Impact of pore size on the vascularization and osseointegration of ceramic bone substitutes in vivo

Influence of a non-biodegradable porous structure on bone repair

Pore and interconnection size are two key structural parameters for bone tissue engineering scaffolds.

Influence of hydroxyapatite granule size, porosity, and crystallinity on tissue reaction in vivo. Part A: synthesis, characterization of the materials, and SEM analysis

OBJECTIVE

The aim of this study was the synthesis and analysis of the tissue reaction to three different Hydroxyapatite (HA)-based bone substitute materials differing only in granule size, porosity, and crystallinity through an animal experimental model at 60 days.

MATERIALS AND METHODS

Three different HA-based biomaterials were synthesized and characterized by X-ray diffraction, SEM, and EDS analysis, the resultant product was ground in three particle sizes: Group I (2000-4000 μm), Group II (1000-2000 μm), and Group III (600-1000 μm). Critical size defects were created in both tibias of 15 rabbits. Four defects per rabbit for a total of 60 defects were grafted with the synthesized materials as follows: Group I (15 defects), Group II (15 defects), Group III (15 defects), and empty (15 defects control). After animals sacrifice at 60 days samples were obtained and processed for SEM and EDS evaluation of Ca/P ratios, elemental mapping was performed to determine the chemical degradation process and changes to medullary composition in all the four study groups.

RESULTS

The tendency for the density was to increase with the increasing annealing temperature; in this way it was possible to observe that the sample that shows highest crystallinity and crystal size corresponding to that of group I. The SEM morphological examination showed that group III implant showed numerous resorption regions, group II implant presented an average resorption rate of all the implants. The group I displayed smoother surface features, in comparison with the other two implants.

CONCLUSION

The data from this study show that changing the size, porosity, and crystallinity of one HA-based bone substitute material can influence the integration of the biomaterials within the implantation site and the new bone formation.

Scaling up self-assembly: bottom-up approaches to macroscopic particle organization

This review presents an overview of recent work in the field of non-Brownian particle self-assembly. Compared to nanoparticles that naturally self-assemble due to Brownian motion, larger, non-Brownian particles (d > 6 μm) are less prone to autonomously organize into crystalline arrays. The tendency for particle systems to experience immobilization and kinetic arrest grows with particle radius. In order to overcome this kinetic limitation, some type of external driver must be applied to act as an artificial "thermalizing force" upon non-Brownian particles, inducing particle motion and subsequent crystallization. Many groups have explored the use of various agitation methods to overcome the natural barriers preventing self-assembly to which non-Brownian particles are susceptible. The ability to create materials from a bottom-up approach with these characteristics would allow for precise control over their pore structure (size and distribution) and surface properties (topography, functionalization and area), resulting in improved regulation of key characteristics such as mechanical strength, diffusive properties, and possibly even photonic properties. This review will highlight these approaches, as well as discuss the potential impact of bottom-up macroscale particle assembly. The applications of such technology range from customizable and autonomously self-assembled niche microenvironments for drug delivery and tissue engineering to new acoustic dampening, battery, and filtration materials, among others. Additionally, crystals made from non-Brownian particles resemble naturally derived materials such as opals, zeolites, and biological tissue (i.e. bone, cartilage and lung), due to their high surface area, pore distribution, and tunable (multilevel) hierarchy.

Ridge augmentation using recombinant human fibroblast growth factor-2 with biodegradable gelatin sponges incorporating β-tricalcium phosphate: a preclinical study in dogs

BACKGROUND AND OBJECTIVE

Fibroblast growth factor-2 (FGF-2) regulates the proliferation and differentiation of osteogenic cells, resulting in the promotion of bone formation. Biodegradable gelatin sponges incorporating β-tricalcium phosphate (β-TCP) have been reported as a scaffold, which has the ability to control growth factor release, offering sufficient mechanical strength and efficient migration of mesenchymal cells. In this study, we evaluated the effects of the combined use of recombinant human FGF-2 (rhFGF-2) and gelatin/β-TCP sponge on ridge augmentation in dogs.

MATERIAL AND METHODS

Six male beagle dogs were used in this study. Twelve wk after tooth extraction, bilateral 10 × 5 mm (width × depth) saddle-type defects were created 3 mm apart from the mesial side of the maxillary canine. At the experimental sites, the defects were filled with gelatin/β-TCP sponge infiltrated with 0.3% rhFGF-2, whereas gelatin/β-TCP sponge infiltrated with saline was applied to the control sites. Eight wk after surgery, qualitative and quantitative analyses were performed.

RESULTS

There were no signs of clinical inflammation at 8 wk after surgery. Histometric measurements revealed that new bone height at the experimental sites (2.98 ± 0.65 mm) was significantly greater than that at the control sites (1.56 ± 0.66 mm; p = 0.004). The total tissue height was greater at the experimental sites (6.62 ± 0.66 mm) than that at the control sites (5.95 ± 0.74 mm), although there was no statistical significant difference (p = 0.051). Cast model measurements revealed that the residual defect height at the experimental sites (2.31 ± 0.50 mm) was significantly smaller than that at the control sites (3.51 ± 0.78 mm; p = 0.012).

CONCLUSION

The combined use of rhFGF-2 and gelatin/β-TCP sponge promotes ridge augmentation in canine saddle-type bone defects.

Effect of Macroscopic Grooves on Bone Formation and Osteoblastic Differentiation

OBJECTIVES

The aim of this study is to investigate the effect of macroscopic grooves on bone formation in vivo and differentiation of human mesenchymal stem cells (hMSCs) in vitro.

MATERIALS AND METHODS

The effects of macroscopic grooves on titanium alloy implants and disks were tested in rabbit tibiae and cultured hMSCs. The bone-to-implant contact (BIC) and bone area were evaluated in rabbit tibiae at 6 and 24 weeks after implant insertion. Osteoblastic differentiation was assessed by alkaline phosphatase (ALP) activity and real-time reverse-transcription polymerase chain reaction (RT-PCR) on days 7, 14, and 21. All values were statically analyzed.

RESULTS

BIC and bone area inside the grooves were significantly higher than those of control implants (P < 0.05). ALP activity was significantly higher for titanium disks with macroscopic grooves than without grooves on day 14 (P < 0.05). Real-time RT-PCR showed that the expression of osteogenic genes was significantly higher for disks with grooves on day 7 (P < 0.01).

CONCLUSIONS

Macroscopic grooves accelerate osteoblastic differentiation in vitro and stimulate direct bone growth and deposition within the grooves in vivo.

Angiogenesis and bone regeneration of porous nano-hydroxyapatite/coralline blocks coated with rhVEGF165 in critical-size alveolar bone defects in vivo

To improve the regenerative performance of nano-hydroxyapatite/coralline (nHA/coral) block grafting in a canine mandibular critical-size defect model, nHA/coral blocks were coated with recombinant human vascular endothelial growth factor(165) (rhVEGF) via physical adsorption (3 μg rhVEGF165 per nHA/coral block). After the nHA/coral blocks and VEGF/nHA/coral blocks were randomly implanted into the mandibular box-shaped defects in a split-mouth design, the healing process was evaluated by histological observation and histomorphometric and immunohistological analyses. The histological evaluations revealed the ingrowth of newly formed blood vessels and bone at the periphery and cores of the blocks in both groups at both 3 and 8 weeks postsurgery, respectively. In the histomorphometric analysis, the VEGF/nHA/coral group exhibited a larger quantity of new bone formation at 3 and 8 weeks postsurgery. The percentages of newly formed bone within the entire blocks in the VEGF/nHA/coral group were 27.3% ± 8.1% and 39.3% ± 12.8% at 3 weeks and 8 weeks, respectively, and these values were slightly greater than those of the nHA/coral group (21.7% ± 3.0% and 32.6% ± 10.3%, respectively), but the differences were not significant (P>0.05). The immunohistological evaluations revealed that the neovascular density in the VEGF/nHA/coral group (146 ± 32.9 vessel/mm(2)) was much greater than that in the nHA/coral group (105 ± 51.8 vessel/mm(2)) at the 3-week time point (P<0.05), but no significant difference was observed at the 8-week time point (341 ± 86.1 and 269 ± 50.7 vessel/mm(2), respectively, P>0.05). The present study indicated that nHA/coral blocks might be optimal scaffolds for block grafting in critical-size mandibular defects and that additional VEGF coating via physical adsorption can promote angiogenesis in the early stage of bone healing, which suggests that prevascularized nHA/coral blocks have significant potential as a bioactive material for bone regeneration in large-scale alveolar defects.

Evaluating 3D-printed biomaterials as scaffolds for vascularized bone tissue engineering

There is an unmet need for a consistent set of tools for the evaluation of 3D-printed constructs. A toolbox developed to design, characterize, and evaluate 3D-printed poly(propylene fumarate) scaffolds is proposed for vascularized engineered tissues. This toolbox combines modular design and non-destructive fabricated design evaluation, evaluates biocompatibility and mechanical properties, and models angiogenesis.

Enhanced effect of β-tricalcium phosphate phase on neovascularization of porous calcium phosphate ceramics: in vitro and in vivo evidence

Neovascularization plays a key role in bone repair and regeneration. In the present study, four types of porous calcium phosphate (CaP) ceramics, namely hydroxyapatite (HA), biphasic calcium phosphates (BCP-1 and BCP-2) and β-tricalcium phosphate (β-TCP), with HA to β-TCP ratios of 100/0, 70/30, 30/70 and 2/98, respectively, were investigated in terms of their angiogenic induction. The in vitro cell culture revealed that the ceramics could promote proliferation and angiogenesis of human umbilical vein endothelial cells (HUVECs). This result could be achieved by stimulating CCD-18Co human fibroblasts to secrete angiogenic factors (vascular endothelial growth factor, basic fibroblast growth factor and transforming growth factor-β) as a paracrine effect, as well as by up-regulating HUVECs to express these angiogenic factors and their receptors (KDR, FGFR1 and ACVRL1) and the downstream eNOS as an autocrine effect. These effects were more significant in β-TCP and BCP-2, which had a higher content of β-TCP phase. In the in vivo implantation into the thigh muscles of mice, the process of neovascularization of the ceramics was initiated at 2 weeks and the mature vascular networks were formed at 4 weeks as visualized by hematoxylin and eosin staining and scanning electron microscopy. Microvessel density count confirmed that β-TCP and BCP-2 induced more microvessels to form than HA or BCP-1. This phenomenon was further confirmed by the significantly up-regulated expressions of angiogenesis-related genes in the ingrowth of cells into the inner pores of the two ceramics. All the results confirmed the angiogenic induction of porous CaP ceramics, and a higher content of β-TCP phase had an enhanced effect on the neovascularization of the ceramics.

Effect of different hydroxyapatite incorporation methods on the structural and biological properties of porous collagen scaffolds for bone repair

Scaffolds which aim to provide an optimised environment to regenerate bone tissue require a balance between mechanical properties and architecture known to be conducive to enable tissue regeneration, such as a high porosity and a suitable pore size. Using freeze-dried collagen-based scaffolds as an analogue of native ECM, we sought to improve the mechanical properties by incorporating hydroxyapatite (HA) in different ways while maintaining a pore architecture sufficient to allow cell infiltration, vascularisation and effective bone regeneration. Specifically we sought to elucidate the effect of different hydroxyapatite incorporation methods on the mechanical, morphological, and cellular response of the resultant collagen-HA scaffolds. The results demonstrated that incorporating either micron-sized (CHA scaffolds) or nano-sized HA particles (CnHA scaffolds) prior to freeze-drying resulted in moderate increases in stiffness (2.2-fold and 6.2-fold, respectively, vs. collagen-glycosaminoglycan scaffolds, P < 0.05, a scaffold known to support osteogenesis), while enabling good cell attachment, and moderate mesenchymal stem cell (MSC)-mediated calcium production after 28 days' culture (2.1-fold, P < 0.05, and 1.3-fold, respectively, vs. CG scaffolds). However, coating of collagen scaffolds with a hydroxyapatite precipitate after freeze-drying (CpHA scaffolds) has been shown to be a highly effective method to increase the compressive modulus (26-fold vs. CG controls, P < 0.001) of scaffolds while maintaining a high porosity (~ 98%). The coating of the ligand-dense collagen structure results in a lower cell attachment level (P < 0.05), although it supported greater cell-mediated calcium production (P < 0.0001) compared with other scaffold variants after 28 days' culture. The comparatively good mechanical properties of these high porosity scaffolds is obtained partially through highly crosslinking the scaffolds with both a physical (DHT) and chemical (EDAC) crosslinking treatment. Control of scaffold microstructure was examined via alterations in freezing temperature. It was found that the addition of HA prior to freeze-drying generally reduced the pore size and so the CpHA scaffold fabrication method offered increased control over the resulting scaffolds microstructure. These findings will help guide future design considerations for composite biomaterials and demonstrate that the method of HA incorporation can have profound effects on the resulting scaffold structural and biological response.

Ectopic osteoid and bone formation by three calcium-phosphate ceramics in rats, rabbits and dogs

Calcium phosphate ceramics with specific physicochemical properties have been shown to induce de novo bone formation upon ectopic implantation in a number of animal models. In this study we explored the influence of physicochemical properties as well as the animal species on material-induced ectopic bone formation. Three bioceramics were used for the study: phase-pure hydroxyapatite (HA) sintered at 1200°C and two biphasic calcium phosphate (BCP) ceramics, consisting of 60 wt.% HA and 40 wt.% TCP (β-Tricalcium phosphate), sintered at either 1100°C or 1200°C. 108 samples of each ceramic were intramuscularly implanted in dogs, rabbits, and rats for 6, 12, and 24 weeks respectively. Histological and histomorphometrical analyses illustrated that ectopic bone and/or osteoid tissue formation was most pronounced in BCP sintered at 1100°C and most limited in HA, independent of the animal model. Concerning the effect of animal species, ectopic bone formation reproducibly occurred in dogs, while in rabbits and rats, new tissue formation was mainly limited to osteoid. The results of this study confirmed that the incidence and the extent of material-induced bone formation are related to both the physicochemical properties of calcium phosphate ceramics and the animal model.

Effect of particle size on osteoinductive potential of microstructured biphasic calcium phosphate ceramic

Material factors such as chemistry, surface microstructure and geometry have shown their influence on osteoinduction of calcium phosphate ceramics. Hereby we report that osteoinduction of a micro-structured biphasic calcium phosphate ceramic (BCP) has a relation with the particle sizes. BCP particles with the size of 212-300 µm, 106-212 µm, 45-106 µm, and smaller than 45 µm were prepared and implanted in paraspinal muscle of dogs for 12 weeks. Histological evaluation of the explants showed abundant bone in all samples with particle size of 212-300 µm, 106-212 µm, and 45-106 µm, while no bone was seen in any sample having particle size smaller than 45 µm. Bone was formed as early as 3 weeks after implantation in implants having BCP particles bigger than 45 µm and the volume of the formed bone was similar among the implants with particles larger than 45 µm after 12 weeks implantation. The results herein show that a size limitation of microstructured calcium phosphate ceramic particles for osteoinduction. It is most likely that the particle size affect inductive bone formation via macroporous structures for body fluid infiltration, cell/tissue ingrowth and angiogenesis.

Assessment of retention force and bone apposition in two differently coated femoral stems after 6 months of loading in a goat model

Background

Since the introduction of uncemented hip implants, there has been a search for the best surface coating to enhance bone apposition in order to improve retention. The surface coating of the different stems varies between products. The aim was to assess the retention force and bone adaption in two differently coated stems in a weight-bearing goat model.

Materials and methods

Hydroxyapatite (HA) and electrochemically deposited calcium phosphate (CP; Bonit®) on geometrically comparable titanium-based femoral stems were implanted into 12 (CP group) and 35 (HA group) goats. The animal model included physiological loading of the implants for 6 months. The pull-out force of the stems was measured, and bone apposition was microscopically evaluated.

Results

After exclusion criteria were applied, the number of available goats was 4 in the CP group and 11 in the HA group. The CP-coated stems had significantly lower retention forces compared with the HA-coated ones after 6 months (CP median 47 N, HA median 1,696 N, p = 0.003). Bone sections revealed a lower degree of bone apposition in the CP-coated stems, with more connective tissue in the bone/implant interface compared with the HA group.

Conclusion

In this study, HA had better bone apposition and needed greater pull-out force in loaded implants. The application of CP on the loaded titanium surface to enhance the apposition of bone is questioned.

Adenovirus-mediated transfer of VEGF into marrow stromal cells combined with PLGA/TCP scaffold increases vascularization and promotes bone repair in vivo

INTRODUCTION

Large osseous defect remains a serious clinical problem due to the lack of sufficient blood supply and it has been proposed that this situation can be relieved by accelerating the formation of new vessels in the process of bone defect repair. The aim of this study was to develop a new type of artificial bone by transferring the VEGF gene into marrow stromal cells (MSCs) and seeding them into a porous scaffold.

MATERIAL AND METHODS

An adenovirus vector was employed to transfer the VEGF gene into MSCs and expression of the exogenous gene was confirmed by ELISA. Next the transduced cells were seeded into a collagen I modified PLGA/TCP scaffold. The constructed new complex artificial bone was then assessed for biocompatibility in vitro and blood vessel formation and bone formation in vivo.

RESULTS

We found that adenovirus mediated VEGF gene transfer into MSCs sustained VEGF expression in MSCs for 3 weeks. Porous scaffold PLGA/TCP made by rapid prototyping technology exhibited improved biocompatibility resulting from crosslinking with collagen I. Furthermore, the in vivo study showed that large amounts of blood vessels were detected histologically 1 week after artificial bone implantation, and significant bone formation was detected 8 weeks after implantation.

CONCLUSIONS

Our findings suggest that gene transfer of VEGF into MSCs combined with PLGA/TCP scaffold enhances bone repair in vivo by promoting vascularization.

Safety evaluation of a bioglass-polylactic acid composite scaffold seeded with progenitor cells in a rat skull critical-size bone defect

Treating large bone defects represents a major challenge in traumatic and orthopedic surgery. Bone tissue engineering provides a promising therapeutic option to improve the local bone healing response. In the present study tissue biocompatibility, systemic toxicity and tumorigenicity of a newly developed composite material consisting of polylactic acid (PLA) and 20% or 40% bioglass (BG20 and BG40), respectively, were analyzed. These materials were seeded with mesenchymal stem cells (MSC) and endothelial progenitor cells (EPC) and tested in a rat calvarial critical size defect model for 3 months and compared to a scaffold consisting only of PLA. Serum was analyzed for organ damage markers such as GOT and creatinine. Leukocyte count, temperature and free radical indicators were measured to determine the degree of systemic inflammation. Possible tumor occurrence was assessed macroscopically and histologically in slides of liver, kidney and spleen. Furthermore, the concentrations of serum malondialdehyde (MDA) and sodium oxide dismutase (SOD) were assessed as indicators of tumor progression. Qualitative tissue response towards the implants and new bone mass formation was histologically investigated. BG20 and BG40, with or without progenitor cells, did not cause organ damage, long-term systemic inflammatory reactions or tumor formation. BG20 and BG40 supported bone formation, which was further enhanced in the presence of EPCs and MSCs.

This investigation reflects good biocompatibility of the biomaterials BG20 and BG40 and provides evidence that additionally seeding EPCs and MSCs onto the scaffold does not induce tumor formation.

Suitability of Biomorphic Silicon Carbide Ceramics as Drug Delivery Systems against Bacterial Biofilms

The present work is aimed at getting a new insight into biomorphic silicon carbides (bioSiCs) as bone replacement materials. BioSiCs from a variety of precursors were produced, characterized, and loaded with a broad-spectrum antibiotic. The capacity of loaded bioSiCs for preventing and/or treating preformed S. aureus biofilms has been studied. The differences in precursor characteristics are maintained after the ceramic production process. All bioSiCs allow the loading process by capillarity, giving loaded materials with drug release profiles dependent on their microstructure. The amount of antibiotic released in liquid medium during the first six hours depends on bioSiC porosity, but it could exceed the minimum inhibitory concentration of Staphylococcus aureus, for all the materials studied, thus preventing the proliferation of bacteria. Differences in the external surface and the number and size of open external pores of bioSiCs contribute towards the variations in the effect against bacteria when experiments are carried out using solid media. The internal structure and surface properties of all the systems seem to facilitate the therapeutic activity of the antibiotic on the preformed biofilms, reducing the number of viable bacteria present in the biofilm compared to controls.

Fabrication and characterization of biomimetic collagen-apatite scaffolds with tunable structures for bone tissue engineering

The objective of the current study is to prepare a biomimetic collagen-apatite scaffold for improved bone repair and regeneration. A novel bottom-up approach has been developed, which combines a biomimetic self-assembly method with a controllable freeze-casting technology. In this study, the mineralized collagen fibers were generated using a simple one-step co-precipitation method which involved collagen self-assembly and in situ apatite precipitation in a collagen-containing modified simulated body fluid (m-SBF). The precipitates were then subjected to controllable freeze casting, forming scaffolds with either an isotropic equiaxed structure or a unidirectional lamellar structure. These scaffolds were comprised of collagen fibers and poorly crystalline bone-like carbonated apatite nanoparticles. The mineral content in the scaffold could be tailored in the range 0-54wt.% by simply adjusting the collagen content in the m-SBF. Further, the mechanisms of the formation of both the equiaxed and the lamellar scaffolds were investigated, and freezing regimes for equiaxed and lamellar solidification were established. Finally, the bone-forming capability of such prepared scaffolds was evaluated in vivo in a mouse calvarial defect model. It was confirmed that the scaffolds well support new bone formation.

Evaluation of healing following tooth extraction with ridge preservation using cortical versus cancellous freeze-dried bone allograft

BACKGROUND

The objective of this study is to compare histologic and clinical healing following tooth extraction and ridge preservation with either cortical or cancellous freeze-dried bone allograft (FDBA) in non-molar extraction sockets.

METHODS

Forty patients requiring implant placement were enrolled, with 20 patients randomly assigned to each group (cortical versus cancellous FDBA). All of the allograft materials were obtained from the same donor to control for variability between donors and processing. Patients returned after 17 to 21 weeks (average: 18.2 weeks), and a 2-mm-diameter core biopsy was obtained before implant placement. Histomorphometric analysis was performed to determine percentage of new bone formation, residual graft material, and non-mineralized connective tissue (CT)/other material. Clinical measurements of ridge dimensions were taken at the time of tooth extraction and again at implant placement.

RESULTS

There was no significant difference in new bone formation between the cortical and cancellous FDBA groups (P = 0.857). A significantly greater percentage of residual graft material was detected in the cortical FDBA group compared with the cancellous FDBA group (P = 0.019). A significantly greater percentage of non-mineralized CT/other material was found in the cancellous FDBA group compared with the cortical FDBA group (P = 0.040). The only significant clinical difference between groups was a greater loss of lingual ridge height in the cancellous group.

CONCLUSIONS

This is the first reported study to compare the histologic changes following tooth extraction with ridge preservation in humans using cortical versus cancellous FDBA. There were no differences in the percentage of new bone formation between the groups.

Three-dimensional modeling of angiogenesis in porous biomaterial scaffolds

Vascularization of biomaterial scaffolds is essential for the successful clinical application of engineered tissues. Experimental studies are often performed to investigate the role of scaffold architecture on vascularized tissue formation. However, experiments are expensive and time-consuming and synthesis protocols often do not allow for independent investigation of specific scaffold properties. Computational models allow for rapid screening of potential material designs with control over scaffold properties that is difficult in laboratory settings. We have developed and tested a three-dimensional agent-based framework for investigating the effect of scaffold pore architecture on angiogenesis. Software agents represent endothelial cells, interacting together and with their micro-environment, leading to the invasion of blood vessels into the scaffold. A rule base, driven by experimental findings, governs the behavior of individual agents. 3D scaffold models with well-defined homogeneous and heterogeneous pore architectures were simulated to investigate the impact of various design parameters. Simulation results indicate that pores of larger size with higher interconnectivity and porosity support rapid and extensive angiogenesis. The developed framework can be used to screen biomaterial scaffold designs for optimal vascularization and investigate complex interactions among invading blood vessels and their micro-environment.

The effect of sinusoidal AC electric stimulation of 3D PCL/CNT and PCL/β-TCP based bio-composites on cellular activities for bone tissue regeneration

Various physical stimulations have been widely applied to tissue regenerative applications. In particular, for bone tissue regeneration, several experimental studies have reported that electric stimulation can enhance the mineral formation in cultured osteoblasts and even alter the pattern of gene expression, promoting bone tissue formation. However, to date, for rapid-prototyped polycaprolactone (PCL)-based composites of pure PCL and dispersed materials including carbon nanotubes and β-tricalcium phosphate (TCP), the effect of electric stimulation on various cellular activities has not been analyzed. Here, a sinusoidal AC electric field (55 ± 8 mV cm^-1 and 60 Hz) between parallel electrodes was applied to three-dimensional scaffolds (pure PCL, PCL/CNT-0.2 wt%, and PCL/β-TCP-20 wt%) cultured with osteoblast-like cells (MG63) 30 min per day for 14 days. When exposed to electric stimulation, alkaline phosphatase and calcium mineralization were enhanced in all scaffolds, and the PCL/β-TCP scaffold in particular showed the highest improvement in bone mineralization compared with other scaffolds. In this work, we surmised that the improvement may have been due to chemical precipitation of the calcium ions from the PCL/β-TCP scaffolds. To evaluate the effect of the released calcium ions from the composite scaffold, we observed the cellular behavior (cellular contraction) of proliferated cells under electric stimulation. The results indicate that in addition to the applied electric field conditions, the scaffold materials are also an important parameter for successful electric stimulation.

Osteogenic and angiogenic potentials of monocultured and co-cultured human-bone-marrow-derived mesenchymal stem cells and human-umbilical-vein endothelial cells on three-dimensional porous beta-tricalcium phosphate scaffold

The use of biodegradable beta-tricalcium phosphate (β-TCP) scaffolds holds great promise for bone tissue engineering. However, the effects of β-TCP on bone and endothelial cells are not fully understood. This study aimed to investigate cell proliferation and differentiation of mono- or co-cultured human-bone-marrow-derived mesenchymal stem cells (hBMSCs) and human-umbilical-vein endothelial cells (HUVECs) on a three-dimensional porous, biodegradable β-TCP scaffold. In co-culture studies, the ratios of hBMSCs:HUVECs were 5:1, 1:1 and 1:5. Cellular morphologies of HUVECs, hBMSCs and co-cultured HUVECs/hBMSCs on the β-TCP scaffolds were monitored using confocal and scanning electron microscopy. Cell proliferation was monitored by measuring the amount of double-stranded DNA (dsDNA) whereas hBMSC and HUVEC differentiation was assessed using the osteogenic and angiogenic markers, alkaline phosphatase (ALP) and PECAM-1 (CD31), respectively. Results show that HUVECs, hBMSCs and hBMSCs/HUVECs adhered to and proliferated well on the β-TCP scaffolds. In monoculture, hBMSCs grew faster than HUVECs on the β-TCP scaffolds after 7 days, but HUVECs reached similar levels of proliferation after 14 days. In monoculture, β-TCP scaffolds promoted ALP activities of both hBMSCs and HUVECs when compared to those grown on tissue culture well plates. ALP activity of cells in co-culture was higher than that of hBMSCs in monoculture. Real-time polymerase chain reaction results indicate that runx2 and alp gene expression in monocultured hBMSCs remained unchanged at days 7 and 14, but alp gene expression was significantly increased in hBMSC co-cultures when the contribution of individual cell types was not distinguished.

Neovascularization in biodegradable inverse opal scaffolds with uniform and precisely controlled pore sizes

The formation of a stable vascular network in a scaffold is one of the most challenging tasks in tissue engineering and regenerative medicine. Despite the common use of porous scaffolds in these applications, little is known about the effect of pore size on the neovascularization in these scaffolds. Herein is fabricated poly(D, L-lactide-co-glycolide) inverse opal scaffolds with uniform pore sizes of 79, 147, 224, and 312 μm in diameter and which are then used to systematically study neovascularization in vivo. Histology analyses reveal that scaffolds with small pores (<200 μm) favor the formation of vascular networks with small vessels at high densities and poor penetration depth. By contrast, scaffolds with large pores (>200 μm) favor the formation of vascular networks with large blood vessels at low densities and deep penetration depth. Based on the different patterns of vessel ingrowth as regulated by the pore size, a model is proposed to describe vascularization in a 3D porous scaffold, which can potentially serve as a guideline for future design of porous scaffolds.

Functionalization of microstructured open-porous bioceramic scaffolds with human fetal bone cells

Bone substitute materials allowing trans-scaffold migration and in-scaffold survival of human bone-derived cells are mandatory for development of cell-engineered permanent implants to repair bone defects. In this study, we evaluated the influence on human bone-derived cells of the material composition and microstructure of foam scaffolds of calcium aluminate. The scaffolds were prepared using a direct foaming method allowing wide-range tailoring of the microstructure for pore size and pore openings. Human fetal osteoblasts (osteo-progenitors) attached to the scaffolds, migrated across the entire bioceramic depending on the scaffold pore size, colonized, and survived in the porous material for at least 6 weeks. The long-term biocompatibility of the scaffold material for human bone-derived cells was evidenced by in-scaffold determination of cell metabolic activity using a modified MTT assay, a repeated WST-1 assay, and scanning electron microscopy. Finally, we demonstrated that the osteo-progenitors can be covalently bound to the scaffolds using biocompatible click chemistry, thus enhancing the rapid adhesion of the cells to the scaffolds. Therefore, the different microstructures of the foams influenced the migratory potential of the cells, but not cell viability. Scaffolds allow covalent biocompatible chemical binding of the cells to the materials, either localized or widespread integration of the scaffolds for cell-engineered implants.

Mineralized poly(lactic acid) scaffolds loading vascular endothelial growth factor and the in vivo performance in rat subcutaneous model

The functionalization of degradable polymeric scaffolds with therapeutic molecules such as vascular endothelial growth factor (VEGF) is a key strategy to gain better regenerative ability of damaged bone tissue by stimulating vascularization and tissue perfusion. Here, we combined VEGF with poly(lactic acid) (PLA) porous scaffold, after modifying the PLA surface with calcium phosphate (CaP) mineral. The mineralized PLA scaffold (mPLA) showed more effective loading capacity of VEGF than the PLA without mineralization as well as profiled sustainable release of VEGF for up to a couple of weeks. The VEGF-loaded mPLA scaffold presented significantly improved proliferation of primary endothelial cells for up to 7 days, with respect to the scaffold without the VEGF loading. The performance of the engineered scaffold was assessed after subcutaneous implantation in rats for 4 weeks. Histological results showed favorable tissue compatibility of both the mPLA scaffolds (with and without VEGF loading), as characterized by infiltration of inflammatory cells, formation of fibrous capsule, and ingrowth of fibroblasts into the matrices. Immunohistochemical staining of the von Willebrand Factor revealed significantly improved formation of neo-capillaries in the VEGF-loaded mPLA. Based on this study, the strategy of VEGF loading onto mineralized PLA scaffold is considered beneficial for gaining improved vascularization of the polymeric scaffolds, suggesting potential applications for bone tissue engineering.

Preparation and characterization of collagen-nanohydroxyapatite biocomposite scaffolds by cryogelation method for bone tissue engineering applications

Recent efforts of bone repair focus on development of porous scaffolds for cell adhesion and proliferation. Collagen-nanohydroxyapatite (HA) scaffolds (70:30; 50:50; and 30:70 mass percentage) were produced by cryogelation technique using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide hydrochloride/N-hydroxysuccinimide as crosslinking agents. A pure collagen scaffold was used as control. Morphology analysis revealed that all cryogels had highly porous structure with interconnective porosity and the nanoHA aggregates were randomly dispersed throughout the scaffold structure. Chemical analysis showed the presence of all major peaks related to collagen and HA in the biocomposites and indicated possible interaction between nanoHA aggregates and collagen molecules. Porosity analysis revealed an enhancement in the surface area as the nanoHA percentage increased in the collagen structure. The biocomposites showed improved mechanical properties as the nanoHA content increased in the scaffold. As expected, the swelling capacity decreased with the increase of nanoHA content. In vitro studies with osteoblasts cells showed that they were able to attach and spread in all cryogels surfaces. The presence of collagen-nanoHA biocomposites resulted in higher overall cellular proliferation compared to pure collagen scaffold. A statistically significant difference between collagen and collagen-nanoHA cryogels was observed after 21 day of cell culture. These innovative collagen-nanoHA cryogels could have potentially appealing application as scaffolds for bone regeneration.

Vascularized bone tissue engineering: approaches for potential improvement

Significant advances have been made in bone tissue engineering (TE) in the past decade. However, classical bone TE strategies have been hampered mainly due to the lack of vascularization within the engineered bone constructs, resulting in poor implant survival and integration. In an effort toward clinical success of engineered constructs, new TE concepts have arisen to develop bone substitutes that potentially mimic native bone tissue structure and function. Large tissue replacements have failed in the past due to the slow penetration of the host vasculature, leading to necrosis at the central region of the engineered tissues. For this reason, multiple microscale strategies have been developed to induce and incorporate vascular networks within engineered bone constructs before implantation in order to achieve successful integration with the host tissue. Previous attempts to engineer vascularized bone tissue only focused on the effect of a single component among the three main components of TE (scaffold, cells, or signaling cues) and have only achieved limited success. However, with efforts to improve the engineered bone tissue substitutes, bone TE approaches have become more complex by combining multiple strategies simultaneously. The driving force behind combining various TE strategies is to produce bone replacements that more closely recapitulate human physiology. Here, we review and discuss the limitations of current bone TE approaches and possible strategies to improve vascularization in bone tissue substitutes.

Optimally porous and biomechanically compatible scaffolds for large-area bone regeneration

Large-area or critical-sized bone defects pose a serious challenge in orthopedic surgery, as all current treatment options present with shortcomings. Bone tissue engineering offers a more promising alternative treatment strategy. However, this approach requires mechanically stable scaffolds that support homogenous bone formation throughout the scaffold thickness. Despite advances in scaffold fabrication, current scaffold-based techniques are unable to support uniform, three-dimensional bone regeneration, and are limited to only the scaffold surface in vitro and in vivo. This is mainly because of inadequate scaffold pore sizes (<200 μm) and accessible pore volume, and the associated limited oxygen diffusion and vascular invasion. In this study, we have adopted a method combining microsphere-sintering and porogen-leaching techniques to fabricate scaffolds with an increased accessible pore volume. Of the scaffolds developed, moderately porous poly(85 lactide-co-15 glycolide) (PLGA) microsphere scaffolds were selected as most advantageous, since they retain mechanical strength in the range of human cancellous bone and display a significantly higher accessible pore volume, which is attributed to an increased percentage of larger pores (i.e., size range 200-600 μm). Unlike control scaffolds with a limited pore size and an accessible pore volume, moderately porous scaffolds displayed increased oxygen diffusion, pre-osteoblast cell infiltration, proliferation, and survival throughout the entire scaffold. Furthermore, moderately porous PLGA microsphere scaffolds displayed enhanced and homogenous mineralization in vitro. Since these newly designed moderately porous scaffolds are weight bearing, are fully osteoconductive, and have the ability to support vascularization, they may serve as effective scaffolds for large-area bone defect repair/regeneration. In addition, this study demonstrates the ability to modulate scaffold porosity and, in turn, to develop oxygen tension-controlled matrices that are effective for large-area bone regeneration.

Endothelial differentiation of human stem cells seeded onto electrospun polyhydroxybutyrate/polyhydroxybutyrate-co-hydroxyvalerate fiber mesh

Tissue engineering is based on the association of cultured cells with structural matrices and the incorporation of signaling molecules for inducing tissue regeneration. Despite its enormous potential, tissue engineering faces a major challenge concerning the maintenance of cell viability after the implantation of the constructs. The lack of a functional vasculature within the implant compromises the delivery of nutrients to and removal of metabolites from the cells, which can lead to implant failure. In this sense, our investigation aims to develop a new strategy for enhancing vascularization in tissue engineering constructs. This study's aim was to establish a culture of human adipose tissue-derived stem cells (hASCs) to evaluate the biocompatibility of electrospun fiber mesh made of polyhydroxybutyrate (PHB) and its copolymer poly-3-hydroxybutyrate-co-3-hydroxyvalerate (PHB-HV) and to promote the differentiation of hASCs into the endothelial lineage. Fiber mesh was produced by blending 30% PHB with 70% PHB-HV and its physical characterization was conducted using scanning electron microscopy analysis (SEM). Using electrospinning, fiber mesh was obtained with diameters ranging 300 nm to 1.3 µm. To assess the biological performance, hASCs were extracted, cultured, characterized by flow cytometry, expanded and seeded onto electrospun PHB/PHB-HV fiber mesh. Various aspects of the cells were analyzed in vitro using SEM, MTT assay and Calcein-AM staining. The in vitro evaluation demonstrated good adhesion and a normal morphology of the hASCs. After 7, 14 and 21 days of seeding hASCs onto electrospun PHB/PHB-HV fiber mesh, the cells remained viable and proliferative. Moreover, when cultured with endothelial differentiation medium (i.e., medium containing VEGF and bFGF), the hASCs expressed endothelial markers such as VE-Cadherin and the vWF factor. Therefore, the electrospun PHB/PHB-HV fiber mesh appears to be a suitable material that can be used in combination with endothelial-differentiated cells to improve vascularization in engineered bone tissues.

Combined effect of osteopontin and BMP-2 derived peptides grafted to an adhesive hydrogel on osteogenic and vasculogenic differentiation of marrow stromal cells

The objective of this work was to investigate the combined effect of grafting the peptide corresponding to amino acid residues 162-168 of osteopontin (OPD peptide) and the peptide corresponding to amino acid residues 73-92 of bone morphogenetic protein-2 (BMP peptide) to an RGD-conjugated inert hydrogel on osteogenic and vasculogenic differentiation of bone marrow stromal (BMS) cells. RGD-conjugated three-dimensional (3D) porous hydrogel scaffolds with well-defined cylindrical pore geometry were produced from sacrificial wax molds fabricated by fused deposition modeling rapid prototyping system. Propargyl acrylate and 4-pentenal were conjugated to the hydrogel for orthogonal grafting of BMP and OPD peptides by click reaction and oxime ligation, respectively. The OPD peptide was grafted by the reaction between aminooxy moiety of aminooxy-mPEG-OPD (mPEG = mini-poly(ethylene glycol)) and the aldehyde moiety in the hydrogel. The BMP peptide was grafted by the reaction between the azide moiety of Az-mPEG-BMP and the propargyl moiety in the hydrogel. The hydrogels seeded with BMS cells were characterized by biochemical, immunocytochemical, and mRNA analyses. Groups included RGD control hydrogel (RGD), RGD and BMP peptides without OPD (RGD+BMP), RGD and BMP peptides with mutant OPD (RGD+BMP+mOPD), and RGD and BMP peptides with OPD (RGD+BMP+OPD) grafted hydrogels. The extent of mineralization of RGD, RGD+BMP, RGD+BMP+mOPD, and RGD+BMP+OPD groups after 28 days was 650 ± 70, 990 ± 30, 850 ± 30, and 1150 ± 40 mg/(mg of DNA), respectively, indicating that the BMP and OPD peptides enhanced osteogenic differentiation of the BMS cells. The BMS cells seeded on RGD+BMP+OPD grafted hydrogels stained positive for vasculogenic markers α-SMA, PECAM-1, and VE-cadherin while the groups without OPD peptide (RGD+BMP and RGD+BMP+mOPD) stained only for α-SMA but not PECAM-1 or VE-cadherin. These results were consistent with the significantly higher PECAM-1 mRNA expression for RGD+BMP+OPD group after 21 and 28 days, compared to the groups without OPD. These findings suggest that the RGD+BMP+OPD peptides provide a favorable microenvironment for concurrent osteogenic and vasculogenic differentiation of progenitor marrow-derived cells.

Intravital microscopic studies of angiogenesis during bone defect healing in mice calvaria

PURPOSE

Due to the great availability of specific antibodies, gene-targeted animals and knockout strains, mouse models came into the focus of musculoskeletal research. Herein, we introduce a calvarian defect model in mice that allows the repetitive analysis of blood vessel formation during bone repair by intravital microscopy.

METHODS

The right parietal calvaria of 20 adult CD-1 mice were exposed by skin excision. Under continuous irrigation, a circular defect (Ø0.75 mm) was drilled into the calvarium without penetrating the inner cortical shell. A circular glass (Ø12 mm; thickness 0.15 mm) was fixed by two microscrews (M1; length 2mm) to cover the bone defect. Angiogenesis was analysed by intravital microscopy at days 0, 3, 6, 9, 12, 15, 18 and 21. In addition, bone repair was evaluated by histomorphometry at days 3, 6, 9 and 15. Immunohistochemical stainings for the angiogenic growth factor vascular endothelial growth factor (VEGF) and the cell proliferation marker proliferating cell nuclear antigen (PCNA) were performed to assess angiogenic and proliferative activity during healing of the calvarian defect.

RESULTS

Histomorphometry showed a typical pattern of intramembranous bone repair. Osseous bridging of the defect was observed at day 9. This was associated with the formation of a neo-periosteum, which covered the new woven bone and contained a dense network of newly formed blood vessels. At day 9, particularly cells of the neo-periosteum showed intense staining for VEGF, whilst PCNA-positive staining was found mainly in osteoblasts. At day 15, the major fraction of fibrous tissue was replaced by bone undergoing extensive remodelling. Intravital microscopy revealed an increase of vascular density between days 3 and 15. Blood vessel diameters showed an increase between days 3 and 9 and a subsequent decrease between days 9 and 21.

CONCLUSIONS

The present calvarian defect model provides a powerful tool to evaluate the process of angiogenesis during intramembranous bone repair in mice.

Migration of co-cultured endothelial cells and osteoblasts in composite hydroxyapatite/polylactic acid scaffolds

Regeneration of bone in large segmental bone defects requires regeneration of both cortical bone and trabecular bone. A scaffold design consisting of a hydroxyapatite (HA) ring surrounding a polylactic acid (PLA) core simulates the structure of bone and provides an environment for indirect and direct co-culture conditions. In this experiment, human umbilical vein endothelial cells (EC) and normal human primary osteoblasts (OB) were co-cultured to evaluate cell migration and interactions within this biphasic composite scaffold. Both cell types were able to migrate between the different material phases of the scaffold. It was also observed that OB migration increased when they were co-cultured with ECs, whereas EC migration decreased in co-culture. The results show that co-culture of ECs and OBs in this composite biphasic scaffold allows for migration of cells throughout the scaffold and that pre-seeding a scaffold with ECs can increase OB infiltration into desired areas of the scaffold.

An agent-based model for the investigation of neovascularization within porous scaffolds

The ability to control blood vessel assembly in polymer scaffolds is important for clinical success in tissue engineering. A mathematical and computational representation of the relationship between scaffold properties and neovascularization may provide a better understanding of the fundamental process itself and help guide the design of new therapeutic approaches. This article proposes a multilayered, multiagent framework to model sprouting angiogenesis in porous scaffolds and examines the impact of pore structure on vessel invasion and network structure. We have defined the speed of vessel sprouting in the agent-based model based on in vivo results in the absence of a polymer scaffold. A number of cases were run to investigate the effect of scaffold pore size on angiogenesis. The simulation results indicate that the rate of scaffold vascularization increases with pore size. Pores of larger size (160-270 μm) support rapid and extensive angiogenesis throughout the scaffold. Model predictions were compared to experimental results of vascularization in porous poly(ethylene glycol) hydrogels to validate the results. This model can be used to provide insight into optimal scaffold properties that support vascularization of engineered tissues.

Biocompatibility and osteoconduction of active porous calcium-phosphate films on a novel Ti-3Zr-2Sn-3Mo-25Nb biomedical alloy

The purpose of this study is to investigate the biocompatibility and osteoconduction of active porous calcium-phosphate films on the novel Ti-3Zr-2Sn-3Mo-25Nb biomedical alloy. The active porous calcium-phosphate films were prepared by the micro-arc oxidation method on the surface of a near β biomedical Ti-3Zr-2Sn-3Mo-25Nb alloy, and then activated in a hydroxyl solution followed by an aminated solution. The phase composition, surface micro-topography and elemental characteristics of the active porous calcium-phosphate films were investigated with XRD, SEM, EDS and XPS. The biocompatibility was assessed using corrosion testing, the in vitro osteoblast cultivation test and implantation in soft tissue (subcutaneous and musculature). The osteoconduction was evaluated using the simulated body fluid test and by implantation in hard tissue. The results show that the active porous films are mainly composed of TiO(2) anatase and rutile. The oxide layer is a kind of porous ceramic intermixture containing Ca and P. Immersion in simulated body fluid can induce apatite formation on the porous calcium-phosphate films resulting in excellent bioactivity. Cell cultures revealed that MC3T3-E1 cells grew on the surface exhibiting favorable morphologies. These results indicate that the Ti-3Zr-2Sn-3Mo-25Nb biomedical alloy coated with an active porous calcium-phosphate film has been shown to have excellent corrosion resistance, good biocompatibility and osteoconduction, which can promote cell proliferation and bone formation.

Stereolithographic bone scaffold design parameters: osteogenic differentiation and signal expression

Scaffold design parameters including porosity, pore size, interconnectivity, and mechanical properties have a significant influence on osteogenic signal expression and differentiation. This review evaluates the influence of each of these parameters and then discusses the ability of stereolithography (SLA) to be used to tailor scaffold design to optimize these parameters. Scaffold porosity and pore size affect osteogenic cell signaling and ultimately in vivo bone tissue growth. Alternatively, scaffold interconnectivity has a great influence on in vivo bone growth but little work has been done to determine if interconnectivity causes changes in signaling levels. Osteogenic cell signaling could be also influenced by scaffold mechanical properties such as scaffold rigidity and dynamic relationships between the cells and their extracellular matrix. With knowledge of the effects of these parameters on cellular functions, an optimal tissue engineering scaffold can be designed, but a proper technology must exist to produce this design to specification in a repeatable manner. SLA has been shown to be capable of fabricating scaffolds with controlled architecture and micrometer-level resolution. Surgical implantation of these scaffolds is a promising clinical treatment for successful bone regeneration. By applying knowledge of how scaffold parameters influence osteogenic cell signaling to scaffold manufacturing using SLA, tissue engineers may move closer to creating the optimal tissue engineering scaffold.

Comparison of six bone-graft substitutes regarding to cell seeding efficiency, metabolism and growth behaviour of human mesenchymal stem cells (MSC) in vitro

INTRODUCTION

Various synthetic bone-graft substitutes are used commercially as osteoconductive scaffolds in the treatment of bone defects and fractures. The role of bone-graft substitutes is changing from osteoconductive conduits for growth to an delivery system for biologic fracture treatments. Achieving optimal bone regeneration requires biologics (e.g. MSC) and using the correct scaffold incorporated into a local environment for bone regeneration. The need for an unlimited supply with high quality bone-graft substitutes continue to find alternatives for bone replacement surgery.

MATERIALS AND METHODS

This in vitro study investigates cell seeding efficiency, metabolism, gene expression and growth behaviour of MSC sown on six commercially clinical available bone-graft substitutes in order to define their biological properties: synthetic silicate-substituted porous hydroxyapatite (Actifuse ABX), synthetic alpha-TCP (Biobase), synthetic beta-TCP (Vitoss), synthetic beta-TCP (Chronos), processed human cancellous allograft (Tutoplast) and processed bovines hydroxyapatite ceramic (Cerabone). 250,000 MSC derived from human bone marrow (n=4) were seeded onto the scaffolds, respectively. On days 2, 6 and 10 the adherence of MSC (fluorescence microscopy) and cellular activity (MTT assay) were analysed. Osteogenic gene expression (cbfa-1) was analysed by RT-PCR and scanning electron microscopy was performed.

RESULTS

The highest number of adhering cells was found on Tutoplast (e.g. day 6: 110.0+/-24.0 cells/microscopic field; p<0.05) followed by Chronos (47.5+/-19.5, p<0.05), Actifuse ABX (19.1+/-4.4), Biobase (15.7+/-9.9), Vitoss (8.8+/-8.7) and Cerabone (8.1+/-2.2). MSC seeded onto Tutoplast showed highest metabolic activity and gene expression of cbfa-1. These data are confirmed by scanning electron microscopy. The cell shapes varied from round-shaped cells to wide spread cells and cell clusters, depending on the bone-graft substitutes. Processed human cancellous allograft is a well-structured and biocompatible scaffold for ingrowing MSC in vitro. Of all other synthetical scaffolds, beta-tricalcium phosphate (Chronos) have shown the best growth behaviour for MSC.

DISCUSSION

Our results indicate that various bone-graft substitutes influence cell seeding efficiency, metabolic activity and growth behaviour of MSC in different manners. We detected a high variety of cellular integration of MSC in vitro, which may be important for bony integration in the clinical setting.

Mechanical properties of hydroxyapatite-zirconia compacts sintered by two different sintering methods

Microwave sintering is traditionally employed to reduce the sintering temperature required to densify powder compacts. The effect of microwave heating on hydroxyapatite (HA)-zirconia (ZrO2) green bodies has been investigated in order to understand how microwave energy may affect the physical and mechanical properties of the resultant densified composites. Laboratory synthesised nano-sized HA and a commercial nano-sized ZrO2 powder have been ball milled to create mixtures containing 0-5 wt% ZrO2 loadings. Compacts were microwave sintered at either 700, 1000 or 1200 degrees C with a 1 h hold time. Comparative firings were also performed in a resistive element furnace using the same heating profile in order to assess the differences between conventional and microwave heating on the physical, mechanical and microstructural properties of the composites. Samples sintered at 700 degrees C show little sign of densification with open porosities of approximately 50%. Composites conventionally sintered at 1000 degrees C were between 65 and 75% dense, whereas the samples microwave sintered at this temperature were between 55 and 65% dense. Samples sintered at 1200 degreesbC showed the greatest degree of densification (>80%) with a corresponding reduction in open porosities. TCP generation occurred as a consequence of sintering at 1200 degrees C, even with 0 wt% ZrO2, and increased degradation of the HA phase to form significant amounts of TCP occurred with increasing additions of ZrO2, along with increasing open porosity. Nanosized ZrO2 prevents the densification of the HA matrix by effectively pinning grain boundaries and this effect is more pronounced in the MS materials. Similar strengths are achieved between the microwave and conventionally sintered samples. Greater amount of open porosity and pore interconnectivity are seen in the MS samples, which are considered to be useful for biomedical applications as they can promote osteo-integration.

Adsorption and release of BMP-2 on nanocrystalline apatite-coated and uncoated hydroxyapatite/beta-tricalcium phosphate porous ceramics

The association of bone morphogenetic proteins (BMPs) with calcium phosphate bioceramics is known to confer them osteoinductive properties. The aim of this study was to evaluate the surface properties, especially regarding recombinant human BMP-2 (rhBMP-2) adsorption and release, of commercial sintered biphasic calcium phosphate ceramics after coating with biomimetic nanocrystalline apatite. The raw and coated ceramics exhibited similar macroporous structures but different nanometer-sized pores contents. Both types of ceramics showed Langmuir-type adsorption isotherms of rhBMP-2. The coating noticeably increased the rate of adsorption and the total amount of growth factor taken up, but the maximum coverage per surface area unit as well as the affinity constant appeared lower for coated ceramics compared with raw ceramic surfaces. The limited advantage gained by coating the ceramics can be assigned to a lower accessibility of the surface adsorption sites compared with the raw ceramics. The quantity of rhBMP-2 spontaneously released in cell culture medium during the first weeks was lower for coated samples than for uncoated ceramics and represented a minor fraction of the total adsorbed amount. In conclusion, the nanocrystalline apatite coating was found to favor the adsorption of rhBMP-2 while providing a mean to fine tune the release of the growth factor.

Crosstalk between osteoblasts and endothelial cells co-cultured on a polycaprolactone-starch scaffold and the in vitro development of vascularization

The reconstruction of bone defects based on cell-seeded constructs requires a functional microvasculature that meets the metabolic demands of the engineered tissue. Therefore, strategies that augment neovascularization need to be identified. We propose an in vitro strategy consisting of the simultaneous culture of osteoblasts and endothelial cells on a starch-based scaffold for the formation of pre-vascular structures, with the final aim of accelerating the establishment of a vascular bed in the implanted construct. Human dermal microvascular endothelial cells (HDMECs) were co-cultured with human osteoblasts (hOBs) on a 3D starch-based scaffold and after 21 days of culture HDMEC aligned and organized into microcapillary-like structures. These vascular-like structures evolved from a cord-like configuration to a more complex branched morphology, had a lumen and stained in the perivascular region for type IV collagen. Genetic profiling of 84 osteogenesis-related genes was performed on co-culture vs. monoculture. Osteoblasts in co-culture showed a significant up-regulation of type I collagen and immunohistochemistry revealed that the scaffold was filled with a dense matrix stained for type I collagen. In direct contact with HDMEC hOBs secreted higher amounts of VEGF in relation to monoculture and the highest peak in the release profile correlated with the formation of microcapillary-like structures. The heterotypic communication between the two cell types was also assured by direct cell-cell contact as shown by the expression of the gap junction connexin 43. In summary, by making use of heterotypic cellular crosstalk this co-culture system is a strategy to form vascular-like structures in vitro on a 3D scaffold.