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International Journal of Bioprinting 3D printing innovations against infection

procedures and minimizes postoperative complications. blood, potentially resulting in fever, chest pain, and even
Sonaye et al. developed a patient-specific 3D-printed cardiac arrhythmia, necessitating urgent intervention.
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PEEK dental implant system, utilizing fused filament The application of 3D-printed antimicrobial materials
fabrication (FFF) at high temperatures to create robust, represents the latest innovations in the field of medical
patient-specific PEEK dental implants with high print engineering, offering novel solutions for the treatment
resolution. The results indicated that the 3D-printed dental of cardiac diseases. By custom-designing cardiovascular
implants exhibited commendable fatigue properties, devices, such as stents and valves, and coating the
meeting the clinical and industrial requirements for dental surface of the devices with antimicrobial materials, it
implants. In addition, graphene-based materials, including becomes possible to significantly enhance the precision,
reduced graphene oxide, graphene oxide, and graphene adaptability, and long-term outcomes of treatment. This
nanosheets, are widely embraced in the dental field due to technological innovation is expected to effectively impede
their commendable biocompatibility and high electrical biofilm formation, thereby reducing the risk of infection,
conductivity. Aati et al. 184 improved oral restorative and further improving surgical outcomes, particularly in
materials by incorporating graphene nanoparticles (GNPs) cardiovascular device implantation (Table 4).
into 3D-printed resins. The inclusion of GNPs notably Currently, thrombosis following cardiovascular stent
augmented flexural strength at lower concentrations, implantation stands as a primary cause for the failure of
while higher concentrations contributed to improved the implantation, attributed to delayed endothelialization
hardness and elasticity. Remarkably, the modification of the stent, excessive proliferation of vascular smooth
process exhibited no adverse effects on biocompatibility muscle cells, and inflammatory responses. Therefore,
and demonstrated significant antimicrobial activity,
particularly in reducing the activity of Candida albicans beyond anticoagulation measures and the promotion
(Figure 7D). of endothelialization, functional modification of the
stent is crucial to enhance its anti-inflammatory and
In summary, 3D-printed antimicrobial materials play anti-thrombotic capabilities. Wang et al. achieved
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a crucial role in the treatment of dental diseases and the a significant breakthrough by successfully fabricating
maintenance of oral health. They effectively mitigate polyurethane (PU) vascular scaffolds through 3D
infection risks, improve treatment outcomes, and provide printing technology. These scaffolds were coated with zein
hygienic, personalized solutions that enhance the overall nanospheres nanorods carrying zinc oxide NPs and heparin,
patient experience. This technology introduces innovation resulting in tailored release kinetics. In vitro experiments
to the field of oral healthcare and is poised to further demonstrated the remarkable inhibitory effects of these
advance oral health. functional PU scaffolds against both E. coli and S. aureus.
Validated through a rabbit subcutaneous infection model,
4.5. Innovative 3D-printed cardiovascular implants the functional PU stent effectively reduced infection at the
Cardiovascular implants, such as cardiac stents and valves,
often lead to the accumulation of platelets and fibrin implantation site, showcasing a significantly lower count of
at the suture sites and on the devices. This provides an S. aureus compared to the bare PU stent group.
ideal environment for microorganisms such as S. aureus, Moreover, the incorporation of localized controlled
Streptococcus spp., Gram-negative bacilli, Candida, drug-release systems into cardiovascular implants
Enterococcus, and bifidobacterium-like organisms to emerges as an effective strategy to mitigate inflammation
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colonize and form biofilms. This process can cause occurrences in grafts or stents. For instance, the successful
localized inflammation and a hypercoagulable state of the loading of silver NPs and antibiotics onto vascular grafts

Table 4. Summary of 3D-printed antimicrobial implants for cardiovascular materials and hernia meshes

Device Author Benefits Materials 3D printer Ref.
Good cytocompatibility, anticoagulant
Wang et al. Polyurethane vascular scaffolds 3D inkjet 187
Cardiovascular response and antimicrobial activity
implants
Kabirian et al. Good antibacterial function Small diameter vascular grafts 3D design 188
Good bactericidal action and Polycaprolactone mesh with
Calero et al. histopathological behavior alginate and gentamicin 3D inkjet 181
Hernia meshes
Olmos-Juste et al. Good flexibility, elasticity, and Mesh loaded with alginate and 3D inkjet 86
antimicrobial properties waterborne polyurethane

Volume 10 Issue 4 (2024) 142 doi: 10.36922/ijb.2338