Abstract
Abstract
Background
Titanium and its alloys have been widely employed for bone tissue repair and implant manufacturing. The rapid development of three-dimensional (3D) printing technology has allowed fabrication of porous titanium scaffolds with controllable microstructures, which is considered to be an effective method for promoting rapid bone formation and decreasing bone absorption. The purpose of this systematic review was to evaluate the osteogenic potential of 3D-printed porous Ti6Al4V (Ti64) scaffold for repairing long bone defects in animal models and to investigate the influential factors that might affect its osteogenic capacity.
Methods
Electronic literature search was conducted in the following databases: PubMed, Web of Science, and Embase up to September 2021. The SYRCLE's tool and the modified CAMARADES list were used to assess the risk of bias and methodological quality, respectively. Due to heterogeneity of the selected studies in relation to protocol and outcomes evaluated, a meta-analysis could not be performed.
Results
The initial search revealed 5858 studies. Only 46 animal studies were found to be eligible based on the inclusion criteria. Rabbit was the most commonly utilized animal model. A pore size of around 500–600 µm and porosity of 60–70% were found to be the most ideal parameters for designing the Ti64 scaffold, where both dodecahedron and diamond pores optimally promoted osteogenesis. Histological analysis of the scaffold in a rabbit model revealed that the maximum bone area fraction reached 59.3 ± 8.1% at weeks 8–10. Based on micro-CT assessment, the maximum bone volume fraction was found to be 34.0 ± 6.0% at weeks 12.
Conclusions
Ti64 scaffold might act as a promising medium for providing sufficient mechanical support and a stable environment for new bone formation in long bone defects.
Trail registration The study protocol was registered in the PROSPERO database under the number CRD42020194100.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference79 articles.
1. Warnke PH, Douglas T, Wollny P, Sherry E, Steiner M, Galonska S, et al. Rapid prototyping: porous titanium alloy scaffolds produced by selective laser melting for bone tissue engineering. Tissue Eng Part C Methods. 2008;15:115–24.
2. Tamimi F, Torres J, Al-Abedalla K, Lopez-Cabarcos E, Alkhraisat MH, Bassett DC, et al. Osseointegration of dental implants in 3D-printed synthetic onlay grafts customized according to bone metabolic activity in recipient site. Biomaterials. 2014;35:5436–45.
3. Li G, Wang L, Pan W, Yang F, Jiang W, Wu X, et al. In vitro and in vivo study of additive manufactured porous Ti6Al4V scaffolds for repairing bone defects. Sci Rep. 2016;6:34072.
4. Bandyopadhyay A, Mitra I, Shivaram A, Dasgupta N, Bose S. Direct comparison of additively manufactured porous titanium and tantalum implants towards in vivo osseointegration. Addit Manuf. 2019;28:259–66.
5. Zimmer. https://www.zimmerbiomet.com/en/products-and-solutions/specialties/spine/trelloss-tc-porous-ti-interbody-system.html. Accessed 31 Dec 2021.