to CPC, MPC exhibit a higher degradation potential and high early strength and they release biologically valuable Mg2+. However, common systems offer some challenges while using them in non-classic cement formulations such as the need for foreign ion supply, the potential acidity of the reaction or the fast setting kinetics. Here, it was possible to develop a chelate-setting MPC paste with a broad spectrum of potential applications.
The general mechanism of the novel setting principle was tested in a proof-of-principle manner. The cement paste consisted of farringtonite with differently concentrated phytic acid solution for chelate formation with Mg2+ from the raw powder. Adjusting the phytic acid content and adding a magnesium oxide as setting regulator to compensate its retarding effect resulted in drillable formulations. Additionally, there is a strong clinical demand for well working bone adhesives especially in a moist environment. Mostly the existing formulations are non-biodegradable. Ex vivo adhesion of the above presented MPC under wet conditions on bone demonstrated over a course of 7 d shear strengths of 0.8 MPa. Further, the hardened cement specimens showed a mass loss of 2 wt.% within 24 d in an aqueous environment and released about 0.17 mg/g of osteogenic Mg2+ per day. Together with the demonstrated cytocompatibility towards human fetal osteoblasts, this cement system showed promising characteristics in terms of degradable biocements with special application purposes.
Mineral bone cements were actually not developed for their application as bone-bonding agents, but as bone void fillers. In particular, calcium phosphate cements (CPC) are considered to be unsuitable for that application, particularly under moist conditions. Here, we showed the ex vivo ability of different magnesium phosphate cements (MPC) to adhere on bovine cortical bone substrates. The cements were obtained from a mixture of farringtonite (Mg\(_3\)(PO\(_4\))\(_2\)) with different amounts of phytic acid (C\(_6\)H\(_{18}\)O\(_{24}\)P\(_6\), inositol hexaphosphate, IP6), whereas cement setting occurred by a chelation reaction between Mg\(^{2+}\) ions and IP6. We were able to show that cements with 25% IP6 and a powder-to-liquid ratio (PLR) of 2.0 g/mL resulted in shear strengths of 0.81 ± 0.12 MPa on bone even after 7 d storage in aqueous conditions. The samples showed a mixed adhesive–cohesive failure with cement residues on the bone surface as indicated by scanning electron microscopy and energy-dispersive X-ray analysis. The presented material demonstrated appropriate bonding characteristics, which could enable a broadening of the mineral bone cements’ application field to bone adhesives
Background
The spectrum of indications for the use of membranes and scaffolds in the field of oral and maxillofacial surgery includes, amongst others, guided bone regeneration (GBR). Currently available membrane systems face certain disadvantages such as difficult clinical handling, inconsistent degradation, undirected cell growth and a lack of stability that often complicate their application. Therefore, new membranes which can overcome these issues are of great interest in this field.
Methods
In this pilot study, we investigated polycaprolactone (PCL) scaffolds intended to enhance oral wound healing by means of melt electrospinning writing (MEW), which allowed for three-dimensional (3D) printing of micron scale fibers and very exact fiber placement. A singular set of box-shaped scaffolds of different sizes consisting of medical-grade PCL was examined and the scaffolds’ morphology was evaluated via scanning electron microscopy (SEM). Each prototype sample with box sizes of 225 μm, 300 μm, 375 μm, 450 μm and 500 μm was assessed for cytotoxicity and cell growth by seeding each scaffold with human osteoblast-like cell line MG63.
Results
All scaffolds demonstrated good cytocompatibility according to cell viability, protein concentration, and cell number. SEM analysis revealed an exact fiber placement of the MEW scaffolds and the growth of viable MG63 cells on them. For the examined box-shaped scaffolds with pore sizes between 225 μm and 500 μm, a preferred box size for initial osteoblast attachment could not be found.
Conclusions
These well-defined 3D scaffolds consisting of medical-grade materials optimized for cell attachment and cell growth hold the key to a promising new approach in GBR in oral and maxillofacial surgery.
Biofabrication aims to fabricate biologically functional products through bioprinting or bioassembly (Groll et al 2016 Biofabrication 8 013001). In biofabrication processes, cells are positioned at defined coordinates in three-dimensional space using automated and computer controlled techniques (Moroni et al 2018 Trends Biotechnol. 36 384–402), usually with the aid of biomaterials that are either (i) directly processed with the cells as suspensions/dispersions, (ii) deposited simultaneously in a separate printing process, or (iii) used as a transient support material. Materials that are suited for biofabrication are often referred to as bioinks and have become an important area of research within the field. In view of this special issue on bioinks, we aim herein to briefly summarize the historic evolution of this term within the field of biofabrication. Furthermore, we propose a simple but general definition of bioinks, and clarify its distinction from biomaterial inks.
Bone graft substitutes in orthopedic applications have to fulfill various demanding requirements. Most calcium phosphate (CaP) bone graft substitutes are highly porous to achieve bone regeneration, but typically lack mechanical stability. This study presents a novel approach, in which a scaffold structure with appropriate properties for bone regeneration emerges from the space between specifically shaped granules. The granule types were tetrapods (TEPO) and pyramids (PYRA), which were compared to porous CaP granules (CALC) and morselized bone chips (BC). Bulk materials of the granules were mechanically loaded with a peak pressure of 4 MP; i.e., comparable to the load occurring behind an acetabular cup. Mechanical loading reduced the volume of CALC and BC considerably (89% and 85%, respectively), indicating a collapse of the macroporous structure. Volumes of TEPO and PYRA remained almost constant (94% and 98%, respectively). After loading, the porosity was highest for BC (46%), lowest for CALC (25%) and comparable for TEPO and PYRA (37%). The pore spaces of TEPO and PYRA were highly interconnected in a way that a virtual object with a diameter of 150 µm could access 34% of the TEPO volume and 36% of the PYRA volume. This study shows that a bulk of dense CaP granules in form of tetrapods and pyramids can create a scaffold structure with load capacities suitable for the regeneration of an acetabular bone defect
To facilitate true regeneration, a vascular graft should direct the evolution of a neovessel to obtain the function of a native vessel. For this, scaffolds have to permit the formation of an intraluminal endothelial cell monolayer, mimicking the tunica intima. In addition, when attempting to mimic a tunica media‐like outer layer, the stacking and orientation of vascular smooth muscle cells (vSMCs) should be recapitulated. An integral scaffold design that facilitates this has so far remained a challenge. A hybrid fabrication approach is introduced by combining solution electrospinning and melt electrowriting. This allows a tissue‐structure mimetic, hierarchically bilayered tubular scaffold, comprising an inner layer of randomly oriented dense fiber mesh and an outer layer of microfibers with controlled orientation. The scaffold supports the organization of a continuous luminal endothelial monolayer and oriented layers of vSM‐like cells in the media, thus facilitating control over specific and tissue‐mimetic cellular differentiation and support of the phenotypic morphology in the respective layers. Neither soluble factors nor a surface bioactivation of the scaffold is needed with this approach, demonstrating that heterotypic scaffold design can direct physiological tissue‐like cell organization and differentiation.
Biofabrication is an advancing new research field that might, one day, lead to complex products like tissue replacements or tissue analogues for drug testing. Although great progress was made during the last years, there are still major hurdles like new types of materials and advanced processing techniques. The main focus of this thesis was to help overcoming this hurdles by challenging and improving existing fabrication processes like extrusion-based bioprinting but also by developing new techniques. Furthermore, this thesis assisted in designing and processing materials from novel building blocks like recombinant spider silk proteins or inks loaded with charged nanoparticles.
A novel 3D printing technique called Melt Electrospinning Writing (MEW) was used in Chapter 3 to create tubular constructs from thin polymer fibers (roughly 12 μm in diameter) by collecting the fibers onto rotating and translating cylinders. The main focus was put on the influence of the collector diameter and its rotation and translation on the morphology of the constructs generated by this approach. In a first step, the collector was not moving and the pattern generated by these settings was analyzed. It could be shown that the diameter of the stationary collectors had a big impact on the morphology of the constructs. The bigger the diameter of the mandrel (smallest collector diameters 0.5 mm, biggest 4.8 mm) got, the more the shape of the generated footprint converged into a circular one known from flat collectors. In a second set of experiments the mandrels were only rotated. Increasing the rotational velocity from 4.2 to 42.0 rpm transformed the morphology of the constructs from a figure-of-eight pattern to a sinusoidal and ultimately to a straight fiber morphology. It was possible to prove that the transformation of the pattern was comparable to what was known from increasing the speed using flat collectors and that at a critical speed, the so called critical translation speed, straight fibers would appear that were precisely stacking on top of each other. By combining rotation and translation of the mandrel, it was possible to print tubular constructs with defined winding angles. Using collections speeds close to the critical translation speed enabled higher control of fiber positioning and it was possible to generate precisely stacked constructs with winding angles between 5 and 60°.
In Chapter 4 a different approach was followed. It was based on extrusion-based bioprinting in combination with a hydrogel ink system. The ink was loaded with nanoparticles and the nanoparticle release was analyzed. In other words, two systems, a printable polyglycidol/hyaluronic acid ink and mesoporous silica nanoparticles (MSN), were combined to analyze charge driven release mechanism that could be fine-tuned using bioprinting. Thorough rheological evaluations proved that the charged nanoparticles, both negatively charged MSN-COOH and positively charged MSN-NH2, did not alter the shear thinning properties of the ink that revealed a negative base charge due to hyaluronic acid as one of its main components. Furthermore, it could be shown that the particles did also not have a negative effect on the recovery properties of the material after exposure to high shear. During printing, the observations made via rheological testing were supported by the fact that all materials could be printed at the same settings of the bioprinter. Using theses inks, it was possible to make constructs as big as 12x12x3 mm3 composed of 16 layers. The fiber diameters produced were about 627±31 μm and two-component constructs could be realized utilizing the two hydrogel print heads of the printer to fabricate one hybrid construct. The particle distribution within those constructs was homogeneous, both from a microscopic and a macroscopic point of view. Particle release from printed constructs was tracked over 6 weeks and revealed that the print geometry had an influence on the particle release. Printed in a geometry with direct contact between the strands containing different MSN, the positively charged particles quickly migrated into the strand previously containing only negatively charged MSN-COOH. The MSN-COOH seemed to be rather released into the surrounding liquid and also after 6 weeks no MSN-COOH signal could be detected in the strand previously only containing MSN-NH2. In case of a geometry without direct contact between the strands, the migration of the positively charged nanoparticles into the MSN-COOH containing strand was strongly delayed. This proved that the architecture of the printed construct can be used to fine-tune the particle release from nanoparticle containing printable hydrogel ink systems.
Chapter 5 discusses an approach using hydrogel inks based on recombinant spider silk proteins processed via extrusion-based bioprinting. The ink could be applied for printing at protein concentrations of 3 % w/v without the addition of thickeners or any post process crosslinking. Both, the recombinant protein eADF4(C16) and a modification introducing a RGD-sequence to the protein (eADF4(C16)-RGD), could be printed revealing a very good print fidelity. The RGD modification had positive effect on the adhesion of cells seeded onto printed constructs. Furthermore, human fibroblasts encapsulated in the ink at concentrations of 1.2 million cells per mL did not alter the print fidelity and did not interfere with the crosslinking mechanism of the ink. This enabled printing cell laden constructs with a cell survival rate of 70.1±7.6 %. Although the cell survival rate needs to be improved in further trials, the approach shown is one of the first leading towards the shift of the window of biofabrication because it is based on a new material that does not need potentially harmful post-process crosslinking and allows the direct encapsulation of cells staying viable throughout the print process.
Brushite cements have been clinically used for irregular bone defect filling applications, and various strategies have been previously reported to modify and improve their physicochemical properties such as strength and injectability. However, strategies to address other limitations of brushite cements such as low radiopacity or acidity without negatively impacting mechanical strength have not yet been reported. In this study, we report the effect of substituting the beta-tricalcium phosphate reactant in brushite cement with baghdadite (Ca\(_3\)ZrSi\(_2\)O\(_9\)), a bioactive zirconium-doped calcium silicate ceramic, at various concentrations (0, 5, 10, 20, 30, 50, and 100 wt%) on the properties of the final brushite cement product. X-ray diffraction profiles indicate the dissolution of baghdadite during the cement reaction, without affecting the crystal structure of the precipitated brushite. EDX analysis shows that calcium is homogeneously distributed within the cement matrix, while zirconium and silicon form cluster-like aggregates with sizes ranging from few microns to more than 50 µm. X-ray images and µ-CT analysis indicate enhanced radiopacity with increased incorporation of baghdadite into brushite cement, with nearly a doubling of the aluminium equivalent thickness at 50 wt% baghdadite substitution. At the same time, compressive strength of brushite cement increased from 12.9 ± 3.1 MPa to 21.1 ± 4.1 MPa with 10 wt% baghdadite substitution. Culture medium conditioned with powdered brushite cement approached closer to physiological pH values when the cement is incorporated with increasing amounts of baghdadite (pH = 6.47 for pure brushite, pH = 7.02 for brushite with 20 wt% baghdadite substitution). Baghdadite substitution also influenced the ionic content in the culture medium, and subsequently affected the proliferative activity of primary human osteoblasts in vitro. This study indicates that baghdadite is a beneficial additive to enhance the radiopacity, mechanical performance and cytocompatibility of brushite cement