RESOURCES

Abstract
Additive manufacturing, popularly known as “3D printing”, enables us to fabricate advanced scaffolds and cell-scaffold constructs for tissue engineering. 4D printing makes dynamic scaffolds for human tissue regeneration, while bioprinting involves living cells for constructing cell-laden structures. However, 3D/4D printing and bioprinting have limitations. This article provides an up-to-date review of 3D/4D printing and bioprinting in tissue engineering. Based on 3D/4D printing, 5D printing is conceptualized and explained. In 5D printing, information as the fifth dimension in addition to 3D space and time is embedded in printed structures and can be subsequently delivered, causing change/changes of the environment of 5D printed objects. Unlike 3D/4D printing that makes passive/inactive products, 5D printing produces active or intelligent products that interact with the environments and cause their positive changes. Finally, the application of 5D printing in tissue engineering is illustrated by our recent work. 3D/4D/5D printing and bioprinting are powerful manufacturing platforms for tissue engineering.

Abstract
Complex bony defects such as those of the orbital floor are challenging to repair. Additive manufacturing techniques open up possibilities for the fabrication of implants with a designed macro-porosity for the reconstruction of such defects. Apart from a designed macro-porosity for tissue ingrowth, a micro-porosity in the implant struts will be beneficial for nutrient diffusion, protein adsorption and drug loading and release. In this work, we report on a low-temperature extrusion-based additive manufacturing method for the preparation of composite photo-crosslinked structures of poly(trimethylene carbonate) with bone-forming nano-hydroxyapatite and noricaritin (derived from bone growth stimulating icariin). In this method, we extrude a dispersion of nano-hydroxyapatite and noricaritin particles in a solution of photo-crosslinkable poly(trimethylene carbonate) in ethylene carbonate into defined three-dimensional structures. The ethylene carbonate is subsequently crystallized and extracted after photo-crosslinking. We show that this results in designed macro-porous structures with micro-pores in the struts. The dispersion used to fabricate these structures shows favorable properties for extrusion-based processing, such as a sharp crystallization response and shear thinning. The formed photo-crosslinked materials have a micro-porosity of up to 48%, and the E modulus, ultimate tensile strength and toughness are in excess of 24 MPa, 2.0 N/mm2 and 113 N/mm2 respectively. A sustained release of noricaritin from these materials was also achieved. The results show that the technique described here is promising for the fabrication of micro-porous photo-crosslinked composite structures of poly(trimethylene carbonate) with nano-hydroxyapatite and that these may be applied in the reconstruction of orbital floor defects. Copyright © 2016 John Wiley & Sons, Ltd.