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Currently considered the gold standard of cranio-maxillofacial (CMF) bone defect treatments, transplantation of harvested autologous grafts is hindered by complex grafting procedures, donor site morbidity and limited availability1. A particular difficulty is shaping and fixing the rigid autograft tightly into the defect in order to obtain osseointegration and to prevent graft resorption. Tissue engineering has been investigated as an alternative strategy to autografting and synthetic bone substitutes (e.g. bone cement)2,3. Critical to the success of a tissue engineering approach is a scaffold with a specific set of properties. First, in order to achieve osseointegration, the scaffold must form close contact with adjacent bone tissue4. The scaffold should also be osteoconductive, permitting cell migration, nutrient diffusion and neotissue deposition4,5. This behavior is generally achieved with biodegradable scaffolds exhibiting a highly interconnected pore morphology. Lastly, the scaffold should be bioactive so as to promote integration and bonding with surrounding bone tissue5.
Here, we present a protocol to prepare a tissue engineering scaffold with these properties. Importantly, this scaffold exhibits the ability to “self-fit” into irregular CMF defects due to its shape memory behavior6. Thermoresponsive shape memory polymers (SMPs) are known to undergo shape change upon exposure to heat7,8. SMPs are comprised of “netpoints” (i.e. chemical or physical crosslinks) which determine the permanent shape and “switching segments” which maintain the temporary shape and recover the permanent shape. The switching segments exhibit a thermal transition temperature (Ttrans) corresponding to either the glass transition (Tg) or melt transition (Tm) of the polymer. As a result, SMPs may be sequentially deformed into a temporary shape at T > Ttrans, fixed in the temporary shape at T < Ttrans, and recovered to the permanent shape at T > Ttrans. Thus, an SMP scaffold could achieve “self-fitting” within a CMF defect as follows6. After exposure to warm saline (T > Ttrans), an SMP scaffold would become malleable, permitting a generically prepared cylindrical scaffold to be hand-pressed into an irregular defect, with shape recovery promoting expansion of the scaffold to the defect boundary. Upon cooling (T < Ttrans), the scaffold would return to its relatively more rigid state, with shape fixity maintaining its new temporary shape within the defect. In this protocol, an SMP scaffold is prepared from polycaprolactone (PCL), a biodegradable polymer studied extensively for tissue regeneration and other biomedical applications9-11. For shape memory, the Tm of PCL serves as the Ttrans and varies between 43 and 60 ºC, depending on the molecular weight of the PCL12. In this protocol, the Ttrans (i.e. Tm) of the scaffold is 56.6±0.3 ºC6.
In order to achieve osteoconductivity, a protocol was developed to make PCL-based SMP scaffolds with highly interconnected pores based on a solvent-casting particulate-leaching (SCPL) method6,13,14. Polycaprolactone diacrylate (PCL-DA) (Mn = ~10,000 g/mol) was utilized to permit rapid, photochemical crosslinking and was dissolved in dichloromethane (DCM) to allow solvent-casting over the salt template. Following photochemical cure and solvent evaporation, the salt template was removed by leaching into water. The average salt size regulates scaffold pore size. Importantly, the salt template was fused with water prior to solvent-casting to achieve pore interconnectivity.
Bioactivity was imparted to the SMP scaffold by the in situ formation of a polydopamine coating onto pore walls6. Bioactivity is often introduced into scaffolds by the inclusion of glass or glass-ceramic fillers15. However, these may give rise to unwanted brittle mechanical properties. Dopamine has been shown to form an adherent, thin polydopamine layer on a variety of substrates16-19. In this protocol, the SMP scaffold was subjected to a slightly basic solution (pH = 8.5) of dopamine to form a nanothick coating of polydopamine on all pore wall surfaces6. In addition to enhancing surface hydrophilicity for improved cell adhesion and spreading, polydopamine has been shown to be bioactive in terms of formation of hydroxyapatite (HAp) upon exposure to simulated body fluid (SBF)18,20,21. In a last step, the coated scaffold is exposed to heat treatment at 85 ºC (T > Ttrans) which leads to scaffold densification. Heat treatment was previously noted to be essential for scaffold shape memory behavior, perhaps due to PCL crystalline domains reorganizing to closer proximity14.
We additionally describe the methods to characterize the self-fitting behavior within an irregular model defect, shape memory behavior in terms strain-controlled cyclic-thermal mechanical compression tests (i.e. shape recovery and shape fixity), pore morphology, and in vitro bioactivity. Strategies to tailor scaffold properties are also presented.