Abstract
Critical-size bone defects are a common clinical problem. The golden standard to treat these defects is autologous bone grafting. Besides the limitations of availability and co-morbidity, autografts have to be manually adapted to fit in the defect, which might result in a sub-optimal fit and impaired healing. Scaffolds with precise dimensions can be created using 3-dimensional (3D) printing, enabling the production of patient-specific, 'tailor-made' bone substitutes with an exact fit. Calcium phosphate (CaP) is a popular material for bone tissue engineering due to its biocompatibility, osteoconductivity, and biodegradable properties. To enhance bone formation, a bioactive 3D-printed CaP scaffold can be created by combining the printed CaP scaffold with biological components such as growth factors and cytokines, e.g., vascular endothelial growth factor (VEGF), bone morphogenetic protein-2 (BMP-2), and interleukin-6 (IL-6). However, the 3D-printing of CaP with a biological component is challenging since production techniques often use high temperatures or aggressive chemicals, which hinders/inactivates the bioactivity of the incorporated biological components. Therefore, in our laboratory, we routinely perform extrusion-based 3D-printing with a biological binder at room temperature to create porous scaffolds for bone healing. In this method paper, we describe in detail a 3D-printing procedure for CaP paste with K-carrageenan as a biological binder.