This paper describes in detail the design, fabrication, clinical trial evaluation and post clinical application analysis of 3D-printed bone implants made from the nHAp@PLDLLA [nanohydroxyapatite; poly( l -lactide- co - d , l -lactide)] biomaterial.

Biodegradable craniofacial and cranial implants are a new aspect in terms of reducing potential complications, especially in the long term after surgery. They are also an important contribution in the field of surgical reconstructions for children, for whom it is important to restore natural bone in a relatively short time, due to the continuous growth of bones. The aim of this study was to verify the impact of the technology on biodegradability and to estimate the risk of inappropriate implant resorption time, which is an important aspect necessary to select prototypes of implants for in vivo testing. Prototypes of implants were made using two technologies: 3D printing using a PLDLA: poly(L-co-D,L lactide) (PLDLA) filament containing hydroxyapatite nanoparticles, and injection using PLDLA. After the radiation sterilization process, they were subjected to in vitro degradation under accelerated conditions. As part of this study, the in vitro degradation of newly developed biodegradable implant technologies was assessed in accordance with the guidelines of European standards. It was found that the implant manufacturing process had a significant impact on the degradation time under simulated conditions in various media. Implants made using the injection technique were characterized by lower susceptibility to degradation media compared to the 3D-printed implant under accelerated conditions.

Herein, a chitosan-based thermosensitive hydrogel (CH) containing hydroxyapatite (HAp), poly(lactic acid) (PLDLLA) or their mixture is proposed as an innovative, biomimetic composition with antimicrobial and bone-forming properties for guided bone regeneration. The modified hydrogels were synthesized and characterized to verify their suitability for the treatment of periodontitis periapicalis chronica. Compared to the unmodified hydrogel, both CH_HAp and CH_PLDLLA revealed improved mechanical properties, as evidenced by rotational rheology. FTIR analysis proved that no chemical interplay existed between the components. All the tested samples displayed no cytotoxicity against osteoblast-like cell culture and confirmed antimicrobial features, both crucial from an application perspective. Radiation sterilization dosage was tailored for the tested samples to maintain sterility for a minimum of 8 weeks of storage and limit crosslinking of the samples. Finally, the hydrogel was used in a clinical trial to treat a patient with chronic inflammation of periapical tissues in teeth 26 and 27. The medical procedure proved the safety, nontoxicity, non-allergenicity, and, most importantly, bone-forming properties of the hydrogel formulation. The kinetics of new bone formation was analyzed in-depth using graphical cross-sections of anatomical structures obtained from pre- and post-operative CBCT scans.

The main purpose of the article is to describe the methodology used for multi-criteria optimization of the geometric features of the orthopedic implant used for the reconstruction of the anterior cruciate ligament located in the knee joint. The methodology includes: 1. Method of development of the bones of the knee joint model; 2. Method of multi-criteria optimization of the geometric features of the orthopedic implant using an artificial immune system, the objective function and the Pareto front; 3. Expert evaluation method based on forms. The work confirmed that the assumed thesis, a multi-criteria optimization using an artificial immune system, which is a specially defined objective function, and the Pareto method, which allows to determine the geometrical features of the implant, will lead to fulfill optimal blood perfusion and sufficient strength properties of the implant simultaneously. We conclude that the described methodology allowed to achieve the optimal geometrical features of the orthopedic implant used for reconstruction of the anterior cruciate ligament located in the knee joint.