Additive manufacturing processes take the information from a computer-aided design (CAD) file that is later converted to a stereolithography (STL) file. In this process, the drawing made in the CAD software is approximated by triangles and sliced containing the information of each layer that is going to be printed. There is a discussion of the relevant additive manufacturing processes and their applications. The aerospace industry employs them because of the possibility of manufacturing lighter structures to reduce weight. Additive manufacturing is transforming the practice of medicine and making work easier for architects. In 2004, the Society of Manufacturing Engineers did a classification of the various technologies and there are at least four additional significant technologies in 2012. Studies are reviewed which were about the strength of products made in additive manufacturing processes. However, there is still a lot of work and research to be accomplished before additive manufacturing technologies become standard in the manufacturing industry because not every commonly used manufacturing material can be handled. The accuracy needs improvement to eliminate the necessity of a finishing process. The continuous and increasing growth experienced since the early days and the successful results up to the present time allow for optimism that additive manufacturing has a significant place in the future of manufacturing.

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A Review of Additive Manufacturing

With advances in tissue engineering, the possibility of regenerating injured tissue or failing organs has become a realistic prospect for the first time in medical history. Tissue engineering - the combination of bioactive materials with cells to generate engineered constructs that functionally replace lost and/or damaged tissue - is a major strategy to achieve this goal. One facet of tissue engineering is biofabrication, where three-dimensional tissue-like structures composed of biomaterials and cells in a single manufacturing procedure are generated. Cell-laden hydrogels are commonly used in biofabrication and are termed "bioinks". Hydrogels are particularly attractive for biofabrication as they recapitulate several features of the natural extracellular matrix and allow cell encapsulation in a highly hydrated mechanically supportive three-dimensional environment. Additionally, they allow for efficient and homogeneous cell seeding, can provide biologically-relevant chemical and physical signals, and can be formed in various shapes and biomechanical characteristics. However, despite the progress made in modifying hydrogels for enhanced bioactivation, cell survival and tissue formation, little attention has so far been paid to optimize hydrogels for the physico-chemical demands of the biofabrication process. The resulting lack of hydrogel bioinks have been identified as one major hurdle for a more rapid progress of the field. In this review we summarize and focus on the deposition process, the parameters and demands of hydrogels in biofabrication, with special attention to robotic dispensing as an approach that generates constructs of clinically relevant dimensions. We aim to highlight this current lack of effectual hydrogels within biofabrication and initiate new ideas and developments in the design and tailoring of hydrogels. The successful development of a "printable" hydrogel that supports cell adhesion, migration, and differentiation will significantly advance this exciting and promising approach for tissue engineering.

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25th Anniversary Article: Engineering Hydrogels for Biofabrication

3D Bioprinting Human Chondrocytes with Nanocellulose-Alginate Bioink for Cartilage Tissue Engineering Applications

3D bioprinting for engineering complex tissues.

Current advances and future perspectives in extrusion-based bioprinting.

The enhancement of mature vessel formation and cardiac function in infarcted hearts using dual growth factor delivery with self-assembling peptides

Bioprinting is a technology for constructing bioartificial tissue or organs of complex three-dimensional (3-D) structure with high-precision spatial shape forming ability in larger scale than conventional tissue engineering methods and simultaneous multiple components composition ability. It utilizes computer-controlled 3-D printer mechanism or solid free-form fabrication technologies. In this study, sodium alginate hydrogel that can be utilized for large-dimension tissue fabrication with its fast gelation property was studied regarding material-specific printing technique and printing parameters using a multinozzle bioprinting system developed by the authors. A sodium alginate solution was prepared with a concentration of 1% (wt/vol), and 1% CaCl(2) solution was used as cross-linker for the gelation. The two materials were loaded in each of two nozzles in the multinozzle bioprinting system that has a total of four nozzles of which the injection speed can be independently controlled. A 3-D alginate structure was fabricated through layer-by-layer printing. Each layer was formed through two phases of printing, the first phase with the sodium alginate solution and the second phase with the calcium chloride solution, in identical printing pattern and speed condition. The target patterns were lattice shaped with 2-mm spacing and two different line widths. The nozzle moving speed was 6.67 mm/s, and the injection head speed was 10 µm/s. For the two different line widths, two injection needles with inner diameters of 260 and 410 µm were used. The number of layers accumulated was five in this experiment. By varying the nozzle moving speed and the injection speed, various pattern widths could be achieved. The feasibility of sodium alginate hydrogel free-form formation by alternate printing of alginate solution and sodium chloride solution was confirmed in the developed multinozzle bioprinting system.

Sodium alginate hydrogel-based bioprinting using a novel multinozzle bioprinting system.

Laparoscopic surgery, a type of minimally invasive surgery, is used in a variety of clinical surgeries because it has a faster recovery rate and causes less pain. However, in general, the robotic system used in laparoscopic surgery can cause damage to the surgical instruments, organs, or tissues during surgery due to a narrow field of view and operating space, and insufficient tactile feedback. This study proposes real-time models for the detection of surgical instruments during laparoscopic surgery by using a CNN(Convolutional Neural Network). A dataset included information of the 7 surgical tools is used for learning CNN. To track surgical instruments in real time, unified architecture of YOLO apply to the models. So as to evaluate performance of the suggested models, degree of recall and precision is calculated and compared. Finally, we achieve 72.26% mean average precision over our dataset.

Surgical-tools detection based on Convolutional Neural Network in laparoscopic robot-assisted surgery

Hyaluronic acid (170 kDa)-based hydrogel was synthesized using acrylated hyaluronic acid (HA) and matrix metalloproteinase (MMP) sensitive HA-based hydrogels were then prepared by conjugation with two different peptides: cell adhesion peptides containing integrin-binding domains (Arg-Gly-Asp: RGD) and a cross-linker with MMP degradable peptides to mimic the remodeling characteristics of natural extracellular matrices by cell-derived MMPs. Mechanical properties of these hydrogels were evaluated with different weight percentages (2.5 and 3.5 wt %) by measuring elastic modulus, viscous modulus, and swelling ratio. Human mesenchymal stem cells (hMSCs) were then cultured in MMP-sensitive or insensitive HA-based hydrogels and/or immobilized cell adhesive RGD peptides in vitro. Actin staining and image analysis proved that cells cultured in the MMP-sensitive hydrogel with RGD peptides showed extensive cell spreading and sprouting. Gene expression analysis showed that bone specific genes such as alkaline phosphatase, osteocalcin, and osteopontin increased in MMP-sensitive hydrogels as biomolecules such as BMPs and cells were added in the gels. For in vivo calvarial defect regeneration, five different samples (MMP insensitive hydrogel, MMP sensitive hydrogel, MMP sensitive hydrogel with BMP-2, MMP sensitive hydrogel with hMSC, and MMP sensitive hydrogel with BMP-2 and hMSC) were prepared. After 4 weeks of implantation, the Masson-Trichrome staining and micro computed tomography scan results demonstrated that the MMP sensitive hydrogels with BMP-2 and hMSCs have the highest mature bone formation. The MMP sensitive HA-based hydrogel could become useful scaffolds in bone tissue engineering with improvements on tissue remodeling rates and regeneration activity.

Jaesoon Choi

Papers

The enhancement of mature vessel formation and cardiac function in infarcted hearts using dual growth factor delivery with self-assembling peptides

Sodium alginate hydrogel-based bioprinting using a novel multinozzle bioprinting system.

Surgical-tools detection based on Convolutional Neural Network in laparoscopic robot-assisted surgery

In vivo evaluation of MMP sensitive high-molecular weight HA-based hydrogels for bone tissue engineering.

Cellular behavior in micropatterned hydrogels by bioprinting system depended on the cell types and cellular interaction