Journal of Physics: Conference Series

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Porosity and compressive strength of PLA-based scaffold coated with

hydroxyapatite-gelatin to reconstruct mandibula: a literature review
To cite this article: S A Reina et al 2021 J. Phys.: Conf. Ser. 1816 012085

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The 10th International Conference on Theoretical and Applied Physics (ICTAP2020) IOP Publishing
Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

Porosity and compressive strength of PLA-based scaffold

coated with hydroxyapatite-gelatin to reconstruct mandibula:
a literature review

S A Reina1, B J E Tito1, M H Malini1, F G Iqrimatien1, E Sa’diyah1 and

Aminatun1
1
Department of Physics, Faculty of Science and Technology, Universitas Airlangga,
Jl. Mulyorejo, Kampus C, Surabaya 60115 Indonesia

E-mail: [email protected]

Abstract. Ameloblastoma is one of odontogenic tumours that is classified as benign,

aggressive, and destructive. Mandibular tumours potentially cause bone disruption or damage,
so it is necessary to do a resection to remove the infected part. Treatment done by resection
may cause defects starting from the gap in the alveolar bone to the discontinuity of the
mandible. Thus, it is necessary to reconstruct the mandible using a scaffold. Scaffold is made
by using the PLA 3D-printing with the Fused Deposition Modelling (FDM) method. PLA is
non-bioactive and hydrophobic, so the surface needs to be modified by coating PLA with
hydroxyapatite (HA) and gelatine. This article aims to examine the effect of PLA surface
modification using HA-Gelatine through a review article. The searching strategy for articles is
by using databases of internationally reputable journals with certain keywords. From the
search, journals were obtained (with status Q3, Q2 and Q1) as reference journals in this review.
Literature review shows that the addition of hydroxyapatite can improve the bioactive
properties of PLA, while the addition of gelatine can increase its hydrophilicity properties.
Therefore, HA-Gelatin coating on 3D PLA has the potential to be used as a scaffold for
mandibular reconstruction.

1. Introduction
Many cases of bone damage are caused by diseases, especially tumors in the mandible.
Ameloblastoma is a benign odontogenic tumor originating from epithelial remnants during tooth
formation. There were 31 cases of ameloblastoma of various subtypes reported. Of these cases,
90.32% occurred in the mandible, while 9.67% occurred in the maxilla [1]. Mandibular tumors have
the potential to cause bone destruction and require resection to remove the infected part. This results in
defects ranging from gaps in the alveolar bone to mandibular bone discontinuity [2]. As a result of this
resection it is necessary to reconstruct the mandible.
One of the replacement materials for mandibular reconstruction that is being developed is the
scaffold. The scaffold is biodegradable, so that it is replaced by osteoblast cells that attach to the
scaffold [3]. Scaffold manufacture must be precise and consistent with regard to porosity, pore size,
pore distribution and interconnectivity between pores [4]. The way to make scaffold is by using
conventional techniques or depending on the process and design. Conventional techniques have
limitations in controlling pore size, pore geometry, interconnection between pores, pore distribution

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The 10th International Conference on Theoretical and Applied Physics (ICTAP2020) IOP Publishing
Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

and construction of internal scaffold channels [5]. Making scaffold in accordance with these criteria
can be done by using 3D-printing technology.
3D-printing is one of the latest innovation that offers solutions for creating three-dimensional
objects with various desired shapes. In medical aplications, 3D-printing helps to make replicas of
human body parts, as is being developed, namely the manufacture of scaffold. Sophisticated
techniques that are alternative in controlling the scaffold design include Fused Deposition Modeling
(FDM), which is a method of melting thermoplastic material using an extruder mechanism. The FDM
method has the feasibility of making scaffold directly and is a high-precision technique [6].
Materials that are often used in 3D-printing with the FDM method generally come from a
thermoplastic polymer material, the type of Polylactic Acid (PLA). PLA is biodegradable and
biocompatible so that this material has many applications in the medical world such as tissue
regeneration, healing of fractures and surgical threads. However, PLA has non-bioactive and
hydrophobic properties so that a coating is needed to support the scaffold properties in the body [7].
Material which hydroxyapatite and gelatin can be used to improve the properties of PLA.
Hydroxypatite (HA) with the chemical formula Ca10 (PO4)6(OH)2 is one of the compounds that
make up hard tissue in the human body such as bones, teeth, and etc [8]. HA has biocompatible,
bioactive, and osteoconductive properties. However, the weakness is that it is brittle and less elastic so
it is necessary to add gelatin (C102H151N31). Gelatin has hydrophilic properties (contact angle 47.3o) so
that it can improve PLA properties [9]. Gelatin plays a role in migration, mineralization, and can
increase cell adhesion [10]. Gelatin is often composited with hydroxyapatite because it can improve
mechanical properties and is able to stick and fill the pores of hydroxyapatite so that the resulting
matrix becomes stronger [11].
Based on this background, in this article the authors conducted a literature review from various
reputable international journals to determine the effect of surface modification of PLA scaffold using
hydroxyapatite-gelatin material. Literature review is carried out by comparing various properties such
as porosity and mechanical properties from internationally reputed journals. The results of this
narrative review are expected to add insight and can become a theoretical reference for further
research in the development of scaffold as a material for mandibular reconstruction.

2. Method
This research was conducted through a literature review. The literature review provides a framework
related to new findings and previous finding to identify indications of progress of the results of a study
through comprehensive research and interpretation of literature related to particular topic. The articles
that used in literature review are focused on original empirical research articles or research articles that
contain results from actual observations or experiments where there are abstracts, introductions,
methods, results, and discussions. The literature review stage begins with a search for articles relevant
to the topic being discussed. The article search strategy using a database of articles in journals of
international repute such as ScienceDirect and Google Search with keywords that mandibular
reconstruction, PLA 3D scaffold, modifications scaffold PLA and fused deposition modeling. The
journal criteria used are journals published in the last 5 years, full text articles in English indexed by
Scopus. The search results were then carried out by scanning the journal based on the type of material,
namely polylactic acid (PLA) which is composited with hydroxyapatite and gelatin and is
biocompatible if used as a scaffold for bone tissue engineering. After doing the screening, journals
with the status of Q3, Q2, and Q1 will be used as reference journals in this review. Furthermore,
research journals that match the criteria are collected and journal summaries are made. The journal
summary is then analyzed for the content contained in the research objectives and research result. The
journal is analyzed by compiling, determining the strengths and weaknesses of each literature, looking
at the relationship between one literature and another, and comparing each literature obtained from
various properties such as porosity and mechanical properties.

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The 10th International Conference on Theoretical and Applied Physics (ICTAP2020) IOP Publishing
Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

3. Result and Discussion

3.1. Advantages of 3D-Printing Scaffold with Fused Deposition Modelling (FDM) Method
The use of 3D printing allows the design of scaffold with an adapted structure and produces synthetic
bone grafts with a multifunctional effect suitable for bone repair [12]. One of the ideal requirements
scaffold should be biomimetic i.e., it mimics the extracellular matrix and provides a suitable
environment for cell growth. The characteristics that a scaffold must have are biocompatibility,
osteoconductivity, osteoinductivity, biodegradability, porosity, and appropriate pore size, as well as
mechanical strength [13]. 3D printing technology with the FDM method has several advantages,
including raw materials and equipment that are cost effective, easy to use, and the ability to blend
polymers. In addition, this technology supports the creation of thermoplastic products that are
mechanically and environmentally stable. Complex geometric shapes and cavities can be generated
easily using FDM technology [14]. The FDM technique is feasible for modeling the mandible used for
reconstructive surgery. This technique has been used in the surgical planning and design of
maxillofacial and mandibular prostheses [15].
Several studies have reported the process of making scaffold PLA 3D using FDM. Research has
reported the process of making scaffolds using PLA filaments with a diameter of 1.75 mm (Figure 1)
[16]. PLA is used as a raw material in 3D FDM printing for porous scaffolding applications because of
its biodegradability, good mechanical properties and low toxicity. The temperature used in the printing
process on the nozzle is 200oC, the hotbed is 60oC, the nozzle diameter is 0.4 mm and the speed of the
3D printer motor is 30 mm/s. The results of this study indicate that it has succeeded in making scaffold
porous with 3D printing.

Figure 1. Scaffold fabrication scheme [16].

Figure 2. Computer model (A), cut model (B), and PLA/HA 3D-printed result (C) [17].

One of the study report the process of making scaffolds using PLA/HA filaments with a diameter
of 1.6 ± 0.2 mm [17]. The scaffold design is made using SolidWorks as shown in Figure 2A, then
converted into stereolithography (.stl) format so that it can be applied to 3D object printing software

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The 10th International Conference on Theoretical and Applied Physics (ICTAP2020) IOP Publishing
Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

such as (Figure 2B). Furthermore, the PLA filament was extruded at 210oC with a nozzle diameter of
200 µm and a 3D printer motor speed of 30 mm/s.

3.2. Porosity of PLA-Based Scaffold

Porosity is an important factor in characterization scaffold because it serves to facilitate cell migration,
blood circulation and the vascular process [13]. The porosity of the developed scaffold was
determined by the liquid displacement method [13]. Sufficient porosity and pore size are needed in the
process of cell distribution and nutrition throughout the structure [17]. In one of study, the porosity
produced from the scaffold 3D PLA/Gelatin fibrous by immersing for 90 minutes ranged from 77.52%
to 86.18% [19]. These results are in accordance with the criteria for bone porosity values, namely at
least 40% to 80% [20]. The value of the porosity of the scaffold in accordance with the value of the
bone porosity criteria was also reported which ranges from 76% to 83.3% [21]. In making PLA/HA
scaffold using the 3D-printing method, the results are as shown in Table 1 [22]. Based on these
results, the addition of HA to the scaffold will increase density and decrease porosity [22]. Even so,
the 3D-printing PLA/HA scaffold porosity value is in accordance with the bone porosity value
reported previously [20].

Table 1. Young’s modulus, Poisson’s coefficient, and compressive strength of porous bio-
nanocomposite containing PLA and ceramic nanoparticles with different weight percentages made by
three dimensional printing technology [22].
Material properties Poisson ratio Elastic modulus Density (g/cm3) Compressive Porosity
(GPa) strength (MPa) (%)
PLA - - - 35 85
PLA - 5 HA 0.30 3.6 1.1 42 75
PLA - 10 HA 0.33 4.2 1.5 48 79
PLA - 15 HA 0.34 5.6 2.0 56 73
PLA - 25 HA 0.35 6.9 3.0 58 64

3.3. Mechanical Properties of PLA-Based Scaffold

In Esmaeili research, it shows that the higher the HA concentration, the more the compressive strength
and modulus of elasticity of the scaffold [22]. These results have met the criteria for the compressive
strength value of the trabecular bone, which is at least 0.5-50 MPa to receive stresses such as chewing
loads [23]. The increase in compressive strength and modulus of elasticity are proportional to the
increase in scaffold density, which is about 1.1-3.0 g/cm3[22]. The mean trabecular and cortical bone
densities of the mandible were 1.18 g/cm3 and 1.85-2.0 g/cm3. In the research of Zhang, compressive
strength increased with the addition of HA in PLA, from 39.96 MPa (pure PLA) to 45.00 MPa
(PLA/HA 5: 5) [21]. However, as the HA concentration decreased and the PLA concentration
increased, the compressive strength also decreased, from 43.29 MPa (8: 2) to 19.00 MPa (9: 1). These
results also prove that the presence of HA will increase the compressive strength of the scaffold [21].
In the research of Deng which examined the characteristics and physical properties of the gelatin-nano
hydroxyapatite (nHAP) nanofiber film electrospiration was carried out by a tensile test and the results
were listed in Table 2 [24]. Based on Table 2, it is known that an increase in nHAP levels by 10%
reduces tensile strength, an increase in nHAP levels by 25% resulted in severe agglomeration and
exposure to nanoparticles as defects in the fibers. This results in a significant reduction in tensile
strength and makes the scaffold brittle. The modulus young value is in accordance with the criteria for
the modulus young value of the trabecular bone, namely 24.9-240 MPa [25].

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The 10th International Conference on Theoretical and Applied Physics (ICTAP2020) IOP Publishing
Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

Table 2. Young’s modulus, tensile strength and elongation at break of the electrospun nanofibrous
films. Different letters indicate significant difference (P<0.05) [24].
Film sample Young’s modulus (MPa) Tensile strength (MPa) Elongation at break (%)

HAP0 68.6 ± 6.98a 1.75 ± 0.17a 4.73 ± 0.03a

HAP10 67.1 ± 10.4a 1.66 ± 0.24a 5.08 ± 2.04a
HAP25 47.2 ± 4.61b 1.13 ± 0.07b 4.19 ± 0.27a
HAP50 60.2 ± 6.27ab 1.12 ± 0.16b 3.04 ± 0.77a

4. Conclusion
Based on the literature review, it can be concluded that the addition of hydroxyapatite to the PLA 3D-
printing scaffold can improve the bioactive properties of the PLA scaffold. Modification of the PLA
scaffold surface with hydroxyapatite can support cell proliferation and differentiation which leads to
increased mineralization of the PLA-HA scaffold and increases osteoinductive properties. The
addition of gelatin to the PLA scaffold can increase the hydrophilicity properties so that it can improve
the hydrophobic properties of PLA and gelatin is biocompatibility and supports cell proliferation.

Acknowledgment
We acknowledge Airlangga University for their kind support and also gratefully acknowledge the
following individuals who have reviewed manuscripts.Their generous contribution of time and
experise would shape the quality of our journal.

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Journal of Physics: Conference Series 1816 (2021) 012085 doi:10.1088/1742-6596/1816/1/012085

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