Novel bioactive materials with different mechanical properties

Facile Surface Modification Method for Synergistically Enhancing the Biocompatibility and Bioactivity of Poly(ether ether ketone) That Induced Osteodifferentiation

Poly(ether ether ketone) (PEEK) is a promising material in biomedical engineering due to its suitable mechanical properties and excellent chemical resistance and biocompatibility. However, the biological inertness of PEEK limits its applications. In this study, we developed a facile approach of immersion to generate a biocompatible and bioactive PEEK that induced osteodifferentiation. First, micropores on the surface of PEEK were introduced by concentrated sulfuric acid and subsequent water immersion, followed by the hydrothermal treatment to reduce residual sulfuric acid. Subsequently, the sulfonated PEEK surface was activated by the oxygen plasma treatment and then coated with a poly(dopamine) (PDA) layer by immersion into the dopamine solution. Finally, the tripeptide Arg-Gly-Asp (RGD) was integrated onto the PDA-coated surface of PEEK by immersion into the RGD peptide solution. The surface characteristics (physical chemistry and biological properties) and the ability to form bonelike apatite were systematically investigated by scanning electron microscopy, X-ray photoelectron spectroscopy, water contact angle analysis, the Archimedes' fluid saturation method, ellipsometry, a quartz crystal microbalance with dissipation monitoring, cell proliferation, real-time reverse transcription polymerase chain reaction analysis, alizarin red staining, immunocytochemistry staining, and simulated body fluid immersion. Collectively, the modified PEEK showed a significantly improved ability to promote cell proliferation, osteogenic differentiation, and bonelike apatite formation in vitro as compared to the PEEK control. These results demonstrate that combined facile surface modifications for PEEK enhance its bioactivity and biocompatibility, and induce osteodifferentiation. This study presents a strategy for broadening the use of PEEK in the application of orthopedic implants and could be industrially scalable in future.

Additively manufactured calcium phosphate reinforced CoCrMo alloy: Bio-tribological and biocompatibility evaluation for load-bearing implants

Cobalt-chromium-molybdenum (CoCrMo) alloys are widely used in load-bearing implants; specifically, in hip, knee, and spinal applications due to their excellent wear resistance. However, due to in vivo corrosion and mechanically assisted corrosion, metal ion release occurs and accounts for poor biocompatibility. Therefore, a significant interest to find an alternative to CoCrMo alloy exists. In the present work we hypothesize that calcium phosphate (CaP) will behave as a solid lubricant in CoCrMo alloy under tribological testing, thereby minimizing wear and metal ion release concerns associated with CoCrMo alloy. CoCrMo-CaP composite coatings were processed using laser engineered net shaping (LENS™) system. After LENS™ processing, CoCrMo alloy was subjected to laser surface melting (LSM) using the same LENS™ set-up. Samples were investigated for microstructural features, phase identification, and biocompatibility. It was found that LSM treated CoCrMo improved wear resistance by 5 times. CoCrMo-CaP composites displayed the formation of a phosphorus-based tribofilm. In vitro cell-material interactions study showed no cytotoxic effect. Sprague-Dawley rat and rabbit in vivo study displayed increased osteoid formation for CoCrMo-CaP composites, up to 2 wt.% CaP. Our results show that careful surface modification treatments can simultaneously improve wear resistance and in vivo biocompatibility of CoCrMo alloy, which can correlate to a reduction of metal ion release in vivo.

A porous collagen-carboxymethyl cellulose/hydroxyapatite composite for bone tissue engineering by bi-molecular template method

Inspired by the mechanism of bone formation, a porous collagen-carboxymethyl cellulose/hydroxyapatite (Col-CMC/HA) composite was designed and fabricated using a biomimetic template of Col and CMC protein-polysaccharide bi-molecules. The morphology, composition and physical properties of Col-CMC/HA composites were characterized systematically. It was found that the nano-HA homogenously distributed on the surface of Col-CMC bi-templates while the composite presented 3D porous structure with pore size from 100 μm to 300 μm. The porosities of composites were located at the range of 71%-85%. Besides, the compressive strength of composites was highly depended on the ratio of Col to CMC in the organic template. The optimized composite in respect to physical properties showed a compressive strength as high as 7.06 MPa, quite close to that of natural bone. The high relative growth rate of wild-type mouse embryonic fibroblasts cells was found for the composite, indicating a good biocompatibility. The organic-inorganic composite also behaved good in collagenase resistance and could be biodegraded in 8 weeks, with about 50% of initial weight left at the ratio of Col to CMC of 1:9. The results demonstrated that the Col-CMC/HA composite by bi-molecular template method was a rational and safe method to prepare biomaterials with tunable properties.

Mechanical properties of bioactive glasses, ceramics, glass-ceramics and composites: State-of-the-art review and future challenges

The repair and restoration of bone defects in orthopaedic and dental surgery remains a major challenge despite advances in surgical procedures and post-operative treatments. Bioactive glasses, ceramics, glass-ceramics and composites show considerable potential for such applications as they can promote bone tissue regeneration. This paper presents an overview of the mechanical properties of various bioactive materials, which have the potential for bone regeneration. It also identifies current strategies for improving the mechanical properties of these novel materials, as these are rarely ideal as direct replacements for human bone. For this reason bioactive organic-inorganic composites and hybrids that have tailorable mechanical properties are of particular interest. The inorganic component (bioactive glass, ceramic or glass-ceramic) can provide both strength and bioactivity, while the organic component can add structural reinforcement, toughness and processability. Another topic presented in this paper includes 3D porous scaffolds that act as a template for cell attachment, proliferation and bone growth. Mechanical limitations of existing glass and ceramic scaffolds are discussed, along with the relevant challenges and strategies for further improvement. Advantages and disadvantages of different bioactive materials are critically examined. This paper is focused on optimization of biomaterials properties, in particular mechanical properties and bioactivity.

Polyhydroxyalkanoate (PHA): applications in drug delivery and tissue engineering

INTRODUCTION

The applications of naturally obtained polymers are tremendously increased due to them being biocompatible, biodegradable, environmentally friendly and renewable in nature. Among them, polyhydroxyalkanoates are widely studied and they can be utilized in many areas of human life research such as drug delivery, tissue engineering, and other medical applications.

AREAS COVERED

This review provides an overview of the polyhydroxyalkanoates biosynthesis and their possible applications in drug delivery in the range of micro- and nano-size. Moreover, the possible applications in tissue engineering are covered considering macro- and microporous scaffolds and extracellular matrix analogs.

EXPERT COMMENTARY

The majority of synthetic plastics are non-biodegradable so, in the last years, a renewed interest is growing to develop alternative processes to produce biologically derived polymers. Among them, PHAs present good properties such as high immunotolerance, low toxicity, biodegradability, so, they are promisingly using as biomaterials in biomedical applications.

Na2Ti7O15 Nanowires with an Oriented Tunnel Structure and High Mechanical Stability: A Potential Anode of Sodium-Ion Batteries and Gas Sensing Materials

Na2Ti7O15 (NTO) can be selected as candidate anode for high-performance sodium-ion batteries (SIBs). However, there are few reports of research on the mechanical properties of low-dimensional NTO, which is important for the stability of SIBs. In this work, by using the one-step hydrothermal method, NTO nanowires (NWs) with good orientation were prepared successfully. The transmission electron microscopy (TEM) and selected area electron diffraction (SAED)showed that the NTO NWs had a good aspect ratio and dispersion, with lengths over 20 μm. Further microstructure analysis showed that the nanowires grew along the (020) direction, and there were some "stripe" structures along the growing direction, which provides a good tunnel structure for Na ion channels. Further, the in situ mechanical analysis showed that the NTO NWs had excellent elastic deformation characteristics and mechanical structural stability. In addition, the NTO NWs also showed a good gas sensitivity to NO and NH3. Our results showed that the prepared NTO nanowires with a stripe tunnel oriented-structure and excellent mechanical properties may have a potential application in SIBs or other wearable sensor devices.

Design and evaluation of chitosan/chondroitin sulfate/nano-bioglass based composite scaffold for bone tissue engineering

Chitosan, a natural biopolymer with osteoconductive properties is widely investigated to generate scaffolds for bone tissue engineering applications. However, chitosan based scaffolds lacks in mechanical strength and structural stability in hydrated condition and thereby limits its application for bone tissue regeneration. Thus in the present study, to overcome the limitations associated with chitosan based scaffolds, we fabricated polyelectrolyte complexation mediated composite scaffold of chitosan and chondroitin sulfate incorporated with nano-sized bioglass. Developed scaffolds were successfully characterized for various morphological, physico-chemical, mechanical and apatite forming properties using XRD, FT-IR, FE-SEM and TEM. It was observed that polyelectrolyte complexation followed by incorporation of bioglass significantly enhances mechanical strength, reduces excessive swelling behavior and enhances structural stability of the scaffold in hydrated condition. Also, in-vitro cell adhesion, spreading, viability and cytotoxity were investigated to evaluate the cell supportive properties of the developed scaffolds. Furthermore, alkaline phosphatase activity, biomineralization and collagen type I expression were observed to be significantly higher over the composite scaffold indicating its superior osteogenic potential. More importantly, in-vivo iliac crest bone defect study revealed that implanted composite scaffold facilitate tissue regeneration and integration with native bone tissue. Thus, developed composite scaffold might be a suitable biomaterial for bone tissue engineering applications.

Influence of N-acetyl cysteine (NAC) and 2-methylene-1,3-dioxepane (MDO) on the properties of polymethyl methacrylate (PMMA) bone cement

The properties of polymethyl methacrylate (PMMA) bone cement make it a popular bone filling material. However, its disadvantages, such as lack of biodegradability and osteogenesis, restrict its clinical application. Studies have indicated the osteogenic properties of N-acetyl cysteine (NAC) and the biodegradability of 2-methylene-1,3-dioxepane/methyl methacrylate-based (MDO/MMA) copolymers. In this study, we developed bioactive PMMA cements through modification with fixed concentrations of NAC and different proportions of MDO. The purpose of this study was to compare the mechanical properties, morphology, NAC release, biocompatibility, degradability and mineralization capability of modified bone cements with those of conventional cement. The specific-modified specimens (NAC-p (5% MDO-co-MMA)) exhibited a lower bending modulus but had little effect on compressive strength. This material was morphologically compact and nonporous, similar to conventional PMMA bone cement. NAC could be released from NAC-p (5% MDO-co-MMA) continuously and appropriately. NAC-p (5% MDO-co-MMA) was biologically safe and showed satisfactory tissue compatibility. Ester was introduced into the polymer, which reinforced the degradation properties of NAC-p (5% MDO-co-MMA). NAC-p (5% MDO-co-MMA) enhanced the mineralization capability of osteoblastic cells.

The properties of polymethyl methacrylate (PMMA) bone cement make it a popular bone filling material.

A hydrogenated black TiO2 coating with excellent effects for photothermal therapy of bone tumor and bone regeneration

The clinical treatment of bone tumors usually brings about residual tumor cells and large bone defects after tumor removal surgery. To solve this problem, it is imperative to develop a novel implant with bi-functions for eliminating the residual tumor cells and repairing bone defects. In this study, hydrogenated black TiO₂ (H-TiO₂) coating with hierarchical micro/nano-topographies is fabricated by induction suspension plasma spraying (ISPS). The fabricated H-TiO₂ coating possessed excellent and controllable photothermal effect in inhibiting the tumor growth under 808 nm NIR laser irradiation in vitro and in vivo. The hierarchical hybrid micro/nano-structured surface and Ti-OH groups improved the adhesion, proliferation, differentiation and osteogenic gene expressions of rat bone mesenchymal stem cells (rBMSCs). These results demonstrate that the H-TiO₂ coating may be a promising implant material for the treatment of bone tumors and bone regeneration.

Tantalum nanoparticles reinforced polyetheretherketone shows enhanced bone formation

Polyetheretherketone (PEEK) has been used in orthopedic surgery for several decades. Numerous methods were invented to alter the properties of PEEK. By adding nanoparticles, fibers, etc., elastic modulus and strength of PEEK can be changed to meet certain demand. In this study, tantalum (Ta), a promising metal, was introduced to modify the properties of PEEK, in which PEEK was reinforced with different contents of tantalum nanoparticles (from 1 wt% to 9 wt%). Mechanical properties and biological functions (both in vitro and in vivo) were then investigated. The highest elastic modulus and compressive strength were observed in 3%Ta-PEEK. Cell experiments as cell adhesion, collagen secretion, biomineralization and osteogenesis related gene expression showed preferable results in 3%Ta-PEEK and 5%Ta-PEEK. Improved bone integration was shown in 3%Ta-PEEK and 5%Ta-PEEK in vivo. Above all, enhanced mechanical properties and promoted bone formation were proved for 3%Ta-PEEK and 5%Ta-PEEK compared to others groups both in vitro and in vivo, suggesting that the addition of tantalum nanoparticles modified the osseointegration ability of PEEK. This composite of tantalum and PEEK could have a clinical potential for orthopedic implants.

Polymerization kinetics stability, volumetric changes, apatite precipitation, strontium release and fatigue of novel bone composites for vertebroplasty

PURPOSE

The aim was to determine effects of diluent monomer and monocalcium phosphate monohydrate (MCPM) on polymerization kinetics and volumetric stability, apatite precipitation, strontium release and fatigue of novel dual-paste composites for vertebroplasty.

MATERIALS AND METHODS

Polypropylene (PPGDMA) or triethylene (TEGDMA) glycol dimethacrylates (25 wt%) diluents were combined with urethane dimethacrylate (70 wt%) and hydroxyethyl methacrylate (5 wt%). 70 wt% filler containing glass particles, glass fibers (20 wt%) and polylysine (5 wt%) was added. Benzoyl peroxide and MCPM (10 or 20 wt%) or N-tolyglycine glycidyl methacrylate and tristrontium phosphate (15 wt%) were included to give initiator or activator pastes. Commercial PMMA (Simplex) and bone composite (Cortoss) were used for comparison. ATR-FTIR was used to determine thermal activated polymerization kinetics of initiator pastes at 50-80°C. Paste stability, following storage at 4-37°C, was assessed visually or through mixed paste polymerization kinetics at 25°C. Polymerization shrinkage and heat generation were calculated from final monomer conversions. Subsequent expansion and surface apatite precipitation in simulated body fluid (SBF) were assessed gravimetrically and via SEM. Strontium release into water was assessed using ICP-MS. Biaxial flexural strength (BFS) and fatigue properties were determined at 37°C after 4 weeks in SBF.

RESULTS

Polymerization profiles all exhibited an inhibition time before polymerization as predicted by free radical polymerization mechanisms. Initiator paste inhibition times and maximum reaction rates were described well by Arrhenius plots. Plot extrapolation, however, underestimated lower temperature paste stability. Replacement of TEGDMA by PPGDMA, enhanced paste stability, final monomer conversion, water-sorption induced expansion and strontium release but reduced polymerization shrinkage and heat generation. Increasing MCPM level enhanced volume expansion, surface apatite precipitation and strontium release. Although the experimental composite flexural strengths were lower compared to those of commercially available Simplex, the extrapolated low load fatigue lives of all materials were comparable.

CONCLUSIONS

Increased inhibition times at high temperature give longer predicted shelf-life whilst stability of mixed paste inhibition times is important for consistent clinical application. Increased volumetric stability, strontium release and apatite formation should encourage bone integration. Replacing TEGDMA by PPGDMA and increasing MCPM could therefore increase suitability of the above novel bone composites for vertebroplasty. Long fatigue lives of the composites may also ensure long-term durability of the materials.

Fabrication, Morphology Analysis, and Mechanical Properties of Ti Foams Manufactured Using the Space Holder Method for Bone Substitute Materials

Porous titanium (Ti) offers several key attributes as a biomedical material. Among the known characteristics of Ti relevant to biomedical applications, the mechanical performance and effects of a pore structure on the deformation characteristics under compressive loading were examined. The space holder method was employed to generate Ti foams with target porosities of 60%, 70%, and 80%. A micro-computed to mography analysis and light and scanning electron microscopy were performed to examine the pore morphology and microstructure. The mechanical properties along with the elastic modulus and compressive strength were evaluated via uniaxial compression testing. Ti foam samples with three porosity levels displayed average elastic moduli and compressive strengths comparable with those of human cancellous and cortical bone. All the Ti foam samples had elastic moduli similar to those of cancellous bone with their open porous structures. Although the foam samples with ~60% porosity had compressive strength comparable to that of cortical bone, the samples with ~80% porosity displayed compressive strength similar to that of cancellous bone. The results indicate that Ti foam scaffolds produced using the space holder method have great potential for applications in hard tissue engineering, as their mechanical properties and pore structures are similar to those of bone.

Creep, recovery, and stress relaxation behavior of nanostructured bioactive calcium phosphate glass-POSS/polymer composites for bone implants studied under simulated physiological conditions

The creep and recovery and the stress relaxation behaviors of poly(butylene adipate-co-terephthalate) (PBAT) and polyhydroxyalkanoates (PHA) binary blends incorporating 30 wt % of a mixture of trisilanolisobutyl polyhedral oligomeric silsesquioxanes (POSS) and calcium phosphate glass (CaP-g) were investigated under simulated physiological and human body temperature conditions. The synergistic effect of PHA and CaP-g/POSS filler remarkably improved the creep behavior of the PBAT matrix and decreased its residual strain, consequently enhancing its elastic recovery. A considerable increase of the relaxation modulus of the hybrid materials was also observed upon incorporation of PHA and CaP-g/POSS. The relaxation modulus of the neat PBAT sample increased from ~60 MPa to ~1600 MPa after addition of 30 wt % CaP-g/POSS and 70 wt % PHA. However, after exposure of the composites to the simulated human body conditions for 14 days, a drop of dynamic mechanical properties of the studied material systems was observed along with formation of a desirable calcium phosphate phase on the material surface. The long-term (i.e., up to 7 × 10⁵  s) viscoelastic behavior of the studied materials was successfully predicted using the time-temperature superposition principle and the obtained creep strain and the relaxation modulus master curves were satisfactorily fitted to the Findley power law equation and the generalized Maxwell model, respectively. This study demonstrates a facile method for tailoring CaP-g/POSS bioactive glasses composition for bone-like apatite formation on biopolymer surfaces. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2419-2432, 2019.

Fabrication of Porous Bone Scaffolds Using Alginate and Bioactive Glass

Porous composite scaffold using an alginate and bioactive glass ICIE16M was synthesized by a simple freeze-drying technique. The scaffold was characterized using compression testing, Fourier-transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), X-ray diffraction (XRD), X-ray microtomography (XMT) and scanning electron microscopy (SEM). The bioactivity of the scaffold was evaluated by its ability to form apatite on its surface in simulated body fluid (SBF). The data collected showed evidence that the novel material produced had an appropriate pore size for osteoconduction, with an average pore size of 110 µm and maximum pore size of 309 µm. Statistical analysis confirmed that the glass filler significantly (P < 0.05) increased the collapse yield of the scaffolds compared with pure alginate scaffolds. The ICIE16M glass had an amorphous structure, favorable for bioactivity.

Re-designing materials for biomedical applications: from biomimicry to nature-inspired chemical engineering

Gathering inspiration from nature for the design of new materials, products and processes is a topic gaining rapid interest among scientists and engineers. In this review, we introduce the concept of nature-inspired chemical engineering (NICE). We critically examine how this approach offers advantages over straightforward biomimicry and distinguishes itself from bio-integrated design, as a systematic methodology to present innovative solutions to challenging problems. The scope of application of the nature-inspired approach is demonstrated via examples from the field of biomedicine, where much of the inspiration is still more narrowly focused on imitation or bio-integration. We conclude with an outlook on prospective future applications, offered by the more systematic and mechanistically based NICE approach, complemented by rapid progress in manufacturing, computation and robotics. This article is part of the theme issue 'Bioinspired materials and surfaces for green science and technology'.

Enhanced Osteogenesis of Bone Marrow-Derived Mesenchymal Stem Cells by a Functionalized Silk Fibroin Hydrogel for Bone Defect Repair

Silk fibroin (SF) from Bombyx mori is a promising natural material for the synthesis of biocompatible and biodegradable hydrogels for use in biomedical applications from tissue engineering to drug delivery. However, weak gelation performance and the lack of biochemical cues to trigger cell proliferation and differentiation currently significantly limit its application in these areas. Herein, a biofunctional hydrogel containing SF (2.0%) and a small peptide gelator (e.g., NapFFRGD = 1.0 wt%) is generated via cooperative molecular self-assembly. The introduction of NapFFRGD to SF is shown to significantly improve its gelation properties by lowering both its threshold gelation concentration to 2.0% and gelation time to 20 min under physiological conditions (pH = 7.4, 37 °C), as well as functionalizing the SF hydrogel with cell-adhesive motifs (e.g., RGD). Besides mediating cell adhesion, the RGD ligands incorporated within the SF-RGD gel promote the osteogenic differentiation of bone marrow-derived mesenchymal stem cells encapsulated within the gel matrix, leading to bone regeneration in a mouse calvarial defect model, compared with a blank SF gel (2.0%, pH = 7.4). This work suggests that SF could be easily tailored with bioactive peptide gelators to afford bioactive hydrogels with favorable microenvironments for tissue regeneration applications.

Evaluating the bioactivity of a hydroxyapatite-incorporated polyetheretherketone biocomposite

Background

Polyetheretherketone (PEEK) exhibits stable chemical properties, excellent biocompatibility, and rational mechanical properties that are similar to those of human cortical bone, but the lack of bioactivity impedes its clinical application.

Methods

In this study, hydroxyapatite (HA) was incorporated into PEEK to fabricate HA/PEEK biocomposite using a compounding and injection-molding technique. The tensile properties of the prepared HA/PEEK composites (HA content from 0 to 40 wt%) were tested to choose an optimal HA content. To evaluate the bioactivity of the composite, the cell attachment, proliferation, spreading and alkaline phosphatase (ALP) activity of MC3T3-E1 cells, and apatite formation after immersion in simulated body fluid (SBF), and osseointegration in a rabbit cranial defect model were investigated. The results were compared to those from ultra-high molecular weight polyethylene (UHMWPE) and pure PEEK.

Results

By evaluating the tensile properties and elastic moduli of PEEK composite samples/PEEK composites with different HA contents, the 30 wt% HA/PEEK composite was chosen for use in the subsequent tests. The results of the cell tests demonstrated that PEEK composite samples/PEEK composite exhibited better cell attachment, proliferation, spreading, and higher ALP activity than those of UHMWPE and pure PEEK. Apatite islands formed on the HA/PEEK composite after immersion in SBF for 7 days and grew continuously with longer time periods. Animal tests indicated that bone contact and new bone formation around the HA/PEEK composite were more obvious than those around UHMWPE and pure PEEK.

Conclusions

The HA/PEEK biocomposite created by a compounding and injection-molding technique exhibited enhanced osteogenesis and could be used as a candidate of orthopedic implants.

Fabrication and characterization of novel ethyl cellulose-grafted-poly (ɛ-caprolactone)/alginate nanofibrous/macroporous scaffolds incorporated with nano-hydroxyapatite for bone tissue engineering

The major challenge of tissue regeneration is to develop three dimensional scaffolds with suitable properties which would mimic the natural extracellular matrix to induce the adhesion, proliferation, and differentiation of cells. Several materials have been used for the preparation of the scaffolds for bone regeneration. In this study, novel ethyl cellulose-grafted-poly (ɛ-caprolactone) (EC-g-PCL)/alginate scaffolds with different contents of nano-hydroxyapatite were prepared by combining electrospinning and freeze-drying methods in order to provide nanofibrous/macroporous structures with good mechanical properties. For this aim, EC-g-PCL nanofibers were obtained with electrospinning, embedded layer-by-layer in alginate solutions containing nano-hydroxyapatite particles, and finally, these constructions were freeze-dried. The scaffolds possess highly porous structures with interconnected pore network. The swelling, porosity, and degradation characteristics of the EC-g-PCL/alginate scaffolds were decreased with the increase in nano-hydroxyapatite contents, whereas increases in the in-vitro biomineralization and mechanical strength were observed as the nano-hydroxyapatite content was increased. The cell response to EC-g-PCL/alginate scaffolds with/or without nano-hydroxyapatite was investigated using human dental pulp stem cells (hDPSCs). hDPSCs displayed a high adhesion, proliferation, and differentiation on nano-hydroxyapatite-incorporated EC-g-PCL/alginate scaffolds compared to pristine EC-g-PCL/alginate scaffold. Overall, these results suggested that the EC-g-PCL/alginate-HA scaffolds might have potential applications in bone tissue engineering.

Biocompatibility Characteristics of Titanium Coated with Multi Walled Carbon Nanotubes-Hydroxyapatite Nanocomposites

Multi walled carbon nanotubes-hydroxyapatite (MWCNTs-HA) with various contents of MWCNTs was synthesized using the sol-gel method. MWCNTs-HA composites were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). HA particles were generated on the surface of MWCNT. Produced MWCNTs-HA nanocomposites were coated on pure titanium (PT). Characteristic of the titanium coated MWCNTs-HA was evaluated by field-emission scanning electron microscopy (FE-SEM) and XRD. The results show that the titanium surface was covered with MWCNTs-HA nanoparticles and MWCNTs help form the crystalized hydroxyapatite. Furthermore, the MWCNTs-HA coated titanium was investigated for in vitro cellular responses. Cell proliferation and differentiation were improved on the surface of MWCNT-HA coated titanium.

Mineralization in micropores of calcium phosphate scaffolds

With the increasing demand for novel bone repair solutions that overcome the drawbacks of current grafting techniques, the design of artificial bone scaffolds is a central focus in bone regeneration research. Calcium phosphate scaffolds are interesting given their compositional similarity with bone mineral. The majority of studies focus on bone growth in the macropores (>100 µm) of implanted calcium phosphate scaffolds where bone structures such as osteons and trabeculae can form. However, a growing body of research shows that micropores (<50 µm) play an important role not only in improving bone growth in the macropores, but also in providing additional space for bone growth. Bone growth in the micropores of calcium phosphate scaffolds offers major mechanical advantages as it improves the mechanical properties of the otherwise brittle materials, further stabilizes the implant, improves load transfer, and generally enhances osteointegration. In this paper, we review evidence in the literature of bone growth into micropores, emphasizing on identification techniques and conditions under which bone components are observed in the micropores. We also review theories on mineralization and propose mechanisms, mediated by cells or not, by which mineralization may occur in the confined micropore space of calcium phosphate scaffolds. Understanding and validating these mechanisms will allow to better control and enhance mineralization in micropores to improve the design and efficiency of bone implants. STATEMENT OF SIGNIFICANCE: The design of synthetic bone scaffolds remains a major focus for engineering solutions to repair damaged and diseased bone. Most studies focus on the design of and growth in macropores (>100 µm), however research increasingly shows the importance of microporosity (<50 µm). Micropores provide an additional space for bone growth, which provides multiple mechanical advantages to the scaffold/bone composite. Here, we review evidence of bone growth into micropores in calcium phosphate scaffolds and conditions under which growth occurs in micropores, and we propose mechanisms that enable or facilitate growth in these pores. Understanding these mechanisms will allow researchers to exploit them and improve the design and efficiency of bone implants.

The Use of Tantalum Metal in Foot and Ankle Surgery

There are several reconstructive procedures in foot and ankle surgery wherein structural grafts are needed to fill defects, restore height, and maintain correction while providing an osteoconductive environment until fusion occurs. Traditionally used autografts and allografts have their disadvantages and limitations. Porous tantalum, with stiffness similar to bone and its biocompatibility, can be a viable option in foot and ankle reconstructive procedures.

Polydopamine-mediated synthesis of core–shell gold@calcium phosphate nanoparticles for enzyme immobilization

Constructing calcium phosphate (CaP)–gold (Au) nanocomposites for enzyme immobilization to overcome the bottleneck of loss of enzyme activity upon immobilization.

Dual modulation of crystallinity and macro-/microstructures of 3D printed porous titanium implants to enhance stability and osseointegration

The macro architecture and micro surface topological morphology of implants play essential roles in bone tissue regeneration.

Biomimetic assembly of multilevel hydroxyapatite using bacterial cellulose hydrogel as a reactor

Bacterial cellulose hydrogel is used as a reactor to construct a multilevel structure of HA.

Collagen Functionalized With Graphene Oxide Enhanced Biomimetic Mineralization and in Situ Bone Defect Repair

Biomimetic mineralization using simulated body fluid (SBF) can form a bonelike apatite (Ap) on the natural polymers and enhance osteoconductivity and biocompatibility, and reduce immunological rejection. Nevertheless, the coating efficiency of the bonelike apatite layer on natural polymers still needs to be improved. Graphene oxide (GO) is rich in functional groups, such as carbonyls (-COOH) and hydroxyls (-OH), which can provide more active sites for biomimetic mineralization and improve the proliferation of the rat bone marrow stromal cells (r-BMSCs). In this study, we introduced 0%, 0.05%, 0.1%, and 0.2% w/v concentrations of GO into collagen (Col) scaffolds and immersed the fabricated scaffolds into SBF for 1, 7, and 14 days. In vitro environment scanning electron microscopy (ESEM), energy-dispersive spectrometry (EDS), thermogravimetric analysis (TGA), micro-CT, calcium quantitative analysis, and cellular analysis were used to evaluate the formation of bonelike apatite on the scaffolds. In vivo implantation of the scaffolds into the rat cranial defect was used to analyze the bone regeneration ability. The resulting GO-Col-Ap scaffolds exhibited a porous and interconnected structure coated with a homogeneous distribution of bonelike apatite on their surfaces. The Ca/P ratio of 0.1% GO-Col-Ap group was equal to that of natural bone tissue on the basis of EDS analysis. More apatites were observed in the 0.1% GO-Col-Ap group through TGA analysis, micro-CT evaluation, and calcium quantitative analysis. Furthermore, the 0.1% GO-Col-Ap group showed significantly higher r-BMSCs adhesion and proliferation in vitro and more than 2-fold higher bone formation than the Col-Ap group in vivo. Our study provides a new approach of introducing graphene oxide into bone tissue engineering scaffolds to enhance biomimetic mineralization.

Incorporation of Stromal Cell-Derived Factor-1α in Three-Dimensional Hydroxyapatite/Polyacrylonitrile Composite Scaffolds for Bone Regeneration

Bone regeneration strategies rely on biomaterial constructs with stem cells or growth factors. By comparison, cell homing strategies employ chemokines to recruit the host endogenous stem or progenitor cells to the defect site to support endogenous healing. In the present study, we used a novel fluffy hydroxyapatite/polyacrylonitrile (HA/PAN) composite scaffold to provide a better three-dimensional cell culture microenvironment. These HA/PAN composite scaffolds loaded with stromal cell-derived factor-1α (SDF-1α) provided a diffusion-controlled SDF-1α release profile and endowed the scaffolds with cell homing capabilities. Furthermore, the scaffolds significantly stimulated bone marrow stromal cell (BMSC) recruitment, facilitated BMSC osteogenic differentiation, and promoted ectopic bone formation. Our results suggest that a HA/PAN composite scaffold loaded with SDF-1α offers a clinically beneficial bone repair strategy.

Synthesis and characterization of Barium-Iron containing magnetic bioactive glasses: The effect of magnetic component on structure and in vitro bioactivity

CaO-P₂O₅-SiO₂-BaO-Fe₂O₃ magnetic bioactive glasses were prepared via an optimized sol-gel method. This study is focused on investigating effects of magnetic content addition on the bioactive glass properties. To this aim, we evaluate the physical, rheological, and biocompatibility properties of synthesized magnetic bioactive glass. The morphology and composition of these glasses were studied using X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The particle size was also determined using Laser Particle Size Analyzer (LPSA). The thermal measurements were carried out using Differential Thermal Analysis (DTA). For assessing the in-vitro bioactive character of synthesized glasses, the ability for apatite formation on their surface upon immersion in simulated body fluid (SBF) was checked using SEM, EDX and pH measurements. Furthermore, the Ca, Si, Ba and Fe ions in SBF were monitored using Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES). The results showed that the addition of Ba and Fe in the glass composition affect formation of apatite layer onto the glass surfaces. Morphologies of the apatite layers were also different in which the bioactivity decreased with increasing Fe concentration, but the increase of Ba concentration led to an increase in bioactivity. However all of the synthesized glasses are still highly bioactive. Finally, this research demonstrates that the synthesized magnetic bioactive glasses are nontoxic and biocompatible and they can be used as thermoseeds for cancer hyperthermia studies.

Integrating 3D Printing and Biomimetic Mineralization for Personalized Enhanced Osteogenesis, Angiogenesis, and Osteointegration

Titanium (Ti) alloy implants can repair bone defects at load-bearing sites. However, they mechanically mismatch with the natural bone and lack customized adaption with the irregularly major-sized load-bearing bone defects, resulting in the failure of implant fixation. Mineralized collagen (MC), a building block in bone, can induce angiogenesis and osteogenesis, and 3D printing technology can be employed to prepare scaffolds with an overall shape customized to the bone defect. Hence, we induced the formation of MC, made of hydroxyapatite (HAp) nanocrystals and collagen fibers, in 3D-printed porous Ti₆Al₄V (PT) scaffolds through in situ biomimetic mineralization. The resultant MC/PT scaffolds exhibited a bone-like Young's modulus and were customized to the anatomical contour of actual bone defects of rabbit model. We found that the biocompatibility and osteogenic differentiation are best when the mass ratio between HAp nanocrystals and collagen fibers is 1 in MC. We then implanted the MC/PT scaffolds into the customized radius defect rabbit model and found that the MC/PT scaffolds significantly improved the vascularized bone tissue formation and integration between new bone and the implants. Therefore, a combination of 3D printing and biomimetic mineralization could lead to customized 3D PT scaffolds for enhanced angiogenesis, osteogenesis, and osteointegration. Such scaffolds represent novel patient-specific implants for precisely repairing irregular major-sized load-bearing bone defects.

Potential of growth factor incorporated mesoporous bioactive glass for in vivo bone regeneration

Mesoporous bioactive glass (MBG) has drawn much attention due to its superior surface texture, porosity and bioactive characteristics. Aim of the present study is to synthesize MBG using different surfactants, viz., hexadecyltrimethylamonium(CTAB) (M1), poly-ethylene glycol (PEG) (M2) and pluronic P123 (M3); bioactivity study; and to understand their bone regeneration efficacy in combination with insulin-like growth factors (IGF-1) in animal bone defect model. SBF study revealed the formation of calcium carbonate (CaCO₃) and hydroxyapatite (HAp) phase over 14 days. Formation of apatite layer was further confirmed by FTIR, FESEM and EDX analysis. M1 and M2 showed improved crystallinity, while M3 showed slightly decrease in crystalline peak of CaCO₃ and enhanced HAp phase. More Ca-P layer formed in M1 and M2 supported the in vivo experiments subsequently. Degree of new bone formation for all MBGs were high, i.e., M1 (80.7 ± 2.9%), M2 (74.4 ± 2.4%) and M3 (70.1 ± 1.9%) compared to BG (66.9 ± 1.8%). In vivo results indicated that the materials were non-toxic, biodegradable, biocompatible, and is suitable as bone replacement materials. Thus, we concluded that growth factor loaded MBG is a promising candidate for bone tissue engineering application.

Comparative investigation into effects of ZrO2 and Al2O3 addition in fluorapatite laser-clad composite coatings on Ti6Al4V alloy

Composite coatings consisting of fluorapatite mixed with 20 wt% yttria (3 mol%) stabilized cubic phase zirconia (c-ZrO₂, 3Y-TZP) or 20 wt% alumina (α-Al₂O₃) were deposited on Ti6Al4V substrates using a Nd:YAG laser cladding system. The interface morphology, phase composition, micro-hardness and biological properties of the two coatings were examined and compared. The results showed that the fluorapatite/Al₂O₃ specimen underwent a greater inter-diffusion at the interface between the coating layer and the transition layer than the fluorapatite/ZrO₂ specimen. During the cladding process, the ZrO₂ and Al₂O₃ components of the coating were completely decomposed or underwent phase transformation. In addition, the fluorapatite was partially decomposed. For both specimens, the coating layers contained fluorapatite, CaF₂ and CaTiO₃ phases. The coating layer of the fluorapatite/ZrO₂ specimen additionally contained TTCP, CaO, CaZrO₃ and m-ZrO₂ (monoclinic phase), while that of the fluorapatite/Al₂O₃ specimen contained β-TCP, CaAl₂O₄ and θ-Al₂O₃. The average micro-hardness of the fluorapatite/ZrO₂ coating layer (1300 HV) was approximately 200 HV higher than that of the fluorapatite/Al₂O₃ coating layer (1100 HV). Both specimens generated dense bone-like apatite following immersion in simulated body fluid for 3 days. In other words, both specimens had a good in vitro bioactivity. However, the fluorapatite/ZrO₂ specimen showed a better initial attachment and spread of osteoblast-like osteosarcoma MG63 cells than the fluorapatite/Al₂O₃ specimen in in vitro biocompatibility tests performed for 24 h.

Bone-like Polymeric Composites with a Combination of Bioactive Glass and Hydroxyapatite: Simultaneous Enhancement of Mechanical Performance and Bioactivity

An ideal bone substitute requires not only high bioactivity but also sufficient mechanical performance, which is however inaccessible due to the lack of rational structure and composition design. Here, bioactive glass (BG)/hydroxyapatite (HA)/polyethylene (PE) composites with bone-like structure were prepared via a structuring injection molding. The strong and reciprocating shear field offered by the modified injection molding induced plenty of interlocked shish kebabs, mimicking the aligned collagen fibers in the natural bone. Such a bone-like structure enhanced the strength and toughness of the BG/HA/PE composites simultaneously, compensating the mechanical loss caused by the presence of BG. In vitro cell culture assays demonstrated that the combination of BG and HA significantly promoted cell attachment, proliferation, and alkaline phosphatase activity compared to the use of HA alone. It was attributed to upregulated expression of β-catenin stimulated by BG. The mineralization in simulated body fluid revealed that the BG/HA/PE composite exhibited apatite-forming ability stronger than that of the HA/PE counterpart. The integration of excellent mechanical performance and high bioactivity demonstrated the significant potential of the structured BG/HA/PE composites as load-bearing bone substitutes.

Formation of calcium phosphate coatings within polycaprolactone scaffolds by simple, alkaline phosphatase based method

The paper presents a novel approach to the production of calcium phosphate coatings of scaffolds. Mineral deposits were formed during incubation of polycaprolactone (PCL) scaffolds with bovine intestinal alkaline phosphatase in sodium glycerophosphate and calcium chloride medium. To modify hydrophobic surface of scaffolds and intensify attachment of coating, scaffolds were incubated at 50 °C (thermal activation, TA) or at 37 °C after short exposition to lipase (lipase activation, LA). Micro-computed tomography observations demonstrated that both methods resulted in deposition of mineral on the surface of external and internal walls of the scaffolds. Precipitate formed after thermal and lipase activation contained particles with average size of 200-400 nm, and the shape of donuts. In thermal activated PCL coatings X-ray diffraction disclosed peaks typical for hydroxyapatite (HAp), while after lipase activation these peaks could be precisely defined only if left for 6 days in the incubation medium. The Fourier-transform infrared spectroscopy suggested crystalline structure of HAp both after thermal and lipase activation. The adherence of bone marrow mesenchymal stem cells was initially higher on coated than pristine PCL, but during 7 days of culture the cell number increased and was similar on all tested samples. Alkaline phosphatase activity, considered as a sign of osteogenic differentiation, measured on PCL samples after 7 days was 2-3 times lower on pristine PCL than on the coated samples, but after 2 weeks increased significantly and reached similar value as on the calcium phosphate substrates.

Nanolayer coextrusion: An efficient and environmentally friendly micro/nanofiber fabrication technique

Researchers have developed many types of nanoscale materials with different properties. Among them, nanofibers have recently attracted increasing interest and attention due to their functional versatility and potential applications in diverse industries, including tapes, filtration, energy generation, and biomedical technologies. Nanolayer coextrusion, a novel polymer melt fiber processing technology, has gradually received attention due to its environmental friendliness, efficiency, simplicity and ability to be mass-produced. Compared with conventional techniques, nanolayer coextruded non-woven nanofibrous mats offer advantages such as a tunable fiber diameter, high porosity, high surface area to volume ratio, and the potential to manufacture composite nanofibers with different components to achieve desired structures and properties. Dozens of thermoplastic polymers have been coextruded for various applications, and the variety of polymers has gradually continued to increase. This review presents an overview of the nanolayer coextrusion technique and its promising advantages and potential applications. We discuss nanolayer coextrusion theory and the parameters (polymer and processing) that significantly affect the fiber morphology and properties. We focus on varied applications of nanolayer coextruded fibers in different fields and conclude by describing the future potential of this novel technology.

3D bioactive composite scaffolds for bone tissue engineering

Bone is the second most commonly transplanted tissue worldwide, with over four million operations using bone grafts or bone substitute materials annually to treat bone defects. However, significant limitations affect current treatment options and clinical demand for bone grafts continues to rise due to conditions such as trauma, cancer, infection and arthritis. Developing bioactive three-dimensional (3D) scaffolds to support bone regeneration has therefore become a key area of focus within bone tissue engineering (BTE). A variety of materials and manufacturing methods including 3D printing have been used to create novel alternatives to traditional bone grafts. However, individual groups of materials including polymers, ceramics and hydrogels have been unable to fully replicate the properties of bone when used alone. Favourable material properties can be combined and bioactivity improved when groups of materials are used together in composite 3D scaffolds. This review will therefore consider the ideal properties of bioactive composite 3D scaffolds and examine recent use of polymers, hydrogels, metals, ceramics and bio-glasses in BTE. Scaffold fabrication methodology, mechanical performance, biocompatibility, bioactivity, and potential clinical translations will be discussed.

Integrating 3D-printed PHBV/Calcium sulfate hemihydrate scaffold and chitosan hydrogel for enhanced osteogenic property

We developed the 3D-printed poly(3-hydroxybutyrate-co-3-hydroxyvalerate)/calcium sulfate hemihydrate (PHBV/CaSH) scaffolds by using fused deposition modelling (FDM) technique and then coated the scaffolds with chitosan (CS) acetic acid solution. After drying and neutralization, CS hydrogel was formed on the surface of the scaffolds. The resultant PHBV/CaSH/CS scaffolds could promote the adhesion and proliferation of rat bone marrow stromal cells (rBMSCs) and enhance the osteogenesis of rBMSCs by up-regulating the expression level of osteogenic genes compared to the PHBV and PHBV/CaSH scaffolds. In vivo studies further demonstrated the PHBV/CaSH/CS scaffolds could effectively promote new bone formation. Therefore, integrating 3D-printed PHBV/CaSH scaffold and CS hrydogel represents a novel strategy to promote osteogensis property, showing full potential for bone defects repair.

Research: Design and Analysis of a Low-Stiffness Porous Hip Stem

Two major problems are associated with total hip replacement: 1) stress shielding and 2) the adverse tissue reaction to certain elements of the implant material. In this regard, a porous implant provides lower stiffness and vacancies for bone ingrowth, making it more suitable for the human bone compared with a solid stem. Moreover, second-generation titanium biomedical alloys, such as TNZT (Ti35Nb7Zr5Ta) and TMZF (Ti12Mo6Zr2Fe), have been introduced to prevent the adverse tissue reactions related to aluminum and vanadium elements of the popular Ti6Al4V alloy. In the current work, an analysis was performed based on uniaxial compression testing of cubic Ti6Al4V structures of different porosities to predict the governing equations that relate the relative density of the structure to the mechanical properties of the structure according to the Gibson-Ashby model. A numerical study was conducted to evaluate the change in stress distribution obtained by incorporating the new titanium alloys in porous hip stem implants. Implants modeled with the mechanical properties of TNZT and TMZF showed a minimum safety factor of 1.69 and 3.02, respectively, with respect to the yield strength. The results demonstrated an increase in the equivalent von Mises stresses and maximum principal elastic strain up to 7% and 15%, respectively, compared with the porous Ti6Al4V implant and up to 108% and 156%, respectively, compared with the solid Ti6Al4V implant.

Marine Collagen/Apatite Composite Scaffolds Envisaging Hard Tissue Applications

The high prevalence of bone defects has become a worldwide problem. Despite the significant amount of research on the subject, the available therapeutic solutions lack efficiency. Autografts, the most commonly used approaches to treat bone defects, have limitations such as donor site morbidity, pain and lack of donor site. Marine resources emerge as an attractive alternative to extract bioactive compounds for further use in bone tissue-engineering approaches. On one hand they can be isolated from by-products, at low cost, creating value from products that are considered waste for the fish transformation industry. One the other hand, religious constraints will be avoided. We isolated two marine origin materials, collagen from shark skin (Prionace glauca) and calcium phosphates from the teeth of two different shark species (Prionace glauca and Isurus oxyrinchus), and further proposed to mix them to produce 3D composite structures for hard tissue applications. Two crosslinking agents, 1-[3-(dimethylamino)propyl]-3-ethylcarbodiimide hydrochloride/N-Hydroxysuccinimide (EDC/NHS) and hexamethylene diisocyanate (HMDI), were tested to enhance the scaffolds' properties, with EDC/NHS resulting in better properties. The characterization of the structures showed that the developed composites could support attachment and proliferation of osteoblast-like cells. A promising scaffold for the engineering of bone tissue is thus proposed, based on a strategy of marine by-products valorisation.

Avaliação topográfica e in vitro de superfícies de titânio revestidas com vidro bioativo

Resumo Objetivo Avaliar e comparar a rugosidade superficial e a atividade dos osteoblastos em contato com uma nova superfície bioativa e nanoestruturada de titânio grau 4 revestida com vidro bioativo contendo fosfato de cálcio, sintetizada pelo método sol-gel. Material e método Sessenta e três discos de titânio, medindo 4 mm de diâmetro por 2 mm de altura, foram preparados e divididos em três grupos: microtexturizado (Ticp - controle); revestido com vidro bioativo e seco a vácuo a 37 °C por 10 dias (BGTi37), e revestido com vidro bioativo e aquecido a 600 °C por cinco horas (BGTi600). Três espécimes de cada grupo foram utilizados para avaliação da topografia superficial e 18 espécimes, para cultura celular. Resultado O revestimento de vidro bioativo diminuiu a rugosidade média quando comparado ao titânio microtexturizado. A proporção de células viáveis, a produção de fosfatase alcalina e o grau de mineralização da matriz óssea em contato com os espécimes de titânio do grupo BGTi600 foram significativamente menores em relação aos grupos controle e do titânio microtexturizado. Conclusão Apesar de sua marcante menor rugosidade, a superfície BGTi37 apresentou comportamento biológico semelhante a uma superfície de titânio microtexturizada e moderadamente rugosa. A outra superfície experimental (BGTi600), a de menor rugosidade entre todas as testadas, apresentou os piores resultados de ativação dos osteoblastos.

Polydopamine-assisted chlorhexidine immobilization on medical grade stainless steel 316L: Apatite formation and in vitro osteoblastic evaluation

Immobilization of chlorhexidine (CHX) on stainless steel 316L (SS316L), assisted by a polydopamine film as an intermediate layer is projected as an approach in combating infection while aiding bone regeneration for coating development on orthopedic and dental implants. This study aimed to investigate the ability of CHX coating to promote apatite layer, osteoblast cells viability, adhesion, osteogenic differentiation and mineralization. Stainless steel 316L disks were pre-treated, grafted with a polydopamine film and immobilized with different concentrations of CHX (10-30mM). The apatite layer formation was determined through an in vitro simulated body fluid (SBF) test by ATR-FTIR and SEM-EDX analyses. The osteoblastic evaluations including cells viability, cells adhesion, osteogenic differentiation and mineralization were assessed with human fetal osteoblast cells through MTT assay, morphology evaluation under FESEM, ALP enzyme activity and Alizarin Red S assay. The apatite layer was successfully formed on the CHX coated disks, demonstrating potential excellent bioactivity property. The CHX coatings were biocompatible with the osteoblast cells at low CHX concentration (<20mM) with good adhesion on the metal surfaces. The increment of ALP activity and calcium deposition testified that the CHX coated disks able to support osteoblastic maturation and mineralization. These capabilities give a promising value to the CHX coating to be implied in bone regeneration area.