Anagrafe della ricerca

Traumatic brain injuries (TBIs) are regarded as a life-threatening impairment of global importance, leading to death and disability in very young people, usually aged 1 to 44, due mainly to motor vehicle crashes, falls, sports and assaults. Cranioplastic surgery plays a pivotal role in this scenario, with the ultimate aim of providing to the patient the most complete clinical/functional rehabilitation together with a satisfactory aesthetic outcome. However, up to date, no consensus about the optimal materials and procedures for the cranioplasty has been reached, and many criticisms have been evidenced, particularly in terms of the commonly used materials and the associated inflammatory reactions and infection risks. Thus, there is an urgent demand for new systems for cranial reconstruction, simultaneously guaranteeing the inhibition of infections/inflammations occurring and providing a favourable regenerative microenvironment. In this framework, APICRAM proposes a fully integrated therapeutic approach, aimed at overcoming the limits of the actually used polymeric cranial implants, such as low mechanical properties, lack of osseointegration, post-surgery inflammation. Different and innovative approaches will be investigated to improve the tissue/scaffold interface and provide osteointegration, enhanced mechanical properties and biological responsiveness, simultaneously supplying anti-inflammatory and regenerative properties. The APICRAM integrated approach has not been proposed so far. This final ambitious purpose will be achieved through intermediate aims: (i) the formulation of new composite filaments and powders, based on hydroxyapatite and biopolymers, for the production of cranial scaffolds/implants by fused deposition modeling and selective laser sintering, respectively; (ii) the design and realization of functionally graded cranial implants, with a hierarchical interconnected porosity, to resemble the skull hierarchical structure; (iii) the development of an appropriate hydroxyapatite coating selectively around the scaffold perimeter facing the surrounding bone tissue, to promote osseointegration; (iv) the functionalisation of the printed implants/scaffolds by loading them with selected antibiotics/anti-inflammatory agents, bioactive molecules and growth factors, in order to avoid/limit the occurring of possible post surgery inflammation and to create a favourable regenerative microenvironment. The developed technologies and approaches will represent new tools and resources for an innovative and efficient treatment of traumatic cranial defects, through a multidisciplinary and integrated approach. APICRAM results will pave the way for the treatment of TBI but also for other cranial repair indications, e.g., tumor resection, decompressive hemicraniectomy, and, congenital anomalies/growing skull fractures for pediatric patients, significantly improving the patients’ health and life quality.