Computer-aided approach for customized cell-based defect reconstruction.

Computer-aided technologies like computer-aided design (CAD), computer-aided manufacturing (CAM), and a lot of other features like finite element method (FEM) have been recently employed for use in medical ways like in extracorporeal bone tissue engineering strategies. Aim of this pilot experimental study was to test whether autologous osteoblast-like cells cultured in vitro on individualized scaffolds can be used to support bone regeneration in a clinical environment. Mandibular bone defects were surgically introduced into the mandibles of Göttinger minipigs and the scaffold of the defect site was modelled by CAD/CAM techniques. From the minipigs harvested autologous bone cells from the porcine calvaria were cultivated in bioreactors. The cultured osteoblast-like cells were seeded on polylactic acid/polyglycolic acid (PLA/PGA) copolymer scaffolds being generated by rapid prototyping. The bone defects were then reconstructed by implanting these tissue-constructs into bone defects. The postoperative computerized topographic scans as well as the intraoperative sites demonstrated the accurate fit in the defect sites. The individual created, implanted scaffold constructs enriched with the porcine osteoblast-like cells were well tolerated and appeared to support bone formation, as revealed by immunohistochemical and histological analyses. The results of this investigations indicated that the in vitro expanded osteoblast-like cells spread on a resorbable individualized, computer-aided fabricated scaffold is capable of promoting the repair of bone tissue defects in vivo. The shown results warrant further attempts to combine computer modelling and tissue engineering for use in different ways in bone reconstructive surgery.