Substituted hydroxyapatite coatings of bone implants

Thermosensitive vancomycin@PLGA-PEG-PLGA/HA hydrogel as an all-in-one treatment for osteomyelitis

Osteomyelitis is a difficult-to-treat infectious disease. Treatment, which includes controlling the infection and removing necrotic tissues, is challenging. Considering the side effects and drug resistance of systemic antibiotics, local drug delivery systems are being explored. Antibiotic-loaded bone cement is the main treatment strategy; however, it has several disadvantages. Thus, based on its thermosensitive gelation properties, poly(D, L-lactide-co-glycolide)-poly(ethylene glycol)-poly(D, L-lactide-co-glycolide) (PLGA-PEG-PLGA) copolymer was used as a sustained-release drug carrier by calibrating its synthesis parameters. We prepared and characterized vancomycin@PLGA-PEG-PLGA/hydroxyapatite (HA) thermosensitive hydrogel with an LA/GA ratio of 15:1. The rheological characteristics, sol-gel phase-transition properties, and critical micelle concentration value of the PLGA-PEG-PLGA/HA complex confirmed that it undergoes a temperature-sensitive sol-gel phase transition. Furthermore, the HA in the composite increased the storage modulus of the system. FT-IR, XRD, and TEM findings showed that HA could be dispersed uniformly in the PLGA-PEG-PLGA polymer. Moreover, HA neutralized acidity during polymer degradation, improving in vitro cytocompatibility. In vitro and in vivo antibacterial experiments showed that the composite sustained-release system exhibited good bone repair characteristics owing to its efficacy in infection treatment. Therefore, vancomycin@PLGA-PEG-PLGA/HA allows sustained release of antibiotics and promotes bone tissue repair, showing potential for wide clinical applicability.

Evolution of dynamics of physico-chemical and mechanical properties of hydroxyapatite with fluorine addition and degradation stability of new matrices

This multidisciplinary study examined sensitively the change in the dynamics of main mechanical performance, stability of crystal structure, crystallinity quality, strength, corrosion resistance, biocompatibility, resistance to structural degradation/separations and mechanical durability features of hydroxyapatite (HAp) biomedical materials based on the fluorine addition and degradation process to guide future medical and dental treatment studies. In the study, the fluorine ions were used to be the dental coating, filling and supporting material for biologically or synthetically produced bone minerals. The general characteristic properties were investigated by means of standard spectroscopic, structural and mechanical analysis methods including RAMAN, SEM-EDS, TEM, Vickers micro-indentation hardness and density measurements. A time dependent release test was performed to evaluate possible fluorine ion release after the degradation process. It was found that the fundamental characteristic properties of HAp biomedical materials are noted to improve with the increase in the fluoride level up to 2% due much more stabilization of HAp crystal system. The combination of RAMAN spectra and powder XRD analyzes indicates that 2% addition level affects positively the formation velocity of characteristic HAP phase. Besides, fluorine doped HAp materials all exhibited the main characteristic peaks after degradation process. This is attributed to the fact that the fluorine ions enabled the hydroxyapatite to enhance the structural quality and stability towards the corrosion environment. However, in case of excess dopant level of 3% the degradation rates were obtained to increase due to higher contribution rate and especially electrostatic interactions. As for the surface morphology examinations, 2% fluorine added HAp with the highest density of 3.0879 g/cm³ was determined to present the superior crystallinity quality (smallest grain size, best smooth surface, honeycomb pattern, regular shaped particles and densest particle distributions through the specimen surface). Conversely, the excess fluorine triggered to increase seriously degree of micro/macro porosity in the surface morphology and microscopic structural problems in the crystal system. Thus, the HAp doped with 3% was the most affected material from the degradation process. Additionally, the fluorine ion values read after the release process were quite far from the value that could cause toxic effects. Lastly, the optimum fluorine addition provides the positive effects on the highest durability, stiffness and mechanical fracture strength properties as a consequence of differentiation in the surface residual compressive stress regions (lattice strain fields), amplification sites and active operable slip systems in the matrix. Hence, the crack propagations prefer to proceed in the transcrystalline regions rather than the intergranular parts. Similarly, it was found that Vickers micro-indentation hardness tests showed that the microhardness parameters increased after the degradation process. All in all, the fluorine addition level of 2% was noted to be good choice to improve the fundamental characteristic properties of hydroxyapatite biomedical materials for heavy-duty musculoskeletal, orthopedic implant, biological and therapeutic applications in medicine and dentistry application fields.

Rubbing-Assisted Approach for Fabricating Oriented Nanobiomaterials

The highly-oriented structures in biological tissues play an important role in determining the functions of the tissues. In order to artificially fabricate oriented nanostructures similar to biological tissues, it is necessary to understand the oriented mechanism and invent the techniques for controlling the oriented structure of nanobiomaterials. In this review, the oriented structures in biological tissues were reviewed and the techniques for producing highly-oriented nanobiomaterials by imitating the oriented organic/inorganic nanocomposite mechanism of the biological tissues were summarized. In particular, we introduce a fabrication technology for the highly-oriented structure of nanobiomaterials on the surface of a rubbed polyimide film that has physicochemical anisotropy in order to further form the highly-oriented organic/inorganic nanocomposite structures based on interface interaction. This is an effective technology to fabricate one-directional nanobiomaterials by a biomimetic process, indicating the potential for wide application in the biomedical field.

Titanium Surfaces Modified with Graphene Oxide/Gelatin Composite Coatings for Enhanced Antibacterial Properties and Biological Activities

Titanium alloys have been widely used in orthopedic implants due to their excellent physicochemical properties and good biocompatibility. However, in practice, titanium implants may fail to integrate or develop an implant-centered infection. Because of its excellent mechanical properties, bone integrability, biocompatibility, antibacterial properties, and so on, graphene oxide is increasingly being used in the preparation of composite biomaterials. The percutaneous titanium implants are used as the research object in this project. To solve the integration of implant and tissue, a graphene oxide/gelatin (GO/gel) composite coating was used to optimize the implant surface. Bacterial and cell experiments were used to investigate the antimicrobial activity, biocompatibility, and regulation of macrophage polarization of GO/gel-modified titanium. According to our findings, GO/gel-modified titanium has a good bacteriostatic effect against Staphylococcus aureus. On the modified surface, L929 cells proliferated well and showed no cytotoxicity. Simultaneously, the GO/gel-modified titanium surface could inhibit macrophage adhesion and spread in the early stage of culture and showed a more obvious inflammatory decline in the late stage of culture. These findings implied that GO/gel-modified titanium is advantageous for resistant bacteria and tissue remolding.

Electron Paramagnetic Resonance Characterization of Sodium- and Carbonate-Containing Hydroxyapatite Cement

Ionizing radiation-induced paramagnetic defects in calcified tissues like tooth enamel are indicators of irradiation dose. Hydroxyapatite (HA), the principal constituent in these materials, incorporates a variety of anions (CO₃^2-, F^-, Cl^-, and SiO₄^4-) and cations (Mn²⁺, Li⁺, Cu²⁺, Fe³⁺, Mg²⁺, and Na⁺) that directly or indirectly contribute to the formation of stable paramagnetic centers upon irradiation. Here, we used an underexploited synthesis method based on the ambient temperature setting reaction of a self-hardening calcium phosphate cement (CPC) to create carbonate-containing hydroxyapatite (CHA) and investigate its paramagnetic properties following γ-irradiation. Powder X-ray diffraction and IR spectroscopic characterization of the hardened CHA samples indicate the formation of pure B-type CHA cement. CHA samples exposed to γ-radiation doses ranging from 1 Gy to 150 kGy exhibited an electron paramagnetic resonance (EPR) signal from an orthorhombic CO₂^•- free radical. At γ-radiation doses from 30 to 150 kGy, a second signal emerged that is assigned to the CO₃^•- free radical. We observed that the formation of this second species is dose-dependent, which provided a means to extend the useful dynamic range of irradiated CHA to doses >30 kGy. These results indicate that CHA synthesized via a CPC cement is a promising substrate for EPR-based dosimetry. Further studies on the CHA cement are underway to determine the suitability of these materials for a range of biological and industrial dosimetry applications.

Chemical Bonding of Biomolecules to the Surface of Nano-Hydroxyapatite to Enhance Its Bioactivity

Hydroxyapatite (HA) is a significant constituent of bones or teeth and is widely used as an artificial bone graft. It is often used to replace the lost bones or in reconstructing alveolar bones before dental implantation. HA with biological functions finds its importance in orthopedic surgery and dentistry to increase the local concentration of calcium ions, which activate the growth and differentiation of mesenchymal stem cells (MSC). To make relevant use of HA in bone transplantation, the surfaces of orthopedic and dental implants are frequently coated with nanosized hydroxyapatite (nHA), but its low dispersibility and tendency to form aggregates, the purpose of the surface modification of bone implants is defeated. To overcome these drawbacks and to improve the histocompatibility of bone implants or to use nHA in therapeutic applications of implants in the treatment of bone diseases, various studies suggested the attachment of biomolecules (growth factors) or drugs through chemical bonding at the surface of nHA. The growth factors or drugs bonded physically at the surface of nHA are mostly unstable and burst released immediately. Therefore, reported studies suggested that the surface of nHA needs to be modified through the chemical bonding of biologically active molecules at the surface of bone implants such as proteins, peptides, or naturally occurring polysaccharides to prevent the aggregation of nHA and to get homogenous dispersion of nHA in solution. The role of irradiation in producing bioactive and antibacterial nHA through morphological variations in surfaces of nHA is also summarized by considering internal structures and the formation of reactive oxygen species on irradiation. This mini-review aims to highlight the importance of small molecules such as proteins, peptides, drugs, and photocatalysts in surface property modification of nHA to achieve stable, bioactive, and antibacterial nHA to act as artificial bone implants (scaffolds) in combination with biodegradable polymers.

Bone Tissue Engineering through 3D Bioprinting of Bioceramic Scaffolds: A Review and Update

Trauma and bone loss from infections, tumors, and congenital diseases make bone repair and regeneration the greatest challenges in orthopedic, craniofacial, and plastic surgeries. The shortage of donors, intrinsic limitations, and complications in transplantation have led to more focus and interest in regenerative medicine. Structures that closely mimic bone tissue can be produced by this unique technology. The steady development of three-dimensional (3D)-printed bone tissue engineering scaffold therapy has played an important role in achieving the desired goal. Bioceramic scaffolds are widely studied and appear to be the most promising solution. In addition, 3D printing technology can simulate mechanical and biological surface properties and print with high precision complex internal and external structures to match their functional properties. Inkjet, extrusion, and light-based 3D printing are among the rapidly advancing bone bioprinting technologies. Furthermore, stem cell therapy has recently shown an important role in this field, although large tissue defects are difficult to fill by injection alone. The combination of 3D-printed bone tissue engineering scaffolds with stem cells has shown very promising results. Therefore, biocompatible artificial tissue engineering with living cells is the key element required for clinical applications where there is a high demand for bone defect repair. Furthermore, the emergence of various advanced manufacturing technologies has made the form of biomaterials and their functions, composition, and structure more diversified, and manifold. The importance of this article lies in that it aims to briefly review the main principles and characteristics of the currently available methods in orthopedic bioprinting technology to prepare bioceramic scaffolds, and finally discuss the challenges and prospects for applications in this promising and vital field.

Monetite vs. Brushite: Different Influences on Bone Cell Response Modulated by Strontium Functionalization

Monetite and brushite are regarded with increasing interest for the preparation of biomaterials for applications in the musculoskeletal system. Herein, we investigated the influence of strontium substitution in the structures of these two phosphates on bone cell response. To achieve this aim, co-cultures of human primary osteoclasts and human osteoblast-like MG63 cells were tested on strontium-substituted monetite and strontium-substituted brushite, as well as on monetite and brushite, as controls. In both structures, strontium substitution for calcium amounted to about 6 at% and provoked enlargement of the cell parameters and morphologic variations. Cumulative release in physiological solution increased linearly over time and was greater from brushite (up to about 160 and 560 mg/L at 14 days for Sr and Ca, respectively) than from monetite (up to about 90 and 250 mg/L at 14 days for Sr and Ca, respectively). The increasing viability of osteoblast-like cells over time, with the different expression level of some typical bone markers, indicates a more pronounced trigger toward osteoblast differentiation and osteoclast inhibition by brushite materials. In particular, the inhibition of cathepsin K and tartrate-resistant acid phosphatase at the gene and morphological levels suggests strontium-substituted brushite can be applied in diseases characterized by excessive bone resorption.

Preparation and CMAS Wettability Investigation of CMAS Corrosion Resistant Protective Layer with Micro-Nano Double Scale Structure

Solution precursor plasma spray (SPPS) can prepare thermal barrier coatings (TBCs) with nanostructures, which can modify the adhesion and wettability of molten silicate environmental deposits (CMAS) on the surface of TBCs, thereby improving the resistance of TBCs to CMAS corrosion. In this study, SPPS layers with micro-nano double scale structures were prepared on the surface of conventional atmospheric plasma spraying (APS) coatings. The effect of process parameters on the micro-nano double scale structures and the wetting and infiltration behavior of molten CMAS on the surface of coatings were investigated. The results show that micron structure is more sensitive to process parameters. Lower precursor viscosity, closer spraying distance, and smoother APS layer are favorable to form more typical and dense micron structures. After covering the SPPS layer, the CMAS wetting diameter is reduced by about 40% and the steady-state contact angle increased up to three times. The reason is that the micro-nano double scale structures can effectively trap air and form an air layer between the coating surface and the molten CMAS. In addition, nano-particles play a more important role in the formation of the air layer, which in turn determines the steady-state wettability properties. While micron structures can influence the time needed to reach the steady state. However, the SPPS layers composed of nano-particles have a very loose structure and weak cohesion, and they degrade and fail rapidly after the infiltration of molten CMAS. Therefore, maintaining the excellent CMAS wetting resistance of the SPPS layers while taking into account their lifetime and reliability has become the focus of further research.

One-step in situ deposition of phytic acid-metal coordination complexes for combined Porphyromonas gingivalis infection prevention and osteogenic induction

Postoperative infection and poor osteogenesis will cause the failure of dental implant surgery. Thus, the antibacterial and osteogenic activities are the core requirements for the surface modification of dental implants. Inspired by the strong chelating ability of naturally occurring phytic acid (PA), an in situ deposition method on the surface of titanium implants was developed based on the metal-phosphate coordination networks. Biologically relevant metal cations (i.e. ferric ions and divalent copper ions) were selected as metal constituents for the construction of organic-inorganic coordination network films. The stability of PA-metal coordination bonds is rationally explained by the chemical nature of transition metal elements. This PA-metal coordination complex coating exhibited an excellent antibacterial activity against Porphyromonas gingivalis, reducing the bacterial implant colonization by > 3.92 log₁₀. The abundant phosphate groups greatly increased the surface hydrophilicity, promoted the early adhesion of proteins, improved the proliferation of bone marrow mesenchymal stem cells, and finally achieved an enhanced osteogenic activity. In addition, the phosphate groups of PA also facilitated the deposition of hydroxyapatite by providing reaction sites to chelate with calcium ions. These findings evaluate the anti-bacterial and osteogenic potentials of PA-metal coordination complexes, and clarify the feasibility for surface modification of dental implants.

Mesenchymal Stem Cells–Hydrogel Microspheres System for Bone Regeneration in Calvarial Defects

The repair of large bone defects in clinic is a challenge and urgently needs to be solved. Tissue engineering is a promising therapeutic strategy for bone defect repair. In this study, hydrogel microspheres (HMs) were fabricated to act as carriers for bone marrow mesenchymal stem cells (BMSCs) to adhere and proliferate. The HMs were produced by a microfluidic system based on light-induced gelatin of gelatin methacrylate (GelMA). The HMs were demonstrated to be biocompatible and non-cytotoxic to stem cells. More importantly, the HMs promoted the osteogenic differentiation of stem cells. In vivo, the ability of bone regeneration was studied by way of implanting a BMSC/HM system in the cranial defect of rats for 8 weeks. The results confirmed that the BMSC/HM system can induce superior bone regeneration compared with both the HMs alone group and the untreated control group. This study provides a simple and effective research idea for bone defect repair, and the subsequent optimization study of HMs will provide a carrier material with application prospects for tissue engineering in the future.

Immunomodulatory Properties: The Accelerant of Hydroxyapatite-Based Materials for Bone Regeneration

The immunoinflammatory response is the prerequisite step for wound healing and tissue regeneration, and the immunomodulatory effects of biomaterials have attracted increasing attention. Hydroxyapatite [Ca₁₀(PO₄)₆(OH)₂] (HAp), a common calcium phosphate ceramic, due to its structural and functional similarity to the inorganic constituent of natural bones, has been developed for different application purposes such as bone substitutes, tissue engineering scaffolds, and implant coatings. Recently, the interaction between HAp-based materials and the immune system (various immune cells), and the immunomodulatory effects of HAp-based materials on bone tissue regeneration have been explored extensively. Macrophages-mediated regenerative effect by HAp stimulation occupies the mainstream status of immunomodulatory strategies. The immunomodulation of HAp can be manipulated by tuning the physical, chemical, and biological cues such as surface functionalization (physical or chemical modifications), structural and textural characteristics (size, shape, and surface topography), and the incorporation of bioactive substances (cytokines, rare-earth elements, and bioactive ions). Therefore, HAp ceramic materials can contribute to bone regeneration by creating a favorable osteoimmune microenvironment, which would provide a more comprehensive theoretical basis for their further clinical applications. Considering the rapidly developed HAp-based materials as well as their excellent biological performances in the field of regenerative medicine, this review discusses the recent advances concerning the immunomodulatory methods for HAp-based biomaterials and their roles in bone tissue regeneration.

Electrodeposition of Calcium Phosphate Coatings on Metallic Substrates for Bone Implant Applications: A Review

This review summaries more than three decades of scientific knowledge on electrodeposition of calcium phosphate coatings. This low-temperature process aims to make the surface of metallic bone implants bioactive within a physiological environment. The first part of the review describes the reaction mechanisms that lead to the synthesis of a bioactive coating. Electrodeposition occurs in three consecutive steps that involve electrochemical reactions, pH modification, and precipitation of the calcium phosphate coating. However, the process also produces undesired dihydrogen bubbles during the deposition because of the reduction of water, the solvent of the electrolyte solution. To prevent the production of large amounts of dihydrogen bubbles, the current density value is limited during deposition. To circumvent this issue, the use of pulsed current has been proposed in recent years to replace the traditional direct current. Thanks to breaking times, dihydrogen bubbles can regularly escape from the surface of the implant, and the deposition of the calcium phosphate coating is less disturbed by the accumulation of bubbles. In addition, the pulsed current has a positive impact on the chemical composition, morphology, roughness, and mechanical properties of the electrodeposited calcium phosphate coating. Finally, the review describes one of the most interesting properties of electrodeposition, i.e., the possibility of adding ionic substituents to the calcium phosphate crystal lattice to improve the biological performance of the bone implant. Several cations and anions are reviewed from the scientific literature with a description of their biological impact on the physiological environment.

Microstructure and Properties of Hydroxyapatite Coatings Made by Aerosol Cold Spraying–Sintering Technology

Hydroxyapatite is a widely used material used for the bioactivation of an implant’s surface. A promising hydroxyapatite coating approach is the kinetic deposition of powder particles. The possibility of solid-state deposition improvement through the merging of Aerosol Deposition and Low Pressure Cold Spraying techniques is a promising prospect for improving the deposition efficiency and the quality of coatings. The objective of the paper is to study the possibilities of hydroxyapatite coating structure modification through changes in the coating process and post-heat treatment. The novel Aerosol Cold Spraying system joining Low Pressure Cold Spraying and Aerosol Deposition was used for the deposition of coatings. The coating’s post-processing was conducted using two techniques: Spark Plasma Sintering and Pressureless Sintering. The coating’s structure was examined using scanning, transmission, and light microscopy, and X-ray diffraction. Substrate–coating bond strength was assessed using a tensile test. Homogenous buildup using Aerosol Cold Spraying of hydroxyapatite was achieved. Various pores and microcracks were visible in the sprayed coatings. The deposition process and the thermal post-processing did not lead to significant degradation of the hydroxyapatite phase. As a result of the Spark Plasma Sintering and Pressureless Sintering at 800 °C, an increase in tensile adhesion bond strength and crystal size was obtained.

Additive Manufacturing in Orthopedics: A Review

Additive manufacturing is an advanced manufacturing manner that seems like the industrial revolution. It has the inborn benefit of producing complex formations, which are distinct from traditional machining technology. Its manufacturing strategy is flexible, including a wide range of materials, and its manufacturing cycle is short. Additive manufacturing techniques are progressively used in bone research and orthopedic operation as more innovative materials are developed. This Review lists the recent research results, analyzes the strengths and weaknesses of diverse three-dimensional printing strategies in orthopedics, and sums up the use of varying 3D printing strategies in surgical guides, surgical implants, surgical predictive models, and bone tissue engineering. Moreover, various postprocessing methods for additive manufacturing for orthopedics are described.

Biomimetic sponge using duck's feet derived collagen and hydroxyapatite to promote bone regeneration

Collagen, a natural biomaterial derived from animal tissues, has attracted the attention of biomedical material researchers because of its excellent cell affinity and low rejection in vivo. In this study, collagen was extracted using livestock by-product flippers, and an experiment was performed to assess its application as a scaffold for bone tissue implantation. For this purpose, we fabricated 2%, and 3% duck's feet derived collagen (DC) sponges. We then compared them to hydroxyapatite (HAp)-coated DC sponges, and measured the porosity and pore size using scanning electron microscopy (SEM) to analyze the physical properties and morphology of DC and DC/HAp sponges. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay were carried out to measure the proliferation of bone marrow stem cells (BMSCs) in DC and DC/HAp sponges. An alkaline phosphatase activity assay confirmed the osteogenic differentiation ability of BMSCs. Polymerase chain reaction (PCR) was performed to confirm the BMSC-specific genetic marker. The osteogenic potential was confirmed by the bone formation in an in vivo environment on the scaffold by histological and immunohistochemical analysis. Overall, this study shows that DC/HAp sponges have biocompatibility and good physical properties. Additionally, DC/HAp sponges show potential use as bone graft materials for tissue engineering applications.

Coating Ti6Al4V implants with nanocrystalline diamond functionalized with BMP-7 promotes extracellular matrix mineralization in vitro and faster osseointegration in vivo

The present study investigates the effect of an oxidized nanocrystalline diamond (O-NCD) coating functionalized with bone morphogenetic protein 7 (BMP-7) on human osteoblast maturation and extracellular matrix mineralization in vitro and on new bone formation in vivo. The chemical structure and the morphology of the NCD coating and the adhesion, thickness and morphology of the superimposed BMP-7 layer have also been assessed. The material analysis proved synthesis of a conformal diamond coating with a fine nanostructured morphology on the Ti6Al4V samples. The homogeneous nanostructured layer of BMP-7 on the NCD coating created by a physisorption method was confirmed by AFM. The osteogenic maturation of hFOB 1.19 cells in vitro was only slightly enhanced by the O-NCD coating alone without any increase in the mineralization of the matrix. Functionalization of the coating with BMP-7 resulted in more pronounced cell osteogenic maturation and increased extracellular matrix mineralization. Similar results were obtained in vivo from micro-CT and histological analyses of rabbit distal femurs with screws implanted for 4 or 12 weeks. While the O-NCD-coated implants alone promoted greater thickness of newly-formed bone in direct contact with the implant surface than the bare material, a further increase was induced by BMP-7. It can be therefore concluded that O-NCD coating functionalized with BMP-7 is a promising surface modification of metallic bone implants in order to improve their osseointegration.

When the Total Hip Replacement Fails: A Review on the Stress-Shielding Effect

Total hip arthroplasty is one of the most common and successful orthopedic surgeries. Sometimes, periprosthetic osteolysis occurs associated with the stress-shielding effect: it results in the reduction of bone density, where the femur is not correctly loaded, and in the formation of denser bone, where stresses are confined. This paper illustrates the stress shielding effect as a cause of the failing replacement of the hip joint. An extensive literature survey has been accomplished to describe the phenomenon and identify solutions. The latter refer to the design criteria and the choice of innovative materials/treatments for prosthetic device production. Experimental studies and numerical simulations have been reviewed. The paper includes an introduction to explain the scope; a section illustrating the causes of the stress shielding effect; a section focusing on recent attempts to redefine prosthetic device design criteria, current strategies to improve the osteointegration process, and a number of innovative biomaterials; functionally graded materials are presented in a dedicated section: they allow customizing prosthesis features with respect to the host bone. Conclusions recommend an integrated approach for the production of new prosthetic devices: the “engineering community” has to support the “medical community” to assure an effective translation of research results into clinical practice.

Addressing the Needs of the Rapidly Aging Society through the Development of Multifunctional Bioactive Coatings for Orthopedic Applications

The unprecedented aging of the world's population will boost the need for orthopedic implants and expose their current limitations to a greater extent due to the medical complexity of elderly patients and longer indwelling times of the implanted materials. Biocompatible metals with multifunctional bioactive coatings promise to provide the means for the controlled and tailorable release of different medications for patient-specific treatment while prolonging the material's lifespan and thus improving the surgical outcome. The objective of this work is to provide a review of several groups of biocompatible materials that might be utilized as constituents for the development of multifunctional bioactive coatings on metal materials with a focus on antimicrobial, pain-relieving, and anticoagulant properties. Moreover, the review presents a summary of medications used in clinical settings, the disadvantages of the commercially available products, and insight into the latest development strategies. For a more successful translation of such research into clinical practice, extensive knowledge of the chemical interactions between the components and a detailed understanding of the properties and mechanisms of biological matter are required. Moreover, the cost-efficiency of the surface treatment should be considered in the development process.

In vitro characterization of hydroxyapatite and cobalt ferrite nanoparticles compounds and their biocompatibility in vivo

Bioactive materials in combination with antibiotics have been widely developed for the treatment of bone infection. Thus, this work aims to characterize six biomaterials formulated with different concentrations of hydroxyapatite and cobalt ferrite nanoparticles, in addition to the antibiotic ciprofloxacin, using X-ray diffraction (XRD), scanning electron microscopy (SEM), and the antibiotic diffusion test on agar. Furthermore, in vivo biocompatibility and the reabsorption process of these materials were analyzed. XRD showed that both hydroxyapatite and cobalt ferrite present high crystallinity. The photomicrographs obtained by SEM revealed that composites have a complex surface, evidenced by the irregular arrangement of the hydroxyapatite and cobalt ferrite granules, besides demonstrating the interaction between their components. The antibiotic-diffusion test showed that all biomaterials produced an inhibition halo in Staphylococcus aureus cultures. For the biocompatibility study, composites were surgically implanted in the dorsal region of rabbits. At 15, 30, 70, and 100 days, biopsies of the implanted regions were performed. The biomaterials were easily identified during histological analysis and no significant inflammatory process, nor histological signs of toxicity or rejection by the adjacent tissue were observed. We can conclude that the biomaterials analyzed are biocompatible, degradable, and effective in inhibiting the in vitro growth of Staphylococcus aureus. Graphical abstract.

Preparation of multigradient hydroxyapatite scaffolds and evaluation of their osteoinduction properties

Porous hydroxyapatite (HA) scaffolds are often used as bone repair materials, owing to their good biocompatibility, osteoconductivity and low cost. Vascularization and osteoinductivity of porous HA scaffolds were limited in clinical application, and these disadvantages were need to be improved urgently. We used water-in-oil gelation and pore former methods to prepare HA spheres and a porous cylindrical HA container, respectively. The prepared HA spheres were filled in container to assemble into composite scaffold. By adjusting the solid content of the slurry (solid mixture of chitin sol and HA powder) and the sintering temperature, the porosity and crystallinity of the HA spheres could be significantly improved; and mineralization of the HA spheres significantly improved the biological activity of the composite scaffold. The multigradient (porosity, crystallinity and mineralization) scaffold (HA-700) filled with the mineralized HA spheres exhibited a lower compressive strength; however, in vivo results showed that their vascularization ability were higher than those of other groups, and their osteogenic Gini index (Go: an index of bone mass, and inversely proportional to bone mass) showed a continuous decrease with the implantation time. This study provides a new method to improve porous HA scaffolds and meet the demands of bone tissue engineering applications.

Effect of Gold Nanostars Plus Amikacin against Carbapenem-Resistant Klebsiella pneumoniae Biofilms

Simple Summary

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infection rates represent a challenging treatment since the pipeline for effective antibiotics against this pathogen, such as beta-lactams among others, is practically nil. This study aims to evaluate the antibacterial effect of gold nanostars (GNS) alone or associated with some of the most widely used antibiotics for the treatment of CR-KP strains, i.e., meropenem or amikacin, on both planktonic or free-living and sessile forms. GNS were able to inhibit the planktonic growth of CR-KP at 80 µM, to eradicate the bacterial viability at 160 µM, and were unable to inhibit or eradicate the biofilm growth of this bacterium. GNS gave rise to filamentous bacteria through mechanisms mediated by the inhibition of energy-dependent cytoplasmic proteases. The combination of GNS and amikacin was able to inhibit or even eradicate the CR-KP biofilm. This combination was administered to greater wax moth larvae (Galleria mellonella), and this treatment was found to be tolerated well and to prevent the CR-KP infection. Thus, GNS in combination with amikacin represent a promising anti-CR-KP nanomaterial.

Abstract

(1) Background: Carbapenem-resistant Klesiella pneumoniae (CR-KP) infection rates depict an almost pre-antibiotic scenario since the pipeline for effective antibiotics against this pathogen has been almost entirely depleted. This study aims to evaluate the antibacterial effect of gold nanostars (GNS) alone or associated with some of the most widely used antibiotics for the treatment of CR-KP strains, i.e., meropenem or amikacin, on both planktonic and sessile forms. Additionally, we measured the effect of GNS on cell proliferation and biocompatibility in invertebrate in vivo models. (2) Materials and methods: GNS were made from gold seeds grown using a seeded-growth surfactant-free method assisted by silver ions and functionalized with mercapto-poly(ethylene glycol)amino by ligand exchange. The antimicrobial capacity, effect on cell proliferation, and biocompatibility of the most effective combination was evaluated in a Galleria mellonella model. (3) Results: The minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were 80 and 160 µM of GNS for all strains, respectively. The minimum biofilm inhibitory concentration (MBIC) and minimum biofilm eradication concentration (MBEC) were >320 µM of GNS for both. A synergy was found between GNS and amikacin. Larvae administered GNS plus amikacin were found to tolerate the treatment well, which prevented infection. (4) Conclusions: GNS are a promising anti-CR-KP nanomaterial.

Varying Synthesis Conditions and Comprehensive Characterization of Fluorine-Doped Hydroxyapatite Nanocrystals in a Simulated Body Fluid

Bone supports animal bodies, is the place where blood is produced, and is essential for the immune system, among other important functions. The dominant inorganic component in bone is hydroxyapatite (Hap), the structure and dynamics of which still pose many unsolved puzzles. An updated understanding of HAp is of great significance to osteology, dentistry, and the development of artificial bone and other biomaterials. In this work, HAp nanoparticles were synthesized with the wet chemical precipitation method and their structure and morphologies were controlled by varying pH and adding fluoride ions by two different routes: (1) fluoride ions were added during synthesis, and (2) fluoride ions were introduced after the samples were synthesized by soaking the samples in solutions with fluoride ions. XRD and HRTEM were employed to confirm the composition and structure, while various multinuclear (1H, 19F, 31P) solid-state nuclear magnetic resonance (NMR) methods including 1D single pulse, cross-polarization under magic-angle spinning (CPMAS), and 2D heteronuclear correlation (HETCOR) were used to characterize the structure, morphology, and dynamics, validating the general core-shell morphology in these F-HAp samples. It was found that all hydroxide ions were substituted when the fluoride ion concentration was above 0.005 M. An NMR peak corresponding to water structure emerged and the bulk water peak was shifted upfield, indicating that fluoride substitution modifies both the crystalline core and the amorphous shell of F-HAp nanoparticles. With the second route of fluoride substitution, increases in soaking time or fluoride ion concentration could increase fluoride substitution in HAp, but could not achieve complete substitution. Finally, with 1H-31P CPMAS and HETCOR, it was established that there are two types of phosphorous, one in the crystalline core (PO43−) and the other in the amorphous shell (HPO42−). These results are valuable for clarifying the fluoride substitution mechanism in HAp in biomaterials or in organisms, and provide insights for developing next generation replacement materials for bone, tooth, or coating films, drug delivery systems, etc.

Nature-Inspired Effects of Naturally Occurring Trace Element-Doped Hydroxyapatite Combined with Surface Interactions of Mineral-Apatite Single Crystals on Human Fibroblast Behavior

Innovative engineering design for biologically active hydroxyapatites requires enhancing both mechanical and physical properties, along with biocompatibility, by doping with appropriate chemical elements. Herein, the purpose of this investigation was to evaluate and elucidate the model of naturally occurring hydroxyapatite and the effects of doped trace elements on the function of normal human fibroblasts, representing the main cells of connective tissues. The substrates applied (geological apatites with hexagonal prismatic crystal habit originated from Slyudyanka, Lake Baikal, Russia (GAp) and from Imilchil, The Atlas Mountains, Morocco (YAp)) were prepared from mineral natural apatite with a chemical composition consistent with the building blocks of enamel and enriched with a significant F⁻ content. Materials in the form of powders, extracts and single-crystal plates have been investigated. Moreover, the effects on the function of fibroblasts cultured on the analyzed surfaces in the form of changes in metabolic activity, proliferation and cell morphology were evaluated. Apatite plates were also evaluated for cytotoxicity and immune cell activation capacity. The results suggest that a moderate amount of F⁻ has a positive effect on cell proliferation, whereas an inhibitory effect was attributed to the Cl⁻ concentration. It was found that for (100) GAp plate, fibroblast proliferation was significantly increased, whereas for (001) YAp plate, it was significantly reduced, with no cytotoxic effect and no immune response from macrophages exposed to these materials. The study of the interaction of fibroblasts with apatite crystal surfaces provides a characterization relevant to medical applications and may contribute to the design of biomaterials suitable for medical applications and the evaluation of their bioavailability.

Anisotropic expansion effect of Sr doping on the crystal structure of hydroxyapatite

The anisotropic expansion effect of Sr on the HA crystal structure is proposed where the relative expansion rate in the c-axis direction is about 2.22 times that in the a-axis direction.

Bioactive Surface Modifications through Thermally Sprayed Hydroxyapatite Composite Coatings: A Review over Selective Reinforcements

Hydroxyapatite (HA) has been an excellent replacement for the natural bone in orthopedic applications, owing to its close resemblance; however, it is brittle and has low strength. Surface modification techniques...

Modifications on porous absorbable Fe-based scaffolds for bone applications: A review from corrosion and biocompatibility viewpoints

Iron (Fe) and Fe-based scaffolds have become a research frontier in absorbable materials which is inherent to their promising mechanical properties including fatigue strength and ductility. Nevertheless, their slow corrosion rate and low biocompatibility have been their major obstacles to be applied in clinical applications. Over the last decade, various modifications on porous Fe-based scaffolds have been performed to ameliorate both properties encompassing surface coating, microstructural alteration via alloying, and advanced topologically order structural design produced by additive manufacturing (AM) techniques. The recent advent of AM produces topologically ordered porous Fe-based structures with an optimized architecture having controllable pore size and strut thickness, intricate internal design, and larger exposed surface area. This undoubtedly opens up new options for controlling Fe corrosion and its structural strengths. However, the in vitro biocompatibility of the AM porous Fe still needs to be addressed considering its higher corrosion rate due to the larger exposed surface area. This review summarizes the latest progress of the modifications on porous Fe-based scaffolds with a specific focus on their responses on the corrosion behavior and biocompatibility.

Electrophoretic deposition of hydroxyapatite/chitosan nanocomposites: the effect of dispersing agents on the coating properties

In this study, electrophoretic deposition (EPD) was used for the coating on titanium (Ti) substrate with a composite of hydroxyapatite (HA)-chitosan (CS) in the presence of dispersing agents such as polyvinyl butyral (PVB), polyethylene glycol (PEG), and triethanolamine (TEA). The materials were characterized using X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), zeta potential, and Fourier transform infrared (FT-IR) spectroscopy. The addition of PVB, PEG, and TEA agents improved the development of Ti coating during the EPD process. These additives increased the suspension stability and promoted the formation of uniform and compact HA/CS nanocomposite coatings on Ti substrates. The electrochemical polarization tests (e.g., potentiodynamic test) of the substrate with and without coating were investigated. Data analysis showed high corrosion resistance of Ti substrate coated with the HA/CS NP composite. The corrosion potentials displayed a shift toward positive values indicating the increase in the corrosion resistance of Ti after coating. In addition to measuring calcium ion release at various pH values and contact times at a biological pH value of 5.5, the stabilities of Ti substrates coated with HA/CS and different dispersing agents were also evaluated. Ti substrates with high anticorrosion properties may have a new potential application in biomedicine.

Electrophoretic deposition was used for coating of titanium substrate with a composite of hydroxyapatite (HA)-chitosan (CS) in the presence of polyvinyl butyral (PVB), polyethylene glycol (PEG), and triethanolamine (TEA).

Hydroxyapatite Film Coating by Er:YAG Pulsed Laser Deposition Method for the Repair of Enamel Defects

There are treatments available for enamel demineralization or acid erosion, but they have limitations. We aimed to manufacture a device that could directly form a hydroxyapatite (HAp) film coating on the enamel with a chairside erbium-doped yttrium aluminum garnet (Er:YAG) laser using the pulsed laser deposition (PLD) method for repairing enamel defects. We used decalcified bovine enamel specimens and compacted α-tricalcium phosphate (α-TCP) as targets of Er:YAG-PLD. With irradiation, an α-TCP coating layer was immediately deposited on the specimen surface. The morphological, mechanical, and chemical characteristics of the coatings were evaluated using scanning electron microscopy (SEM), scanning probe microscopy (SPM), X-ray diffractometry (XRD), and a micro-Vickers hardness tester. Wear resistance, cell attachment of the HAp coatings, and temperature changes during the Er:YAG-PLD procedure were also observed. SEM demonstrated that the α-TCP powder turned into microparticles by irradiation. XRD peaks revealed that the coatings were almost hydrolyzed into HAp within 2 days. Micro-Vickers hardness indicated that the hardness lost by decalcification was almost recovered by the coatings. The results suggest that the Er:YAG-PLD technique is useful for repairing enamel defects and has great potential for future clinical applications.

Bioinspired Redwood-Like Scaffolds Coordinated by In Situ-Generated Silica-Containing Hybrid Nanocoatings Promote Angiogenesis and Osteogenesis both In Vitro and In Vivo

Inspired by natural redwood and bone, a biomimetic strategy is presented to develop a highly bioactive redwood-like nanocomposite via radial freeze casting of biocompatible hydrogels followed by the in situ coprecipitation of a Si-containing CaP hybrid nanocoating (SCPN). The engineered material displays radially aligned macrochannels and a porous network structure similar to those of natural redwood. In addition to acting as a mechanical reinforcement, introducing SCPNs into the weak redwood-like scaffold yields not only a nanoroughened surface topography, a low swelling ratio, retarded enzymatic degradation, and enhanced protein absorption abilities but also the sustained sequential release of Si and Ca ions, thereby providing essential biophysical and biochemical cues for effective bone regeneration. Benefiting from the redwood-like structures and bioactive SCPNs, the biomimetic materials create a favorable microenvironment for promoting the initial adhesion, spreading, proliferation, and migration of bone marrow-derived mesenchymal stem cells and human umbilical vein endothelial cells. Furthermore, the in vitro and in vivo data showed that the biocompatible redwood-like scaffold with precipitated SCPN can synergistically promote osteogenesis and angiogenesis in their aligned direction. Collectively, this work presents a novel bioinspired redwood-like material with multifunctional properties that provides new insight into bone defect repair.

Biomimetic Deposition of Hydroxyapatite Layer on Titanium Alloys

Over the last decade, researchers have been concerned with improving metallic biomaterials with proper and suitable properties for the human body. Ti-based alloys are widely used in the medical field for their good mechanical properties, corrosion resistance and biocompatibility. The TiMoZrTa system (TMZT) evidenced adequate mechanical properties, was closer to the human bone, and had a good biocompatibility. In order to highlight the osseointegration of the implants, a layer of hydroxyapatite (HA) was deposited using a biomimetic method, which simulates the natural growth of the bone. The coatings were examined by scanning electron microscopy (SEM), X-ray diffraction (XRD), micro indentation tests and contact angle. The data obtained show that the layer deposited on TiMoZrTa (TMZT) support is hydroxyapatite. Modifying the surface of titanium alloys represents a viable solution for increasing the osseointegration of materials used as implants. The studied coatings demonstrate a positive potential for use as dental and orthopedic implants.

Carbon Nanomaterials Modified Biomimetic Dental Implants for Diabetic Patients

Dental implants are used broadly in dental clinics as the most natural-looking restoration option for replacing missing or highly diseased teeth. However, dental implant failure is a crucial issue for diabetic patients in need of dentition restoration, particularly when a lack of osseointegration and immunoregulatory incompetency occur during the healing phase, resulting in infection and fibrous encapsulation. Bio-inspired or biomimetic materials, which can mimic the characteristics of natural elements, are being investigated for use in the implant industry. This review discusses different biomimetic dental implants in terms of structural changes that enable antibacterial properties, drug delivery, immunomodulation, and osseointegration. We subsequently summarize the modification of dental implants for diabetes patients utilizing carbon nanomaterials, which have been recently found to improve the characteristics of biomimetic dental implants, including through antibacterial and anti-inflammatory capabilities, and by offering drug delivery properties that are essential for the success of dental implants.

2-Dodecylmalonic acid-mediated synthesis of mineralized hydroxyapatite amicable for bone cell growth on orthopaedic implant

The present study illustrates the use of 2-dodecylmalonic acid (MA) as a template in biomineralization-inspired synthesis of hydroxyapatite nanoparticles (HANPs). HANPs synthesized in presence of various concentrations of MA displayed varying particle size and shape. The smallest particle size (22-27 nm) was obtained for MA₂-HANP synthesized in presence of 37 µM MA. The critical micelle concentration (CMC) for MA at pH 9.0 relevant for mineralization was ∼35 µM. AFM analysis revealed that at a low concentration of 10 µM and pH 9.0, MA could generate oblong-shaped aggregates. At 40 µM, comparable to the concentration used to generate MA₂-HANP, the amphiphile self-assembled to form a spherical soft scaffold, which likely regulated spatial confinement of ions during mineralization and generated small size HANPs. Osteoblast-like MG-63 cells seeded on titanium wire (TW) coated with MA₂-HANP-incorporated collagen type I (H-TW) displayed enhanced cell proliferation, high expression of osteogenic differentiation marker genes (Col I, ALP, OCN and Runx2) and copious calcium mineral deposition after 14 days of growth. The nuanced role of the self-assembly process of an amphiphilic template in HANP mineralization unravelled in the present study can guide future scaffold design for biomineralization-inspired synthesis of HANPs tailored for bone tissue engineering applications.

Nanohydroxyapatite Electrodeposition onto Electrospun Nanofibers: Technique Overview and Tissue Engineering Applications

Nanocomposite scaffolds based on the combination of polymeric nanofibers with nanohydroxyapatite are a promising approach within tissue engineering. With this strategy, it is possible to synthesize nanobiomaterials that combine the well-known benefits and advantages of polymer-based nanofibers with the osteointegrative, osteoinductive, and osteoconductive properties of nanohydroxyapatite, generating scaffolds with great potential for applications in regenerative medicine, especially as support for bone growth and regeneration. However, as efficiently incorporating nanohydroxyapatite into polymeric nanofibers is still a challenge, new methodologies have emerged for this purpose, such as electrodeposition, a fast, low-cost, adjustable, and reproducible technique capable of depositing coatings of nanohydroxyapatite on the outside of fibers, to improve scaffold bioactivity and cell–biomaterial interactions. In this short review paper, we provide an overview of the electrodeposition method, as well as a detailed discussion about the process of electrodepositing nanohydroxyapatite on the surface of polymer electrospun nanofibers. In addition, we present the main findings of the recent applications of polymeric micro/nanofibrous scaffolds coated with electrodeposited nanohydroxyapatite in tissue engineering. In conclusion, comments are provided about the future direction of nanohydroxyapatite electrodeposition onto polymeric nanofibers.

Histologic and Histomorphometric Evaluation of a New Bioactive Liquid BBL on Implant Surface: A Preclinical Study in Foxhound Dogs

BACKGROUND

Bioactive chemical surface modifications improve the wettability and osseointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre-treated with a novel bone bioactive liquid (BBL) and the commercially available BLT-SLA active.

METHODS

Forty BLT-SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT-SLA pre-treated with BBL) and control (BLT-SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone-to-implant contact (BIC), inter-thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry.

RESULTS

All animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo-integrated. Relative to control groups, test implants demonstrated a significant 1.5- and 1.7-fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82-0.92 mm vs. 33-48 mm in the control group).

CONCLUSIONS

Relative to the commercially available BLT-SLA active implants, BLT-SLA pre-treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.

Study of Electron-Nuclear Interactions in Doped Calcium Phosphates by Various Pulsed EPR Spectroscopy Techniques

Substituted calcium phosphates (CaPs) are vital materials for the treatment of bone diseases and repairing and replacement of defects in human hard tissues. In this paper, we present some applications of the rarely used pulsed electron paramagnetic resonance (EPR) and hyperfine interaction spectroscopy approaches [namely, electron spin-echo envelope modulation (ESEEM) and electron-electron double-resonance detected nuclear magnetic resonance (EDNMR)] to investigate synthetic CaPs (hydroxyapatite, tricalcium, and octacalcium phosphate) doped with various cations (Li+, Na+, Mn2+, Cu2+, Fe3+, and Ba2+). These resonance techniques provide reliable tools to obtain unique information about the presence and localization of impurity centers and values of hyperfine and quadrupole tensors. We show that revealed in CaPs by EPR techniques, radiation-induced stable nitrogen-containing species and carbonate radicals can serve as sensitive paramagnetic probes to follow CaPs' structural changes caused by cation doping. The most pulsed EPR, ESEEM, and EDNMR spectra can be detected at room temperature, reducing the costs of the measurements and facilitating the usage of pulsed EPR techniques for CaP characterization.

A novel multi-structural reinforced treatment on Ti implant utilizing a combination of alkali solution and bioactive glass sol

OBJECTIVE

Alkali treatment and bioactive glass (BG) sol dip-coating are well-known individual methods for titanium (Ti) surface modification. In this study, a unique combination of alkali treatment and bioactive glass sol dip coating was applied to the Ti substrate, then the mechanical properties and cell responses were investigated.

METHODS

Based on the methods introduced above, the Ti substrate was treated by 6 mL of an NaOH 5 M aqueous solution for 24 h at 60 ̊C; this was followed by adding 1.2 mL of a BG 58S sol to form a novel combined nanostructure network covered by a thin BG layer. For the assessment of the formed coating layer, the morphology, elemental analysis, phase structure, adhesion property and the cell response of the untreated and treated surfaces were investigated.

RESULTS

The BG coating layer was reinforced by the nanostructure, fabricated through the alkali treatment. The results obtained by applying the combined modification method confirmed that the mechanical and biological properties of the fabricated surface demonstrated the highest performance compared to that of the unmodified and individually modified surfaces.

SIGNIFICANCE

The achieved upgrades for this method could be gained from the demanded porous nanostructure and the apatite transformation ability of the alkali treatment. Therefore, the hybridized application of the alkali-BG treatment could be introduced as a promising surface modification strategy for hard-tissue replacement applications.

Synergistic Effect of the Photothermal Performance and Osteogenic Properties of MXene and Hydroxyapatite Nanoparticle Composite Nanofibers for Osteogenic Application

MXene has attracted tremendous attention due to its outstanding photothermal properties and biocompatibility. Hydroxyapatite (HA) contains Ca, Mg and P elements, which play important roles in promoting osteogenic differentiation of mesenchymal stem cells (MSCs). In this study, a class of composite nanofibers consisting of MXene nanosheets and HA nanoparticles (M-@HA NFs) are developed based on the synergistic effect of photothermal performance and osteogenic properties. The obtained composite nanofibers demonstrated excellent photothermal properties, and the temperature reached 44 °C under NIR exposure (808 nm). In addition, the composite nanofibers also displayed good biocompatibility and promote the growth and osteogenic differentiation of bone mesenchymal stem cells (BMSCs). More importantly, under NIR exposure, BMSCs on the composite nanofibers achieved much better osteogenic differentiation than those without NIR exposure due to the accelerated release of Ca, Mg and P elements. Therefore, we considered the unique photothermal and osteogenic differentiation to indicate that this new class of MXene composite nanofibers has tremendous application potential in bone tissue engineering.

Dental Implant Nano-Engineering: Advances, Limitations and Future Directions

Titanium (Ti) and its alloys offer favorable biocompatibility, mechanical properties and corrosion resistance, which makes them an ideal material choice for dental implants. However, the long-term success of Ti-based dental implants may be challenged due to implant-related infections and inadequate osseointegration. With the development of nanotechnology, nanoscale modifications and the application of nanomaterials have become key areas of focus for research on dental implants. Surface modifications and the use of various coatings, as well as the development of the controlled release of antibiotics or proteins, have improved the osseointegration and soft-tissue integration of dental implants, as well as their antibacterial and immunomodulatory functions. This review introduces recent nano-engineering technologies and materials used in topographical modifications and surface coatings of Ti-based dental implants. These advances are discussed and detailed, including an evaluation of the evidence of their biocompatibility, toxicity, antimicrobial activities and in-vivo performances. The comparison between these attempts at nano-engineering reveals that there are still research gaps that must be addressed towards their clinical translation. For instance, customized three-dimensional printing technology and stimuli-responsive, multi-functional and time-programmable implant surfaces holds great promise to advance this field. Furthermore, long-term in vivo studies under physiological conditions are required to ensure the clinical application of nanomaterial-modified dental implants.

Natural Drug-Loaded Bimetal-Substituted Hydroxyapatite-Polymeric Composite for Osteosarcoma-Affected Bone Repair

Repairing segmental bone deformities after resection of dangerous bone tumors is a long-standing clinical issue. The study's main objective is to synthesize a natural bioactive compound-loaded bimetal-substituted hydroxyapatite (BM-HA)-based composite for bone regeneration. The bimetal (copper and cadmium)-substituted HAs were prepared by the sol-gel method and reinforced with biocompatible polyacrylamide (BM-HA/PAA). Umbelliferone (UMB) drug was added to the BM-HA/PAA composite to enhance anticancer activity further. The composite's formation was confirmed by various physicochemical investigations, such as FT-IR, XRD, SEM, EDAX, and HR-TEM techniques. The bioactivity was assessed by immersing the sample in simulated body fluid for 1, 3, and 7 days. The zeta potential values of BM-HA/PAA and BM-HA/PAA/UMB are -36.4 mV and -49.4 mV, respectively. The in vitro viability of the prepared composites was examined in mesenchymal stem cells (MSCs). It shows the ability of the composite to produce osteogenic bone regeneration without any adverse effects. From the gene expression and PCR results, the final UMB-loaded composite induced osteogenic markers, such as Runx, OCN, and VEFG. The prepared bimetal substituted polyacrylamide reinforced HA composite loaded with UMB drug has the ability for bone repair/regenerations.

Electrophoretic Deposition of Biocompatible and Bioactive Hydroxyapatite-Based Coatings on Titanium

Current trends in biomaterials science address the issue of integrating artificial materials as orthopedic or dental implants with biological materials, e.g., patients' bone tissue. Problems arise due to the simple fact that any surface that promotes biointegration and facilitates osteointegration may also provide a good platform for the rapid growth of bacterial colonies. Infected implant surfaces easily lead to biofilm formation that poses a major healthcare concern since it could have destructive effects and ultimately endanger the patients' life. As of late, research has centered on designing coatings that would eliminate possible infection but neglected to aid bone mineralization. Other strategies yielded surfaces that could promote osseointegration but failed to prevent microbial susceptibility. Needless to say, in order to assure prolonged implant functionality, both coating functions are indispensable and should be addressed simultaneously. This review summarizes progress in designing multifunctional implant coatings that serve as carriers of antibacterial agents with the primary intention of inhibiting bacterial growth on the implant-tissue interface, while still promoting osseointegration.

Defect Induced Charge Redistribution and Enhanced Adsorption of Lysozyme on Hydroxyapatite for Efficient Antibacterial Activity

Defects in hydroxyapatite (HA) have attracted increasing research interest due to their significant functions to increase the bioactivity and antibacterial ability of hard-tissue implants. However, little is known about the natural property and functional mechanism of the defects in HA. Herein, we reported on the defect property concerned with the coordination state and charge distribution in Al doped HA, as well as the consequent interface and protein capture ability for improved antibacterial activity. Systemic investigations suggested that Al replacing Ca in HA induced coordination defect with decreased coordination number and bond distance, caused charge transfer and redistribution of surrounding O atom and resulted in an increase in negative charge of coordinated O atoms. These O atoms coordinated with Al further served as docking sites for lysozyme molecules via electrostatic and H-bonding interaction. The capacity of lysozyme adsorption for Al-HA increased approximately 10-fold more than that of HA, which significantly increased the antibacterial activity through lysozyme-catalyzed splitting of cell wall of bacteria. Moreover, in vitro studies indicated that Al-HA materials showed good cytocompatibility. These findings not only provided new insights into the important effect of defects on the performances of HA biomaterials by modulation of the coordination state, charge distribution, and chemical activity, but also proposed a promising method for efficient antibacterial activity of HA biomaterials.