The rising use of titanium dental implants has increased the prevalence of peri-implant disease that shortens their useful life. A growing view of peri-implant disease suggests that plaque accumulation and microbiome dysbiogenesis trigger a host immune inflammatory response that destroys soft and hard tissues supporting the implant. The incidence of peri-implant disease is difficult to estimate, but with over 3 million implants placed in the USA alone, and the market growing by 500,000 implants/year, such extensive use demands additional interceptive approaches. We report a water-based, nonsurgical approach to address peri-implant disease using a bifunctional peptide film, which can be applied during initial implant placement and later reapplied to existing implants to reduce bacterial growth. Bifunctional peptides are based upon a titanium binding peptide (TiBP) optimally linked by a spacer peptide to an antimicrobial peptide (AMP). We show herein that dental implant surfaces covered with a bifunctional peptide film kill bacteria. Further, using a simple protocol for cleaning implant surfaces fouled by bacteria, the surface can be effectively recoated with TiBP-AMP to regain an antimicrobial state. Fouling, cleansing, and rebinding was confirmed for up to four cycles with minimal loss of binding efficacy. After fouling, rebinding with a water-based peptide film extends control over the oral microbiome composition, providing a novel nonsurgical treatment for dental implants.

Skin wounds often form scar tissue during healing. Early intervention with tissue-engineered materials and cell therapies may promote scar-free healing. Exosomes and extracellular vesicles (EV) secreted by mesenchymal stromal cells (MSC) are believed to have high regenerative capacity. EV bioactivity is preserved after lyophilization and storage to enable use in remote and typically resource-constrained environments. We developed a bioprinted bandage containing reconstituted EVs that can be fabricated at the point-of-need. An alginate/carboxymethyl cellulose (CMC) biomaterial ink was prepared, and printability and mechanical properties were assessed with rheology and compression testing. Three-dimensional printed constructs were evaluated for Young’s modulus relative to infill density and crosslinking to yield material with stiffness suitable for use as a wound dressing. We purified EVs from human MSC-conditioned media and characterized them with nanoparticle tracking analysis and mass spectroscopy, which gave a peak size of 118 nm and identification of known EV proteins. Fluorescently labeled EVs were mixed to form bio-ink and bioprinted to characterize EV release. EV bandages were bioprinted on both a commercial laboratory bioprinter and a custom ruggedized 3D printer with bioprinting capabilities, and lyophilized EVs, biomaterial ink, and thermoplastic filament were deployed to an austere Arctic environment and bioprinted. This work demonstrates that EVs can be bioprinted with an alginate/CMC hydrogel and released over time when in contact with a skin-like substitute. The technology is suitable for operational medical applications, notably in resource-limited locations, including large-scale natural disasters, humanitarian crises, and combat zones.

Medical response to military conflicts, natural disasters, and humanitarian crises are challenged by operational logistics with unreliable supply chains, delayed medical evacuation, and compatibility of the disparate medical equipment and consumables. In these environments, stocks of supplies will become more quickly depleted and the need for equipment parts increases secondary to their higher likelihood for failure from overuse. Additive Manufacturing (AM), or 3D printing, at or closer to the point-of-need provides potential solutions to mitigate these logistics challenges. AM’s ability to tailor the resultant product through computer design enables real-time modification of a product to meet a specific situation. In this study, we deployed two different 3D printers to an arctic locale to demonstrate the utility of 3D printing and bioprinting in austere environments. Deployment of AM solutions in austere environments will likely impact medical care following natural disasters and conflicts with contested logistics. The work presented here furthers the readiness status of AM for use in austere environments to manufacture medical equipment parts and demonstrates its potential use for tissue engineering and advanced medical treatments in remote environments.

Ocular chemical injuries are common in operational military medicine and enhanced by the threat of chemical warfare. The key to minimising ocular damage and visual impairment is rapid initiation of sustained irrigation.1 The Morgan Lens system (MorTan, Missoula, Montana, USA) is a widely used device that connects an intravenous bag of irrigation fluid to contact lens-like inserts that rest on the eye. Use of the Morgan Lens in austere environments is not always practical as intravenous bags may not be available. However, plastic water bottles are often available, and water is an acceptable substitute for eye irrigation in emergency situations. Directly pouring water on an injured eye, while possible, does not provide the same prolonged irrigation as the Morgan Lens. We developed a universal adapter that enables prolonged ocular irrigation using bottled water in conjunction with a Morgan Lens.

Bioengineered dermal–epidermal composites (DECs) have demonstrated promise initiating skin regeneration and hair follicle neogenesis after injury. DECs in our work comprise a collagen matrix embedded with human dermal papilla cells (HDPCs) overlaid with human keratinocytes. HDPCs, as three-dimensional spheroids, enhance hair follicle formation, working in tandem with keratinocytes. Herein, 3D printed stamped PDMS microwell arrays were used as a strategy for spatially patterning dermal papilla spheroids in the dermal components of the DEC. DECs were transferred to cell culture media for 5 days followed by air–liquid interface culture for 2 days. Spheroid diameter, cell viability, and qPCR gene expression analyses were conducted. DECs were surgically grafted on immunocompromised mice, and healing was followed for 10 weeks. HDPCs cultured in the microwell arrays formed patterned viable spheroids and successfully transferred to the collagen dermal matrix. RNA analysis using qPCR showed upregulation of key HDPC markers (VCAN and BMP6) in DC microwell patterned HDPC spheroids compared to monolayers. This work represents a novel 3D printing strategy optimizing designing patterned HDPC spheroids in the extracellular matrix to regenerate functional human skin instead of scar tissue after injury.