Three-Dimensional Printing Constructs Based on the Chitosan for Tissue Regeneration: State of the Art, Developing Directions and Prospect Trends

Abstract

Chitosan (CS) has gained particular attention in biomedical applications due to its biocompatibility, antibacterial feature, and biodegradability. Hence, many studies have focused on the manufacturing of CS films, scaffolds, particulate, and inks via different production methods. Nowadays, with the possibility of the precise adjustment of porosity size and shape, fiber size, suitable interconnectivity of pores, and creation of patient-specific constructs, 3D printing has overcome the limitations of many traditional manufacturing methods. Therefore, the fabrication of 3D printed CS scaffolds can lead to promising advances in tissue engineering and regenerative medicine. A review of additive manufacturing types, CS-based printed constructs, their usages as biomaterials, advantages, and drawbacks can open doors to optimize CS-based constructions for biomedical applications. The latest technological issues and upcoming capabilities of 3D printing with CS-based biopolymers for different applications are also discussed. This review article will act as a roadmap aiming to investigate chitosan as a new feedstock concerning various 3D printing approaches which may be employed in biomedical fields. In fact, the combination of 3D printing and CS-based biopolymers is extremely appealing particularly with regard to certain clinical purposes. Complications of 3D printing coupled with the challenges associated with materials should be recognized to help make this method feasible for wider clinical requirements. This strategy is currently gaining substantial attention in terms of several industrial biomedical products. In this review, the key 3D printing approaches along with revealing historical background are initially presented, and ultimately, the applications of different 3D printing techniques for fabricating chitosan constructs will be discussed. The recognition of essential complications and technical problems related to numerous 3D printing techniques and CS-based biopolymer choices according to clinical requirements is crucial. A comprehensive investigation will be required to encounter those challenges and to completely understand the possibilities of 3D printing in the foreseeable future.

Keywords: 3D printing; bio-inks; biomedical applications; chitosan; drug delivery; fabrication process; scaffolds; tissue engineering.

Figure 1

Suitable chitosan features for biomedical application.

Figure 2

3D printing methods historical background.

Figure 3

Various applications of 3D printed chitosan constructs.

Figure 4

Various types of printing methods (a) Stereo-lithography, (b) Powder Bed Fusion, (c) Binder Jetting, (d) Sheet Lamination, (e) Directed Energy Deposition, (f) Material Extrusion and (g) Material jetting [18,19,21].

Figure 5

Schematic representation of the preparation process of the scaffolds [86].

Figure 6

Soft tissue application of printed chitosan based constructs, (a) Schematic representation of hNSCc-laden AL-CMC-Ag bioink printing for nerve regeneration application, (b) Chitosan-gelatin preparation and cross-link process, (c) CS and PEC interactions to achieve wound dressing with a capacity of lidocaine delivery and (d) Starfish and leaf printed using chitosan ink referring to printability of chitosan ink at room temperature [121,123,138,155].

Figure 7

Challenges and solutions to overcome for chitosan 3D printed constructs.