Figure 1.
The flow diagram showed the design of electron beam melting (EBM) porous Ti6Al4V implant with CAD for repair of mandibular bone defect:
(1) acquisition of the CT data of the patients; (2) design with CAD and fabrication of custom EBM porous titanium implant; (3) implantation of the patient specific porous implant; (4) reconstruction of the bone defect.
Figure 2.
Characterization of porous Ti6Al4V samples.
(A) Porous Ti6Al4V implants fabricated by electron beam melting process. (B) Reconstructed 3D micro-CT image of the porous implant with honey-like structure. SEM images of porous Ti6Al4V samples with (C) honeycomb-like structure, (D) orthogonal structure, (E) layer structure.
Figure 3.
Digital topographic images of the sample surface.
The images exhibited a rough anisotropic surface with the roughness Ra values of the (A) top and (B) lateral surfaces being in the range of 5–10 and 15–21 µm.
Table 1.
Geometric characteristics and mechanical properties of porous titanium samples.
Figure 4.
Characterization of porous titanium with biomimetic coating.
(A) SEM image of the precipitate on sample surfaces soaked in SBF for 14 days. (B). TF-XRD pattern of the sample surface after alkali-heat treatment and subsequently immersion in SBF for 14 days. (C) FTIR spectra of chemically pretreated Ti6Al4V samples soaked in SBF for 14 days.
Figure 5.
SEM morphologies of cells on porous titanium samples after 14 days of culture.
A great number of osteoblasts attached to the (A–B) pure porous titanium scaffolds and (C–D) porous titanium scaffolds with biomimetic coating, and presented an elongated morphology with cytoplasmic extensions on scaffolds. There were no obvious differences in cell adhesion and morphology between the uncoated and coated samples.
Figure 6.
H&E stained sections of sample after 14 days of in vitro culture.
Large amount of extracellular matrix deposited among the cells, and some cells migrated into the inner pore of both (A–B) uncoated and (C–D) coated samples.
Figure 7.
Cell viability of the sample over 14 days of in vitro culture.
The cells on the porous titanium exerted a high and sustained proliferation rate within 14 days, and no significant difference was observed between the uncoated and coated samples at each timepoint (P>0.05). TiI, pure porous titanium implant; TiC, porous titanium implant with biomimetic coating.
Figure 8.
Fluorochrome labeling of bone regeneration at 12 weeks post-surgery.
The fluorescent labeling indicated that abundant new bone growth into the porous titanium and continuous process of bone remodeling in both (A–B) uncoated and (C–D) coated samples. (E) The rate of bone mineralization apposition was similar in these two kinds of porous titanium at 12 weeks post-surgery (P>0.05). TiI, pure porous titanium implant; TiC, porous titanium implant with biomimetic coating.
Figure 9.
Histological staining for osteogenesis within porous titanium after implantation for 4, 8 and 12 weeks.
The images showed that the rapid increase of bone ingrowth into the pores of titanium throughout the experiment and close contact between bone tissue and EBM implants at 12 weeks post-surgery, while there were no obvious differences between the uncoated and coated samples at each timepoint. TiI, pure porous titanium implant; TiC, porous titanium implant with biomimetic coating.
Figure 10.
Histomorphometric analysis of new bone formation.
The data showed a high percentage of newly formed bone in the defect region in both coated and uncoated implants during the whole experiment (P>0.05). TiI, pure porous titanium implant; TiC, porous titanium implant with biomimetic coating.