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Comparative evaluation of Bone Tissue Regeneration Using 4D-Printed PLMC-Tricalcium Phosphate Scaffolds and PRF with Bone Graft: A Controlled Study in Animals
ABSTRACT
Background:
The handling of extensive periapical and bone defects continues to present difficulties in endodontic surgical procedures because patients who need treatment show limited capacity for bone growth. Research studies have investigated regenerative methods that use biomaterials to improve bone healing. The common practice of using platelet-rich fibrin (PRF) with bone grafts faces challenges due to its low mechanical strength, poor ability to maintain volume, and unpredictable tissue regeneration results. The progress made in both biodegradable polymers and four-dimensional (4D) printing technologies has resulted in the creation of intelligent scaffolds that deliver structural support and biological signalling, and responsive behaviour to treatment areas.
Objective:
Primary objective of this study is to evaluate bone regeneration potential of PLMC- Tricalcium Phosphate and PRF by X-ray imaging and Micro-CT analysis in experimental animals.
Methods:
The process will include surgical creation of standardised cranial bone defects, which will serve as study groups and control groups for their research. The study group will receive a 4D-printed PLMC [Poly(methyl lactate-co-caprolactone)] -TCP (Tricalcium-Phosphate) scaffold, while the control group will be treated with PRF combined with bone graft material. Healing outcomes will be assessed at predetermined time intervals using radiographic, histological, and histomorphometric analyses to evaluate new bone formation, scaffold integration, and tissue response.
Results:
The 4D-printed PLMC-TCP scaffold is expected to demonstrate enhanced bone regeneration, characterised by increased new bone formation, improved structural organisation, and favourable scaffold–bone integration, compared with the PRF and bone graft groups. Histological analysis is expected to reveal minimal inflammatory response and progressive scaffold degradation accompanied by bone tissue ingrowth, indicating good biocompatibility. In contrast, PRF with bone graft is expected to show variable bone fill and less predictable structural maturation.
Conclusions:
The regenerative ability of the 4D-printed PLMC-TCP scaffold is expected to be higher when compared to the regenerative ability of PRF and bone grafting. This material is expected to be effective in the process of providing a scaffold for the healing of the bone in endodontic surgical procedures. Clinical Trial: This in-vivo study is approved by the Institutional Animal Ethics Committee of Datta Meghe Institute of Higher Education and Research, Wardha. (DMIHER/IAEC/2025-26/93)
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