THREE-DIMENSIONAL SHAPE CONTROL OF IMPLANT DEVICES - Intelligent Scaffolds for Tissue Engineering and Regenerative Medicine - page 586

relativelyspeedyunionmayhaveoccurredforthefollowingreasons.
First, the inkjet-printed custom-made artificial bones had superior
dimensional compatibility, which might have helped facilitate bone
regeneration from host tissues by bringing them in close proxim-
ity to the inkjet-printed custom-made artificial bones. Second, the
inkjet-printed custom-made artificial bones were not sintered and
therefore likely had better biodegradability, enhancing bone for-
mation. Third, the inkjet-printed custom-made artificial bones had
macroscopic pores, which might have helped facilitate cell and
blood vessel invasions. All the patients were satisfied with aes-
thetic facial appearance. Based on these findings, a large-scale clin-
ical trial of the inkjet-printed custom-made artificial bones is now
underway.
29.5 Conclusions and Outlook
By controlling the 3D shape of the scaffolds, we succeeded in dra-
matically improving the performance of the artificial bones. Using
the growth factors and cells is interesting and eye catching; how-
ever, it is extremely expensive, is associated with various risks that
cannot be ignored, and is therefore far from clinical applications.
Before thinking of combining the scaffolds with the growth factors
and cells, we should seriously ask ourselves whether there may be
anything left to be done on the scaffolds themselves. In my opinion,
there appears to be much room for improvement of the 3D shape
control of the scaffolds. If such improvement is done, much of the
problem will be solved for a large number of the patients, bringing
usclosertotherealizationoftissueengineering/regenerativemedi-
cine in clinical settings. For the minority of the patients who need
more regeneration inductivity, they will be treated in combination
withthegrowthfactors,andifitisunsuccessful,thetreatmentusing
exogenous cells will be finally considered. In order to achieve suc-
cess in real clinical settings, we find it crucial to structure the treat-
mentstrategystepwisefromtheeasiestandinexpensivetowardthe
most di cult and expensive.
Using the same principle, we have started improving the
performance of granule-type artificial bones. The conventional