Next-Generation Biomedical Implants: A Comprehensive Review of Smart Biomaterials and 4D Bioprinting Technologies for Personalized and Responsive Medicine

Abstract

Smart biomaterials and 4D bioprinting bring the paradigm shift in the field of biomedical implants. Such innovations allow creating the next generation of implants that have an ability to react to physiological factors dynamically and thus make the therapeutic process more efficient and more individualized. This paper seeks to examine in detail the role of the modern development related to the use of smart biomaterialsssuch as shape-memory polymers, stimuli-responsive hydrogels, and multifunctional nanocompositesin implantable medical devices. Here, we also discuss the concepts and advancements of 4D bio-printing, with regard to their intelligent-bios me-inks, programmable structures and time-varying morphological changes. In our methodology, we conducted a proper literature review regarding peer reviewing identified research in significant databases (e.g., Scopus, Web of Science) conducted during the past 10 years. We review and critically analyse the study on the fabrication process, responsiveness to materials, biocompatibility and clinical relevance. The review identifies three main clinical use-cases which are orthopedic scaffolds, cardiovascular stents, neural interfaces, and sensors and actuators in wound healing. Although spectacular advances have been witnessed, limitations to long term biocompatibility, mechanical stability, regulatory acceptability and scalability exist at a clinical translation level. The present review finalizes that the synthesis of smart biomaterials and 4D bioprinting has the tremendous potential of disruptive innovation in customized and responsive medicine. Further interdisciplinary studies, based on advances in biofabrication, modeling and harmonization of regulations, would be necessary to complete the gap between the development and use of biomedical products in the laboratory to biomedical practice.