3D printing technology to control BMP-2 and VEGF delivery spatially and temporally to promote large-volume bone regeneration.

When large engineered tissue structures are used to achieve tissue regeneration, formation of vasculature is an essential process. We report a technique that combines 3D printing with spatial and temporal control of dual growth factors to prevascularize bone tissue. Human dental pulp stem cells (DPSCs) that have both osteogenic and vasculogenic potential were printed with bone morphogenetic protein-2 (BMP-2) in the peripheral zone of the 3D printed construct, and with the vascular endothelial growth factor (VEGF) in the central zone, in which a hypoxic area forms. The structure was implanted in the back of a mouse and tissue regeneration was assessed after 28 d. Microvessels were newly formed in the hypoxic area of the printed large volume structure, and angiogenesis from the host tissue was also observed. Bone regeneration was faster in prevascularized structures than in nonvascularized structures. The 3D-printed prevascularized structure could be a promising approach to overcome the size limitation of tissue implants and to enhance bone regeneration.