Bioactive calcium phosphate materials and applications in bone regeneration

Fabrication and properties of interweaved poly(ether ether ketone) composite scaffolds

This paper interweaved scaffolds with poly(ether ether ketone) (PEEK) and poly(lactic acid)/Walnut shell/hydroxypatite (PLA/WS/HA) composites by using fused filament fabrication technology, although there was a huge difference in thermal property term between PLA and PEEK. In order to keep mechanical properties of PEEK scaffold and remedy the stress loss produced by pores, PLA/WS/HA composites were used to fill the pores with gradient form outside-in (0.4-0.8 mm, 0.6-1.0 mm, 0.8-1.2 mm and 1.6-2.0 mm). The thermal stability, tensile and compression properties, tensile fracture surface morphology, cytotoxicity and in vivo experiment were investigated. The results showed: the scaffolds were intact without any flashes and surface destruction, and kept a well thermal stability. Compared with the PEEK porous scaffolds, the tensile fracture stress and strain, compression yield stress and strain of interweaved scaffolds were dramatically enhanced by 24.1%, 438%, 359.1% and 921.2%, respectively, and they climbed to the climax at 8 wt% of WS. In vivo experiment showed that the degradation of PLA/WS/HA composites synchronized with the adhesion, proliferation and ingrowth of bone cells, keeping the stable biomechanical properties of interweaved scaffolds. Those experiments showed that interweaved PEEK-PLA/WS/HA scaffolds had the potential to be used as bone implant in tissue engineering.

Facile Synthesis of TiO2-SiO2-P2O5/CaO/ZnO with a Core-Shell Structure for Bone Implantation

A facile synthesis method was developed to synthesize TiO₂-SiO₂-P₂O₅/CaO or TiO₂-SiO₂-P₂O₅/ZnO with a core-shell structure. The carboxylic cation exchanger Tokem-250 has a high selectivity for Ca²⁺/Zn²⁺ ions and was used in this study. The framework of the material in the shell was TiO₂-SiO₂-P₂O₅, and the inner part was filled with CaO (sample TiO₂-SiO₂/CaO) or ZnO (sample TiO₂-SiO₂-P₂O₅/ZnO). A stepwise heat treatment (drying in a drying oven at 60 °C for 30 min, then annealing in a muffle furnace for 30 min at 150, 250, and 350 °C, at 600 °C for 6 h, and at 800 °C for 1 h) was needed to obtain a homogeneous material. The poly(vinyl alcohol) was used as a binding additive. The obtained composites were characterized by a regular structure and highly developed surface. The samples exhibit bioactive properties in the simulated body fluid (SBF) solution, since the surface contains active centers (Si⁴⁺, Ti⁴⁺) which contribute to mineralization and precipitation of the calcium-phosphate compounds on the surface from biological media. The TiO₂-SiO₂-P₂O₅/CaO-PVA samples did not exceed acceptable hemolysis levels for medical materials.

Advanced 3D Magnetic Scaffolds for Tumor-Related Bone Defects

The need for bone substitutes is a major challenge as the incidence of serious bone disorders is massively increasing, mainly attributed to modern world problems, such as obesity, aging of the global population, and cancer incidence. Bone cancer represents one of the most significant causes of bone defects, with reserved prognosis regarding the effectiveness of treatments and survival rate. Modern therapies, such as hyperthermia, immunotherapy, targeted therapy, and magnetic therapy, seem to bring hope for cancer treatment in general, and bone cancer in particular. Mimicking the composition of bone to create advanced scaffolds, such as bone substitutes, proved to be insufficient for successful bone regeneration, and a special attention should be given to control the changes in the bone tissue micro-environment. The magnetic manipulation by an external field can be a promising technique to control this micro-environment, and to sustain the proliferation and differentiation of osteoblasts, promoting the expression of some growth factors, and, finally, accelerating new bone formation. By incorporating stimuli responsive nanocarriers in the scaffold's architecture, such as magnetic nanoparticles functionalized with bioactive molecules, their behavior can be rigorously controlled under external magnetic driving, and stimulates the bone tissue formation.

Strontium-doped apatitic bone cements with tunable antibacterial and antibiofilm ability

Injectable calcium phosphate cements (CPCs) represent promising candidates for the regeneration of complex-shape bone defects, thanks to self-hardening ability, bioactive composition and nanostructure offering high specific surface area for cell attachment and conduction. Such features make CPCs also interesting for functionalization with various biomolecules, towards the generation of multifunctional devices with enhanced therapeutic ability. In particular, strontium-doped CPCs have been studied in the last years due to the intrinsic antiosteoporotic character of strontium. In this work, a SrCPC previously reported as osteointegrative and capable to modulate the fate of bone cells was enriched with hydroxyapatite nanoparticles (HA-NPs) functionalized with tetracycline (TC) to provide antibacterial activity. We found that HA-NPs functionalized with TC (NP-TC) can act as modulator of the drug release profile when embedded in SrCPCs, thus providing a sustained and tunable TC release. In vitro microbiological tests on Escherichia coli and Staphylococcus aureus strains proved effective bacteriostatic and bactericidal properties, especially for the NP-TC loaded SrCPC formulations. Overall, our results indicate that the addition of NP-TC on CPC acted as effective modulator towards a tunable drug release control in the treatment of bone infections or cancers.

Small Extracellular Vesicles Released from Bioglass/Hydrogel Scaffold Promote Vascularized Bone Regeneration by Transferring miR-23a-3p

BACKGROUND

The treatment of critical-size bone defect is a great difficulty in orthopedics. Osteogenesis and angiogenesis are critical issue during the process of bone repair and remodeling. Mesenchymal stem cells (MSCs)-derived exosomes have the same therapeutic effect to MSCs-based therapies. The effect of human umbilical cord MSCs-derived sEVs (hUC-MSCs-sEVs) on vascularized bone regeneration and the potential mechanism remains to be investigated. Herein, we aimed to explore the therapeutic effect and the mechanism of hUC-MSCs-sEVs on critical-size bone defect.

METHODS

To investigate the potential osteogenesis and angiogenesis effects of sEVs in vitro, we extracted sEVs from hUC-MSCs, and then sEVs were co-incubated with BMSCs and HUVECs. We next investigated the effect and potential mechanism of sEVs on the effects of osteogenesis and angiogenesis. We fabricated 3D-printed bioglass scaffold with Gelma/nanoclay hydrogel coatings to load sEVs (BG-gel-sEVs) to ensure in vivo sustained efficacy of sEVs. Finally, the skull defect model was used to evaluate the capacity of vascularized bone regeneration of the composited scaffolds.

RESULTS

hUC-MSCs-sEVs facilitated calcium deposition and the endothelial network formation, inducing osteogenic differentiation and angiogenesis by delivering miR-23a-3p to activate PTEN/AKT signaling pathway. Additionally, the BG-gel-sEVs composited scaffold achieved vascularized bone regeneration in vivo.

CONCLUSION

This finding illuminated that hUC-MSCs-sEVs promoted osteogenesis and angiogenesis by delivering miR-23a-3p to activate PTEN/AKT signaling pathway, achieving vascularized bone regeneration.

Biosynthesised Silver Nanoparticles Loading onto Biphasic Calcium Phosphate for Antibacterial and Bone Tissue Engineering Applications

Biphasic calcium phosphate (BCP) serves as one of the substitutes for bone as it consists of an intimate mixture of beta-tricalcium phosphate (β-TCP) and hydroxyapatite (HAP) in different ratios. BCP, because of its inbuilt properties such as osteoconductivity, biocompatibility, and biostability in several clinical models serves as a bone substituent for orthopedic applications. Therefore, the present study aimed to assess the effectiveness of silver (Ag) nanoparticles (NPs) combined with BCP composites for the orthopedic sector of bone tissue regeneration and growth. In this regard, we first synthesized Ag-BCP microclusters by the double-emulsion method and then characterized the composite for various physicochemical properties, including the crystallinity and crystal structure, bonding and functionality, porosity, morphology, surface charges, topography, and thermal stability. In addition, the antibacterial activity of Ag-BCP was tested against gram-positive and gram-negative microorganisms such as Staphylococcus aureus, Candida albicans, and Escherichia coli. Finally, the cytocompatibility of Ag-BCP was confirmed against the fibroblast cells in vitro.

Hydroxyapatite-Tethered Peptide Hydrogel Promotes Osteogenesis

Hydroxyapatite (HAp) as natural bone composition is highly osteoinductive. To harvest its osteoinductivity in bone regenerative engineering, the HAp-supporting hydrogel is urgently needed to minimize inhomogeneous aggregation of HAp. Here, we developed a HAp-stabilizing hydrogel based on peptide self-assembly. FmocFFRR was efficient for HAp-capping due to arginine-phosphate interaction. Tethering FmocFFRR on the HAp surface facilitated self-assembly to form FmocFFRR/HAp hybrid hydrogel, enabling stable dispersion of HAp in it. The molecular interactions between FmocFFRR and HAp particles were studied using microscopic and spectral characterizations. FmocFFRR/HAp hydrogel exhibited more enhanced mechanical properties than FmocFFRR. The biocompatibility of FmocFFRR/HAp hydrogel was verified using an ATP assay and live-dead staining assay. More importantly, FmocFFRR/HAp hydrogel not only enabled cell attachment on its surface, but also supported 3D cell culturing inside the hydrogel. Further, 3D culturing of MC3T3-E1 preosteoblasts inside FmocFFRR/HAp hydrogel significantly enhanced the expressions of osteogenesis markers, including alkaline phosphate (ALP), type-I collagen (COL1), and osteocalcin (OCN), demonstrating the promoting effect of osteoblast differentiation. These findings inspire its potential application in bone regenerative engineering.

The synergetic effect of a gold nanocluster-calcium phosphate composite: enhanced photoluminescence intensity and superior bioactivity

Gold nanoclusters (AuNCs) are a unique class of materials that exhibit visible luminescence. Amorphous calcium phosphate (ACP) is a widely used biomaterial for a variety of purposes, such as drug delivery, bone cementing, and implant coatings. In this study, a nanocomposite of AuNCs and ACP is prepared by biomimetic mineralization in a Dulbecco's modified Eagle's medium (DMEM). The strong interaction between AuNCs and Ca²⁺ ions effectively induces aggregation of AuNCs. The as-formed nanocomposite, AuNCs@ACP, emits significantly enhanced luminescence compared to AuNCs alone. The luminescence enhancement mechanism is investigated using synchrotron X-ray absorption fine structure spectroscopy. In addition, the presence of AuNCs stabilizes ACP and also enhances the biocompatibility of ACP in promoting cell proliferation, and the nanocomposites are promising as nanoprobes for cancer therapy and/or bone tissue engineering.

Injectable demineralized bone matrix particles and their hydrogel bone grafts loaded with β-tricalcium phosphate powder and granules: A comparative study

Demineralized bone matrix (DBM), has been used as a bone-graft material because of its osteoconductivity and osteoinductivity. However, the previous research report that supports the single use of DBM is limited by its rapid resorption caused by the lack of calcium and phosphate. β-Tricalcium phosphate (TCP) is an enriched calcium phosphate material suitable for bone healing with osteoconductive properties. In this study, we have developed injectable bone graft by the loading two kinds of TCP in DBM particles and thermo-sensitive DBM-derived hydrogel (hDBM). TCP powder (pTCP) and TCP granules (gTCP) were loaded into hDBM and DBM, respectively. The bone formation effect was investigated according to the morphological features of TCP. Residual growth factor concentrations were investigated; microstructure and morphology were characterized by SEM. In-vitro studies showed that hDBM/DBM/pTCP and hDBM/DBM/gTCP bone grafts were biocompatible and could promote osteogenesis by up-regulating the expression of Runx2 and OPN, bone-related genes. In-vivo studies using the rabbit-femur defect model revealed that the implanted hDBM/DBM/pTCP bone graft showed similar histology to that of fibrous dysplasia with the expression of CD68, whereas hDBM/DBM/gTCP showed good bone formation. Loading of gTCP in place of pTCP was noticed as an effective way to improve bone regeneration in an injectable hDBM/DBM hydrogel-based bone graft.

The Application of Black Phosphorus Nanomaterials in Bone Tissue Engineering

Recently, research on and the application of nanomaterials such as graphene, carbon nanotubes, and metal-organic frameworks has become increasingly popular in tissue engineering. In 2014, a two-dimensional sheet of black phosphorus (BP) was isolated from massive BP crystals. Since then, BP has attracted significant attention as an emerging nanomaterial. BP possesses many advantages such as light responsiveness, electrical conductivity, degradability, and good biocompatibility. Thus, it has broad prospects in biomedical applications. Moreover, BP is composed of phosphorus, which is a key bone tissue component with good biocompatibility and osteogenic repair ability. Thereby, BP exhibits excellent advantages for application in bone tissue engineering. In this review, the structure and the physical and chemical properties of BP are described. In addition, the current applications of BP in bone tissue engineering are reviewed to aid the future research and application of BP.

Molecular Dynamics Simulation of Biomimetic Biphasic Calcium Phosphate Nanoparticles

Biphasic calcium phosphate (BCP) is used as a bone substitute and bone tissue repair material due to its better control over bioactivity and biodegradability. It is crucial to stabilize the implanted biomaterial while promoting bone ingrowth. However, a lack of standard experimental and theoretical protocols to characterize the physicochemical properties of BCP limits the optimization of its composition and properties. Computational simulations can help us better to learn BCP at a nanoscale level. Here, the Voronoi tessellation method was combined with simulated annealing molecular dynamics to construct BCP nanoparticle models of different sizes, which were used to understand the physicochemical properties of BCP (e.g., melting point, infrared spectrum, and mechanical properties). We observed a ∼20 to 30 Å layer of calcium-deficient hydroxyapatite at the HAP/β-TCP interface due to particle migration, which may contribute to BCP stability. The BCP model may stimulate further research into BCP ceramics and multiphasic ceramics. Moreover, our study may facilitate the optimization of compositions of BCP-based biomaterials.

Layered scaffolds in periodontal regeneration

Periodontitis is a common inflammatory disease in dentistry that may lead to tooth loss and aesthetic problems. Periodontal tissue has a sophisticated architecture including four sections of alveolar bone, cementum, gingiva, and periodontal ligament fiber; all these four can be damaged during periodontitis. Thus, for whole periodontal regeneration, it is important to form both hard and soft tissue structures simultaneously on the tooth root surface without forming junctional epithelium and ankylosis. This condition makes the treatment of the periodontium a challenging process. Various regenerative methods including Guided Bone/Tissue Regeneration (GBR/GTR) using various membranes have been developed. Although using such GBR/GTR membranes was successful for partial periodontal treatment, they cannot be used for the regeneration of complete periodontium. For this purpose, multilayered scaffolds are now being developed. Such scaffolds may include various biomaterials, stem cells, and growth factors in a multiphasic configuration in which each layer is designed to regenerate specific section of the periodontium. This article provides a comprehensive review of the multilayered scaffolds for periodontal regeneration based on natural or synthetic polymers, and their combinations with other biomaterials and bioactive molecules. After highlighting the challenges related to multilayered scaffolds preparation, features of suitable scaffolds for periodontal regeneration are discussed.

Sudoku of porous, injectable calcium phosphate cements – Path to osteoinductivity

With the increase of global population, people's life expectancy is growing as well. Humans tend to live more active lifestyles and, therefore, trauma generated large defects become more common. Instances of tumour resection or pathological conditions and complex orthopaedic issues occur more frequently increasing necessity for bone substitutes. Composition of calcium phosphate cements (CPCs) is comparable to the chemical structure of bone minerals. Their ability to self-set and resorb in vivo secures a variety of potential applications in bone regeneration. Despite the years-long research and several products already reaching the market, finding the right properties for calcium phosphate cement to be osteoinductive and both injectable and suitable for clinical use is still a sudoku. This article is focused on injectable, porous CPCs, reviewing the latest developments on the path toward finding osteoinductive material, which is suitable for injection.

•

Phase separation is an essential factor to be improved to obtain injectable material; several methods have been proposed.

•

Osteoinductive bone substitutes – possible solution for bad mechanical performance of CPCs.

•

Osteoinductivity of CPC could be attained even without the addition of different supplements.

•

Less complex composition of CPC – potentially reduced price of the final product and wider availability on the market.

Effect of chitosan/inorganic nanomaterial scaffolds on bone regeneration and related influencing factors in animal models: A systematic review

Bone tissue engineering (BTE) provides a promising alternative for transplanting. Due to biocompatibility and biodegradability, chitosan-based scaffolds have been extensively studied. In recent years, many inorganic nanomaterials have been utilized to modify the performance of chitosan-based materials. In order to ascertain the impact of chitosan/inorganic nanomaterial scaffolds on bone regeneration and related key factors, this study presents a systematic comparison of various scaffolds in the calvarial critical-sized defect (CSD) model. A total of four electronic databases were searched without publication date or language restrictions up to April 2022. The Animal Research Reporting of In Vivo Experiments 2.0 guidelines (ARRIVE 2.0) were used to assess the quality of the included studies. Moreover, the risk of bias (RoB) was evaluated via the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) tool. After the screening, 22 studies were selected. None of these studies achieved high quality or had a low RoB. In the available studies, scaffolds reconstructed bone defects in radically different extensions. Several significant factors were identified, including baseline characteristics, physicochemical properties of scaffolds, surgery details, and scanning or reconstruction parameters of micro-computed tomography (micro-CT). Further studies should focus on not only improving the osteogenic performance of the scaffolds but also increasing the credibility of studies through rigorous experimental design and normative reports.

Using Copper-Doped Mesoporous Bioactive Glass Nanospheres to Impart Anti-Bacterial Properties to Dental Composites

Experimental dental resin composites containing copper-doped mesoporous bioactive glass nanospheres (Cu-MBGN) were developed to impart anti-bacterial properties. Increasing amounts of Cu-MBGN (0, 1, 5 and 10 wt%) were added to the BisGMA/TEGDMA resin matrix containing micro- and nano-fillers of inert glass, keeping the resin/filler ratio constant. Surface micromorphology and elemental analysis were performed to evaluate the homogeneous distribution of filler particles. The study investigated the effects of Cu-MBGN on the degree of conversion, polymerization shrinkage, porosity, ion release and anti-bacterial activity on S. mutans and A. naeslundii. Experimental materials containing Cu-MBGN showed a dose-dependent Cu release with an initial burst and a further increase after 28 days. The composite containing 10% Cu-MBGN had the best anti-bacterial effect on S. mutans, as evidenced by the lowest adherence of free-floating bacteria and biofilm formation. In contrast, the 45S5-containing materials had the highest S. mutans adherence. Ca release was highest in the bioactive control containing 15% 45S5, which correlated with the highest number of open porosities on the surface. Polymerization shrinkage was similar for all tested materials, ranging from 3.8 to 4.2%, while the degree of conversion was lower for Cu-MBGN materials. Cu-MBGN composites showed better anti-bacterial properties than composites with 45S5 BG.

Bio-Activation of HA/β-TCP Porous Scaffolds by High-Pressure CO2 Surface Remodeling: A Novel "Coating-from" Approach

Biphasic macroporous Hydroxyapatite/β-Tricalcium Phosphate (HA/β-TCP) scaffolds (BCPs) are widely used for bone repair. However, the high-temperature HA and β-TCP phases exhibit limited bioactivity (low solubility of HA, restricted surface area, low ion release). Strategies were developed to coat such BCPs with biomimetic apatite to enhance bioactivity. However, this can be associated with poor adhesion, and metastable solutions may prove difficult to handle at the industrial scale. Alternative strategies are thus desirable to generate a highly bioactive surface on commercial BCPs. In this work, we developed an innovative "coating from" approach for BCP surface remodeling via hydrothermal treatment under supercritical CO₂, used as a reversible pH modifier and with industrial scalability. Based on a set of complementary tools including FEG-SEM, solid state NMR and ion exchange tests, we demonstrate the remodeling of macroporous BCP surface with the occurrence of dissolution-reprecipitation phenomena involving biomimetic CaP phases. The newly precipitated compounds are identified as bone-like nanocrystalline apatite and octacalcium phosphate (OCP), both known for their high bioactivity character, favoring bone healing. We also explored the effects of key process parameters, and showed the possibility to dope the remodeled BCPs with antibacterial Cu²⁺ ions to convey additional functionality to the scaffolds, which was confirmed by in vitro tests. This new process could enhance the bioactivity of commercial BCP scaffolds via a simple and biocompatible approach.

Porous biomaterials for tissue engineering: a review

The field of biomaterials has grown rapidly over the past decades. Within this field, porous biomaterials have played a remarkable role in: (i) enabling the manufacture of complex three-dimensional structures; (ii) recreating mechanical properties close to those of the host tissues; (iii) facilitating interconnected structures for the transport of macromolecules and cells; and (iv) behaving as biocompatible inserts, tailored to either interact or not with the host body. This review outlines a brief history of the development of biomaterials, before discussing current materials proposed for use as porous biomaterials and exploring the state-of-the-art in their manufacture. The wide clinical applications of these materials are extensively discussed, drawing on specific examples of how the porous features of such biomaterials impact their behaviours, as well as the advantages and challenges faced, for each class of the materials.

Dynamics of the natural genesis of β-TCP/HAp phases in postnatal fishbones towards gold standard biocomposites for bone regeneration

The search for gold-standard materials for bone regeneration is still a challenge in reconstruction surgery. The ratio between hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP) in biphasic calcium phosphate ceramics (BCPs) is one of the most important factors in osteoinduction promotion and controlled biodegradability, configurating what is currently considered as a possible gold standard material for bone substitution in reconstructive surgery. Exploring the natural genesis of the HAp and β-TCP phases in fishbones during their postnatal growth, this study developed a biphasic bioceramic obtained from the calcination of Nile tilapia (Oreochromis niloticus) bones as a function of their ages. The natural genesis dynamics of the structural evolution of the β-TCP and HAp phases were characterized by physicochemical methods, taking into account of the age of the fish and the material processing conditions. Thermal analysis (TGA / DTA) showed complete removal of the organic matter and transitions associated with the transformation of carbonated hydroxyapatite (CDHA) to HAp and β-TCP phases. After calcination at 900 °C, the material was characterized by: X-ray diffraction (XRD) and refinement by the Rietveld method; Fourier Transform Infrared Spectroscopy with Attenuated Total Reflection (FTIR-ATR); Raman spectroscopy; Scanning Electron Microscopy (SEM) and Flame Atomic Absorption Spectroscopy (FAAS). The analysis allowed identification and quantitative estimate of the variations of the HAp and β-TCP phases in the formation of the BCPs. The results showed that the decrease in β-TCP against the increase in the HAp phases is symmetrical to the dynamics of the natural genesis of these phases, surprisingly maintaining the balanced phase proportion even when bones of young fishes were used. The microstructure analysis confirms the observed transformation. In addition, in vivo tests demonstrated the osteoinductive potential of BCP scaffolds implanted in an ectopic site, and their remarkable regenerative functionality, as bone graft, was demonstrated in alveolar bone after tooth extraction. MTT cytotoxicity assay for BCP samples for MC3T3-E1 pre-osteoblasts and L929 fibroblasts cells showed viability equal or higher than 100%. A logistic empirical model is presented to explain the three stages of HAp natural formation with fish age and it is also compared to the fish size evolution.

Calcium Phosphate-Based Biomaterials for Bone Repair

Traumatic, tumoral, and infectious bone defects are common in clinics, and create a big burden on patient's families and society. Calcium phosphate (CaP)-based biomaterials have superior properties and have been widely used for bone defect repair, due to their similarities to the inorganic components of human bones. The biological performance of CaPs, as a determining factor for their applications, are dependent on their physicochemical properties. Hydroxyapatite (HAP) as the most thermally stable crystalline phase of CaP is mostly used in the form of ceramics or composites scaffolds with polymers. Nanostructured CaPs with large surface areas are suitable for drug/gene delivery systems. Additionally, CaP scaffolds with hierarchical nano-/microstructures have demonstrated excellent ability in promoting bone regeneration. This review focuses on the relationships and interactions between the physicochemical/biological properties of CaP biomaterials and their species, sizes, and morphologies in bone regeneration, including synthesis strategies, structure control, biological behavior, and the mechanisms of CaP in promoting osteogenesis. This review will be helpful for scientists and engineers to further understand CaP-based biomaterials (CaPs), and be useful in developing new high-performance biomaterials for bone repair.

Inclusion of calcium phosphate does not further improve in vitro and in vivo osteogenesis in a novel, highly biocompatible, mechanically stable and 3D printable polymer

At a time of unpredictable challenges for health, one trend is certain: there is an exceedingly high demand for functional implants, particularly bone grafts. This has encouraged the emergence of bone tissue engineering substitutes as an alternative method to conventional bone grafts. However, the current approaches in the field face several limitations that have prevented the ultimate translation into clinical settings. As a result, many attempts have been made to fabricate synthetic bone implants that can offer suitable biological and mechanical properties.Light curable methacrylate-based polymers have ideal properties for bone repair. These materials are also suitable for 3D printing which can be applicable for restoration of both function and aesthetics. The main objective of this research was to investigate the role of calcium phosphate (CaP) incorporation in a mechanically stable, biologically functional and 3D printable polymer for the reconstruction of complex craniofacial defects. The experimental work initially involved the synthesis of (((((((((((3R,3aR,6S,6aR)- hexahydrofuro[3,2-b]furan-3,6-diyl)bis(oxy))bis(ethane-2,1- 48 diyl))bis(oxy))bis(carbonyl))bis(azanediyl))bis(3,3,5-trimethylcyclohexane-5,1- 49 diyl))bis(azanediyl))bis(carbonyl))bis(oxy))bis(ethane-2,1-diyl) bis(2-methylacrylate) referred to as CSMA and fabrication of composite discs via a Digital Light Printing (DLP) method. The flow behaviour of the polymer as a function of CaP addition, surface remineralisation potential, in vitro cell culture, using MC3T3 and Adipose-Derived Mesenchymal Stem Cells (ADSCs) and ex ovo angiogenic response was assessed. Finally, in vivo studies were carried out to investigate neo-bone formation at 4- and 8-weeks post-implantation. Quantitative micro-CT and histological evaluation did not show a higher rate of bone formation in CaP filled CSMA composites compared to CSMA itself. Therefore, such polymeric systems hold promising features by allowing more flexibility in designing a 3D printed scaffold targeted at the reconstruction of maxillofacial defects.

Zinc-doped calcium silicate additive accelerates early angiogenesis and bone regeneration of calcium phosphate cement by double bioactive ions stimulation and immunoregulation

Calcium phosphate cement (CPC), a popular injectable bone defect repairing material, has deficiencies in stimulating osteogenesis and angiogenesis. To overcome the weaknesses of CPC, zinc-doped calcium silicate (Zn-CS) which can release bioactive silicon (Si) and zinc (Zn) ions was introduced to CPC. The physicochemical and biological properties of CPC and its composites were evaluated. Firstly, the most effective addition content of calcium silicate (CaSiO₃, CS) in promoting the in vitro osteogenesis was first sorted out. On this basis, the most effective Zn doping content in CS for improving osteogenic differentiation of CPC-based composites was screened out. Finally, the immunoregulation of CS/CPC and Zn-CS/CPC in promoting angiogenesis and osteogenesis was studied. The results showed that the most effective incorporation content of CS was 10 wt%. Zn at a doping content of 30 mol% in CS (30Zn-CS) further enhanced the osteogenic capacity of CS/CPC and simultaneously maintained excellent proangiogenic activity. CS/CPC and 30Zn-CS/CPC promoted the recruitment of macrophages and enhanced M2 polarization while inhibiting M1 polarization, which was beneficial to the early vascularization as well as subsequent new bone formation. When implanted into the femoral condylar defects of rabbits, 30Zn-CS/CPC showed high in vivo materials degradation rate, angiogenesis and osteogenesis, due to the synergistic effects of Si and Zn on bio-stimulation and immunoregulation. This study shed light on the synergistic effects of Si and Zn on regulating the angiogenic, osteogenic, and immunoregulatory activity, and 30Zn-CS/CPC is expected to repair the lacunar bone defects effectively.

3D Printing of Bioinert Oxide Ceramics for Medical Applications

Three-dimensionally printed metals and polymers have been widely used and studied in medical applications, yet ceramics also require attention. Ceramics are versatile materials thanks to their excellent properties including high mechanical properties and hardness, good thermal and chemical behavior, and appropriate, electrical, and magnetic properties, as well as good biocompatibility. Manufacturing complex ceramic structures employing conventional methods, such as ceramic injection molding, die pressing or machining is extremely challenging. Thus, 3D printing breaks in as an appropriate solution for complex shapes. Amongst the different ceramics, bioinert ceramics appear to be promising because of their physical properties, which, for example, are similar to those of a replaced tissue, with minimal toxic response. In this way, this review focuses on the different medical applications that can be achieved by 3D printing of bioinert ceramics, as well as on the latest advances in the 3D printing of bioinert ceramics. Moreover, an in-depth comparison of the different AM technologies used in ceramics is presented to help choose the appropriate methods depending on the part geometry.

Protective and vaccine dose-sparing efficacy of Poly I:C-functionalized calcium phosphate nanoparticle adjuvants in inactivated influenza vaccination

Adjuvants are required to increase the immunogenicity and efficacy of vaccination and enable vaccine dose sparing. Polyinosinic-polycytidylic acid (Poly I:C), a toll-like receptor 3 agonist, is a promising adjuvant candidate that can induce cell-mediated immune responses; however, it remains unlicensed owing to its low stability and toxicity. Calcium phosphate (CaP), a biocompatible and biodegradable nanoparticle, is widely used in biomedicine for stable and targeted drug delivery. In this study, we developed Poly I:C-functionalized CaP (Poly-CaP) and evaluated its vaccine adjuvant efficacy in vitro and in vivo. A half dose of Poly-CaP nanoparticles showed similar efficacy to a full dose of soluble Poly I:C in stimulating bone marrow-derived dendritic cells and macrophages to secrete proinflammatory cytokines and express their activation markers. Immunization with a half dose of inactivated influenza vaccine in the presence of Poly I:C or Poly-CaP adjuvants induced sufficient antigen-specific humoral responses after boost immunization. Immunization with Poly I:C, CaP, or Poly-CaP-adjuvanted with a half dose of influenza vaccine showed comparable protective efficacy against lethal virus infection, with lower weight loss and virus titer than a full dose of influenza vaccine. The Poly-CaP adjuvant was effective in stimulating antigen-specific CD4+ T cell proliferation in the lungs. Collectively, our results showed that the Poly-CaP adjuvant enhanced antigen-specific cell-mediated immunity and humoral immune responses with vaccine dose-sparing effects, suggesting its potential as a novel vaccine adjuvant candidate.

Biological Activities of Glass Ionomer Cement Supplemented with Fortilin on Human Dental Pulp Stem Cells

This study aimed to determine the most suitable recombinant fortilin and evaluate the biological activities of glass ionomer cement (GIC) incorporated with fortilin on human dental pulp stem cells (hDPSCs). Full-length and three fragments of Penaeus merguiensis fortilin were cloned and examined for their proliferative and cytoprotective effects on hDPSCs by MTT (3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay. Human DPSCs were cultured with GIC supplemented with fortilin, tricalcium phosphate, or a combination of tricalcium phosphate and fortilin, designated as GIC + FL, GIC + TCP, and GIC + TCP + FL, respectively (n = 4 for each group). At given time points, hDPSCs were harvested and analyzed by MTT, quantitative reverse transcription polymerase chain reaction, alkaline phosphatase activity, and Alizarin Red assays. The full-length fortilin promoted cell proliferation and significantly increased cell survival. This protein was subsequently added into the GIC along with tricalcium phosphate to investigate the biological activities. All experimental groups showed reduced cell viability after treatment with modified GICs on days 1 and 3. The GIC + TCP + FL group significantly promoted odontoblastic differentiation at particular time points. In addition, alkaline phosphatase activity and calcium phosphate deposit were markedly increased in the GIC + TCP + FL group. Among all experimental groups, the GIC incorporated with fortilin and tricalcium phosphate demonstrated the best results on odontogenic differentiation and mineral deposition in hDPSCs.

Recent Advances in Hydroxyapatite-Based Biocomposites for Bone Tissue Regeneration in Orthopedics

Bone tissue is a nanocomposite consisting of an organic and inorganic matrix, in which the collagen component and the mineral phase are organized into complex and porous structures. Hydroxyapatite (HA) is the most used ceramic biomaterial since it mimics the mineral composition of the bone in vertebrates. However, this biomimetic material has poor mechanical properties, such as low tensile and compressive strength, which make it not suitable for bone tissue engineering (BTE). For this reason, HA is often used in combination with different polymers and crosslinkers in the form of composites to improve their mechanical properties and the overall performance of the implantable biomaterials developed for orthopedic applications. This review summarizes recent advances in HA-based biocomposites for bone regeneration, addressing the most widely employed inorganic matrices, the natural and synthetic polymers used as reinforcing components, and the crosslinkers added to improve the mechanical properties of the scaffolds. Besides presenting the main physical and chemical methods in tissue engineering applications, this survey shows that HA biocomposites are generally biocompatible, as per most in vitro and in vivo studies involving animal models and that the results of clinical studies on humans sometimes remain controversial. We believe this review will be helpful as introductory information for scientists studying HA materials in the biomedical field.

Mineralized Enzyme-Based Biomaterials with Superior Bioactivities for Bone Regeneration

The formation and metabolic balance of bone tissue is a controllable process of biomineralization, which is regulated by various cells, biomolecules, and ions. Enzyme molecules play an important role in this process, and alkaline phosphatase (ALP) is one of the most critical factors. In this study, inspired by the process of bone biomineralization, a biomimetic strategy is achieved for the preparation of mineralized ALP nanoparticles (MALPNs), by taking advantages of the unique reaction between ALP and calcium ions in Dulbecco's modified Eagle's medium. Benefiting from the mild biomineralization reaction, the MALPN system highly maintains the activity of ALP. Furthermore, the in vitro studies show that the MALPN system significantly enhances the proliferation of bone marrow mesenchymal stem cells and upregulates their osteogenic differentiation. When evaluated as synthetic graft materials for bone regeneration, the MALPN-incorporated gelatin methacryloyl graft shows excellent mechanical properties, a sustained release profile of ALP, and high biocompatibility and efficacy in guiding bone regeneration and vascularization for critical-sized rat calvarial defect. Moreover, we also demonstrate that the biomimetic mineralization strategy can be adopted for other proteins such as acid phosphatase, bovine serum albumin, fibrinogen, and gelatin, suggesting its universality for constructing mineralized protein-/enzyme-based bioactive materials for the application of tissue regeneration.

Liver tissue-derived ECM loaded nanocellulose-alginate-TCP composite beads for accelerated bone regeneration

Guided bone regeneration with osteoinductive scaffolds is a competitive edge of tissue engineering due to faster and more consistent healing. In the present study, we developed such composite beads with nanocellulose reinforced alginate hydrogel that carried β-tricalcium phosphate (β-TCP) nano-powder and liver-derived extracellular matrix (ECM) from porcine. Interestingly, it was observed that the beads' group containing ECM-βTCP-alginate-nanocellulose (ETAC) was more biocompatible with higher cellular affinity than the others comprised of βTCP-alginate-nanocellulose (TAC) and alginate-nanocellulose (AC). Cell attachment on ETAC beads was dramatically increased with time. In parallel with in vitro results, ETAC beads produced uniform cortical and cancellous bone in the femur defect model of rabbits within two months. Although the group TAC also produced noticeable bone in the defect site, the healing quality was improved and regeneration was faster after adding ECM. This conclusion was not only confirmed by micro-anatomical analysis but also demonstrated with X-ray microtomography. In addition, the characteristic moldable and injectable properties made ETAC a promising scaffold for clinical applications.

Encapsulated vaterite-calcite CaCO3 particles loaded with Mg2+ and Cu2+ ions with sustained release promoting osteogenesis and angiogenesis

Bioactive cations, including calcium, copper and magnesium, have shown the potential to become the alternative to protein growth factor-based therapeutics for bone healing. Ion substitutions are less costly, more stable, and more effective at low concentrations. Although they have been shown to be effective in providing bone grafts with more biological functions, the precise control of ion release kinetics is still a challenge. Moreover, the synergistic effect of three or more metal ions on bone regeneration has rarely been studied. In this study, vaterite-calcite CaCO3 particles were loaded with copper (Cu2+) and magnesium (Mg2+). The polyelectrolyte multilayer (PEM) was deposited on CaCuMg-CO3 particles via layer-by-layer technique to further improve the stability and biocompatibility of the particles and to enable controlled release of multiple metal ions. The PEM coated microcapsules were successfully combined with collagen at the outmost layer, providing a further stimulating microenvironment for bone regeneration. The in vitro release studies showed remarkably stable release of Cu2+ in 2 months without initial burst release. Mg2+ was released in relatively low concentration in the first 7 days. Cell culture studies showed that CaCuMg-PEM-Col microcapsules stimulated cell proliferation, extracellular maturation and mineralization more effectively than blank control and other microcapsules without collagen adsorption (Ca-PEM, CaCu-PEM, CaMg-PEM, CaCuMg-PEM). In addition, the CaCuMg-PEM-Col microcapsules showed positive effects on osteogenesis and angiogenesis in gene expression studies. The results indicate that such a functional and controllable delivery system of multiple bioactive ions might be a safer, simpler and more efficient alternative of protein growth factor-based therapeutics for bone regeneration. It also provides an effective method for functionalizing bone grafts for bone tissue engineering.

3D printed scaffold for repairing bone defects in apical periodontitis

Objectives

To investigate the feasibility of the 3D printed scaffold for periapical bone defects.

Methods

In this study, antimicrobial peptide KSL-W-loaded PLGA sustainable-release microspheres (KSL-W@PLGA) were firstly prepared followed by assessing the drug release behavior and bacteriostatic ability against Enterococcus faecalis and Porphyromonas gingivalis. After that, we demonstrated that KSL-W@PLGA/collagen (COL)/silk fibroin (SF)/nano-hydroxyapatite (nHA) (COL/SF/nHA) scaffold via 3D-printing technique exhibited significantly good biocompatibility and osteoconductive property. The scaffold was characterized as to pore size, porosity, water absorption expansion rate and mechanical properties. Moreover, MC3T3-E1 cells were seeded into sterile scaffold materials and investigated by CCK-8, SEM and HE staining. In the animal experiment section, we constructed bone defect models of the mandible and evaluated its effect on bone formation. The Japanese white rabbits were killed at 1 and 2 months after surgery, the cone beam computerized tomography (CBCT) and micro-CT scanning, as well as HE and Masson staining analysis were performed on the samples of the operation area, respectively. Data analysis was done using ANOVA and LSD tests. (α = 0.05).

Results

We observed that the KSL-W@PLGA sustainable-release microspheres prepared in the experiment were uniform in morphology and could gradually release the antimicrobial peptide (KSL-W), which had a long-term antibacterial effect for at least up to 10 days. HE staining and SEM showed that the scaffold had good biocompatibility, which was conducive to the adhesion and proliferation of MC3T3-E1 cells. The porosity and water absorption of the scaffold were (81.96 ± 1.83)% and (458.29 ± 29.79)%, respectively. Histological and radiographic studies showed that the bone healing efficacy of the scaffold was satisfactory.

Conclusions

The KSL-W@PLGA/COL/SF/nHA scaffold possessed good biocompatibility and bone repairing ability, and had potential applications in repairing infected bone defects.

Clinical significance The 3D printed scaffold not only has an antibacterial effect, but can also promote bone tissue formation, which provides an alternative therapy option in apical periodontitis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02362-4.

A review on bioceramics scaffolds for bone defect in different types of animal models: HA and β -TCP

Increased life expectancy has led to an increase in the use of bone substitutes in numerous nations, with over two million bone-grafting surgeries performed worldwide each year. A bone defect can be caused by trauma, infections, and tissue resections which can self-heal due to the osteoconductive nature of the native extracellular matrix components. However, natural self-healing is time-consuming, and new bone regeneration is slow, especially for large bone defects. It also remains a clinical challenge for surgeons to have a suitable bone substitute. To date, there are numerous potential treatments for bone grafting, including gold-standard autografts, allograft implantation, xenografts, or bone graft substitutes. Tricalcium phosphate (TCP) and hydroxyapatite (HA) are the most extensively used and studied bone substitutes due to their similar chemical composition to bone. The scaffolds should be testedin vivoandin vitrousing suitable animal models to ensure that the biomaterials work effectively as implants. Hence, this article aims to familiarize readers with the most frequently used animal models for biomaterials testing and highlight the available literature for in vivo studies using small and large animal models. This review summarizes the bio ceramic materials, particularly HA and β-TCP scaffolds, for bone defects in small and large animal models. Besides, the design considerations for the pre-clinical animal model selection for bone defect implants are emphasized and presented.

Bioactive Interpenetrating Hydrogel Networks Based on 2-Hydroxyethyl Methacrylate and Gelatin Intertwined with Alginate and Dopped with Apatite as Scaffolding Biomaterials

Our goal was to create bioimitated scaffolding materials for biomedical purposes. The guiding idea was that we used an interpenetrating structural hierarchy of natural extracellular matrix as a “pattern” to design hydrogel scaffolds that show favorable properties for tissue regeneration. Polymeric hydrogel scaffolds are made in a simple, environmentally friendly way without additional functionalization. Gelatin and 2-hydroxyethyl methacrylate were selected to prepare interpenetrating polymeric networks and linear alginate chains were added as an interpenetrant to study their influence on the scaffold’s functionalities. Cryogelation and porogenation methods were used to obtain the designed scaffolding biomaterials. The scaffold’s structural, morphological, and mechanical properties, in vitro degradation, and cell viability properties were assessed to study the effects of the preparation method and alginate loading. Apatite as an inorganic agent was incorporated into cryogelated scaffolds to perform an extensive biological assay. Cryogelated scaffolds possess superior functionalities essential for tissue regeneration: fully hydrophilicity, degradability and mechanical features (2.08–9.75 MPa), and an optimal LDH activity. Furthermore, cryogelated scaffolds loaded with apatite showed good cell adhesion capacity, biocompatibility, and non-toxic behavior. All scaffolds performed equally in terms of metabolic activity and osteoconductivity. Cryogelated scaffolds with/without HAp could represent a new advance to promote osteoconductivity and enhance hard tissue repair. The obtained series of scaffolding biomaterials described here can provide a wide range of potential applications in the area of biomedical engineering.

Various Coated Barrier Membranes for Better Guided Bone Regeneration: A Review

A good barrier membrane is one of the important factors for effective guided bone/tissue regeneration (GBR/GTR) in the case of periodontal bone defects. Several methods are being discussed to overcome and improve the shortcomings of commercially available membranes. One of the methods is to coat the membrane with bioactive materials. In this study, 41 studies related to coated membranes for GBR/GTR published in the last 5 years were reviewed. These studies reported coating the membrane with various bioactive materials through different techniques to improve osteogenesis, antimicrobial properties, and physical/mechanical properties. The reported studies have been classified and discussed based on the purpose of coating. The goal of the most actively studied research on coating or surface modification of membranes is to improve new bone formation. For this purpose, calcium phosphate, bioactive glass, polydopamine, osteoinduced drugs, chitosan, platelet-rich fibrin, enamel matrix derivatives, amelotin, hyaluronic acid, tantalum, and copper were used as membrane coating materials. The paradigm of barrier membranes is changing from only inert (or biocompatible) physical barriers to bioactive osteo-immunomodulatory for effective guided bone and tissue regeneration. However, there is a limitation that there exists only a few clinical studies on humans to date. Efforts are needed to implement the use of coated membranes from the laboratory bench to the dental chair unit. Further clinical studies are needed in the patients’ group for long-term follow-up to confirm the effect of various coating materials.

Strontium Functionalized in Biomaterials for Bone Tissue Engineering: A Prominent Role in Osteoimmunomodulation

With the development of bone tissue engineering bio-scaffold materials by adding metallic ions to improve bone healing have been extensively explored in the past decades. Strontium a non-radioactive element, as an essential osteophilic trace element for the human body, has received widespread attention in the medical field due to its superior biological properties of inhibiting bone resorption and promoting osteogenesis. As the concept of osteoimmunology developed, the design of orthopedic biomaterials has gradually shifted from “immune-friendly” to “immunomodulatory” with the aim of promoting bone healing by modulating the immune microenvironment through implanted biomaterials. The process of bone healing can be regarded as an immune-induced procedure in which immune cells can target the effector cells such as macrophages, neutrophils, osteocytes, and osteoprogenitor cells through paracrine mechanisms, affecting pathological alveolar bone resorption and physiological bone regeneration. As a kind of crucial immune cell, macrophages play a critical role in the early period of wound repair and host defense after biomaterial implantation. Despite Sr-doped biomaterials being increasingly investigated, how extracellular Sr²⁺ guides the organism toward favorable osteogenesis by modulating macrophages in the bone tissue microenvironment has rarely been studied. This review focuses on recent knowledge that the trace element Sr regulates bone regeneration mechanisms through the regulation of macrophage polarization, which is significant for the future development of Sr-doped bone repair materials. We will also summarize the primary mechanism of Sr²⁺ in bone, including calcium-sensing receptor (CaSR) and osteogenesis-related signaling pathways.

A Review of Anodized TiNbSn Alloys for Improvement in Layer Quality and Application to Orthopedic Implants

Titanium alloys are useful for application in orthopedic implants. However, complications, such as prosthetic infections and aseptic loosening, often occur after orthopedic devices are implanted. Therefore, innovation in surface modification techniques is essential to develop orthopedic materials with optimal properties at the biomaterial–bone interface. In this review, we present recent research on the improvement in the osteoconductivity and antibacterial effect of the Ti-33.6% Nb-4% Sn (TiNbSn) alloy by anodic oxidation and other related studies. TiNbSn alloys are excellent new titanium alloys with a low Young’s modulus, high tensile strength, and with gradient functional properties such as a thermally adjustable Young’s modulus and strength. Titanium dioxide (TiO₂), when obtained by the anodic oxidation of a TiNbSn alloy, improves bone affinity and provides antibacterial performance owing to its photocatalytic activity. The safety of TiO₂ and its strong bonding with metal materials make its method of preparation a promising alternative to conventional methods for improving the surface quality of orthopedic implants. Implementing anodization technology for TiNbSn alloys may alleviate orthopedic surgery-related complications, such as loosening, stress shielding, and infection after arthroplasty.

Composite Coatings for Osteoblast Growth Attachment Fabricated by Matrix-Assisted Pulsed Laser Evaporation

The bioactive and biocompatible properties of hydroxyapatite (HAp) promote the osseointegration process. HAp is widely used in biomedical applications, especially in orthopedics, as well as a coating material for metallic implants. We obtained composite coatings based on HAp, chitosan (CS), and FGF2 by a matrix-assisted pulsed laser evaporation (MAPLE) technique. The coatings were physico-chemically investigated by means of X-ray Diffraction (XRD), Transmission Electron Microscopy (TEM), Infrared Microscopy (IRM), and Scanning Electron Microscopy (SEM). Further, biological investigations were performed. The MAPLE-composite coatings were tested in vitro on the MC3T3-E1 cell line in order to endorse cell attachment and growth without toxic effects and to promote pre-osteoblast differentiation towards the osteogenic lineage. These coatings can be considered suitable for bone tissue engineering applications that lack toxicity and promotes cell adhesion and proliferation while also sustaining the differentiation of pre-osteoblasts towards mature bone cells.

Zn-Mn-Doped Mesoporous Bioactive Glass Nanoparticle-Loaded Zein Coatings for Bioactive and Antibacterial Orthopedic Implants

In recent years, natural polymers have replaced synthetic polymers for antibacterial orthopedic applications owing to their excellent biocompatibility and biodegradability. Zein is a biopolymer found in corn. The lacking mechanical stability of zein is overcome by incorporating bioceramics, e.g., mesoporous bioactive glass nanoparticles (MBGNs). In the present study, pure zein and zein/Zn–Mn MBGN composite coatings were deposited via electrophoretic deposition (EPD) on 316L stainless steel (SS). Zn and Mn were co-doped in MBGNs in order to make use of their antibacterial and osteogenic potential, respectively. A Taguchi design of experiment (DoE) study was established to evaluate the effect of various working parameters on the morphology of the coatings. It was observed that coatings deposited at 20 V for 5 min with 4 g/L concentration (conc.) of Zn–Mn MBGNs showed the highest deposition yield. Uniform coatings with highly dispersed MBGNs were obtained adopting these optimized parameters. Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were employed to investigate the morphology and elemental composition of zein/Zn–Mn MBGN composite coatings. Surface properties, i.e., coating roughness and wettability analysis, concluded that composite coatings were appropriate for cell attachment and proliferation. For adhesion strength, various techniques, including a tape test, bend test, pencil hardness test, and tensile test, were performed. Wear and corrosion analysis highlighted the mechanical and chemical stability of the coatings. The colony forming unit (CFU) test showed that the zein/Zn–Mn MBGN composite coating was highly effective against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) due to the presence of Zn. The formation of a hydroxyapatite (HA)-like structure upon immersion in the simulated body fluid (SBF) validated the in vitro bioactivity of the coating. Moreover, a WST-8 assay depicted that the MG-63 cells proliferate on the composite coating. It was concluded that the zein/Zn–Mn MBGN coating synthesized in this work can be used for bioactive and antibacterial orthopedic applications.

Development of Injectable Calcium Sulfate and Self-Setting Calcium Phosphate Composite Bone Graft Materials for Minimally Invasive Surgery

The demand of bone grafting is increasing as the population ages worldwide. Although bone graft materials have been extensively developed over the decades, only a few injectable bone grafts are clinically available and none of them can be extruded from 18G needles. To overcome the existing treatment limitations, the aim of this study is to develop ideal injectable implants from biomaterials for minimally invasive surgery. An injectable composite bone graft containing calcium sulfate hemihydrate, tetracalcium phosphate, and anhydrous calcium hydrogen phosphate (CSH/CaP paste) was prepared with different CSH/CaP ratios and different concentrations of additives. The setting time, injectability, mechanical properties, and biocompatibility were evaluated. The developed injectable CSH/CaP paste (CSH/CaP 1:1 supplemented with 6% citric acid and 2% HPMC) presented good handling properties, great biocompatibility, and adequate mechanical strength. Furthermore, the paste was demonstrated to be extruded from a syringe equipped with 18G needles and exerted a great potential for minimally invasive surgery. The developed injectable implants with tissue repairing potentials will provide an ideal therapeutic strategy for minimally invasive surgery to apply in the treatment of maxillofacial defects, certain indications in the spine, inferior turbinate for empty nose syndrome (ENS), or reconstructive rhinoplasty.

Properties of poly(lactic acid)/walnut shell/hydroxyapatite composites prepared with fused deposition modeling

In this work, fused deposition modeling (FDM) technology was used to prepare poly(lactic acid)/walnut shell/hydroxyapatite (PLA/WS/HA) composite filaments. HA was treated with silane and characterized by Fourier transform infrared spectroscopy (FTIR). The composites were investigated by using simultaneous thermal analyzer, scanning electron microscopy (SEM) and a universal mechanical testing machine. The results showed that incorporating either HA or WS improved the thermal stability and water absorption of PLA, but lowered the tensile and compression strength. Fillers toughened the PLA matrix, resulting in higher tensile elongation and compressive strain. The tensile and compressive strengths of samples significantly dropped after water-immersion for 6 weeks. Finally, scaffolds were manufactured by using FDM. The compression modulus and structural feature of scaffolds indicated that the PLA/WS/HA composites have the potential to be applied in structural parts, such as bone implants.

Influence of Xenogeneic and Alloplastic Carriers for Bone Augmentation on Human Unrestricted Somatic Stem Cells

Alloplastic and xenogeneic bone grafting materials are frequently used for bone augmentation. The effect of these materials on precursor cells for bone augmentation is yet to be determined. The aim of this study was to ascertain, in vitro, how augmentation materials influence the growth rates and viability of human unrestricted somatic stem cells. The biocompatibility of two xenogeneic and one alloplastic bone graft was tested using human unrestricted somatic stem cells (USSCs). Proliferation, growth, survival and attachment of unrestricted somatic stem cells were monitored after 24 h, 48 h and 7 days. Furthermore, cell shape and morphology were evaluated by SEM. Scaffolds were assessed for their physical properties by Micro-CT imaging. USSCs showed distinct proliferation on the different carriers. Greatest proliferation was observed on the xenogeneic carriers along with improved viability of the cells. Pore sizes of the scaffolds varied significantly, with the xenogeneic materials providing greater pore sizes than the synthetic inorganic material. Unrestricted somatic stem cells in combination with a bovine collagenous bone block seem to be very compatible. A scaffold’s surface morphology, pore size and bioactive characteristics influence the proliferation, attachment and viability of USSCs.

Simultaneous Substitution of Fe and Sr in Beta-Tricalcium Phosphate: Synthesis, Structural, Magnetic, Degradation, and Cell Adhesion Properties

β-tricalcium phosphate is a promising bone graft substitute material with biocompatibility and high osteoinductivity. However, research on the ideal degradation and absorption for better clinical application remains a challenge. Now, we focus on modifying physicochemical properties and improving biological properties through essential ion co-substitution (Fe and Sr) in β-TCPs. Fe- and Sr-substituted and Fe/Sr co-substituted β-TCP were synthesized by aqueous co-precipitation with substitution levels ranging from 0.2 to 1.0 mol%. The β-TCP phase was detected by X-ray diffraction and Fourier transform infrared spectroscopy. Changes in Ca–O and P–O bond lengths of the co-substituted samples were observed through X-ray photoelectron spectroscopy. The results of VSM represent the M-H graph having a combination of diamagnetic and ferromagnetic properties. A TRIS–HCl solution immersion test showed that the degradation and resorption functions act synergistically on the surface of the co-substituted sample. Cell adhesion tests demonstrated that Fe enhances the initial adhesion and proliferation behavior of hDPSCs. The present work suggests that Fe and Sr co-substitution in β-TCP can be a candidate for promising bone graft materials in tissue engineering fields. In addition, the possibility of application of hyperthermia for cancer treatment can be expected.

Oxygen generating scaffolds regenerate critical size bone defects

Recent innovations in bone tissue engineering have introduced biomaterials that generate oxygen to substitute vasculature. This strategy provides the immediate oxygen required for tissue viability and graft maturation. Here we demonstrate a novel oxygen-generating tissue scaffold with predictable oxygen release kinetics and modular material properties. These hydrogel scaffolds were reinforced with microparticles comprised of emulsified calcium peroxide (CaO2) within polycaprolactone (PCL). The alterations of the assembled materials produced constructs within 5 ± 0.81 kPa to 34 ± 0.9 kPa in mechanical strength. The mass swelling ratios varied between 11% and 25%. Our in vitro and in vivo results revealed consistent tissue viability, metabolic activity, and osteogenic differentiation over two weeks. The optimized in vitro cell culture system remained stable at pH 8-9. The in vivo rodent models demonstrated that these scaffolds support a 70 mm3 bone volume that was comparable to the native bone and yielded over 90% regeneration in critical size cranial defects. Furthermore, the in vivo bone remodeling and vascularization results were validated by tartrate-resistant acid phosphatase (TRAP) and vascular endothelial growth factor (VEGF) staining. The promising results of this work are translatable to a repertoire of regenerative medicine applications including advancement and expansion of bone substitutes and disease models.

Strong and bioactive bioinspired biomaterials, next generation of bone adhesives

The bone adhesive is a clinical requirement for complicated bone fractures always articulated by surgeons. Applying glue is a quick and easy way to fix broken bones. Adhesives, unlike conventional fixation methods such as wires and sutures, improve healing conditions and reduce postoperative pain by creating a complete connection at the fractured joint. Despite many efforts in the field of bone adhesives, the creation of a successful adhesive with robust adhesion and appropriate bioactivity for the treatment of bone fractures is still in its infancy. Because of the resemblance of the body's humid environment to the underwater environment, in the latest decades, researchers have pursued inspiration from nature to develop strong bioactive adhesives for bone tissue. The aim of this review article is to discuss the recent state of the art in bone adhesives with a specific focus on biomimetic adhesives, their action mechanisms, and upcoming perspective. Firstly, the adhesive biomaterials with specific affinity to bone tissue are introduced and their rational design is studied. Consequently, various types of synthetic and natural bioadhesives for bone tissue are comprehensively overviewed. Then, bioinspired-adhesives are described, highlighting relevant structures and examples of biomimetic adhesives mainly made of DOPA and the complex coacervates inspired by proteins secreted in mussel and sandcastle worms, respectively. Finally, this article overviews the challenges of the current bioadhesives and the future research for the improvement of the properties of biomimetic adhesives for use as bone adhesives.

Mineralizing Coating on 3D Printed Scaffolds for the Promotion of Osseointegration

Design and fabrication of implants that can perform better than autologous bone grafts remain an unmet challenge for the hard tissue regeneration in craniomaxillofacial applications. Here, we report an integrated approach combining additive manufacturing with supramolecular chemistry to develop acellular mineralizing 3D printed scaffolds for hard tissue regeneration. Our approach relies on an elastin-like recombinamer (ELR) coating designed to trigger and guide the growth of ordered apatite on the surface of 3D printed nylon scaffolds. Three test samples including a) uncoated nylon scaffolds (referred to as "Uncoated"), b) ELR coated scaffolds (referred to as "ELR only"), and c) ELR coated and in vitro mineralized scaffolds (referred to as "Pre-mineralized") were prepared and tested for in vitro and in vivo performance. All test samples supported normal human immortalized mesenchymal stem cell adhesion, growth, and differentiation with enhanced cell proliferation observed in the "Pre-mineralized" samples. Using a rabbit calvarial in vivo model, 'Pre-mineralized' scaffolds also exhibited higher bone ingrowth into scaffold pores and cavities with higher tissue-implant integration. However, the coated scaffolds ("ELR only" and "Pre-mineralized") did not exhibit significantly more new bone formation compared to "Uncoated" scaffolds. Overall, the mineralizing coating offers an opportunity to enhance integration of 3D printed bone implants. However, there is a need to further decipher and tune their immunologic response to develop truly osteoinductive/conductive surfaces.

Osteoconductive Silk Fibroin Binders for Bone Repair in Alveolar Cleft Palate: Fabrication, Structure, Properties, and In Vitro Testing

Osteoconductive silk fibroin (SF) binders were fabricated for the bone repair of an alveolar cleft defect. Binders were prefigureared by mixing different ratios of a mixture of random coils and SF aggregation with SF fibrils: 100:0 (SFB100), 75:25 (SFB75), 50:50 (SFB50), 25:75 (SFB25), and 0:100 (SFB0). The gelation, molecular organization, structures, topography, and morphology of the binders were characterized and observed. Their physical, mechanical, and biological properties were tested. The SF binders showed gelation via self-assembly of SF aggregation and fibrillation. SFB75, SFB50, and SFB25 had molecular formation via the amide groups and showed more structural stability than SFB100. The morphology of SFB0 demonstrated the largest pore size. SFB0 showed a lowest hydrophilicity. SFB100 showed the highest SF release. SFB25 had the highest maximum load. SFB50 exhibited the lowest elongation at break. Binders with SF fibrils showed more cell viability and higher cell proliferation, ALP activity, calcium deposition, and protein synthesis than without SF fibrils. Finally, the results were deduced: SFB25 demonstrated suitable performance that is promising for the bone repair of an alveolar cleft defect.

Enhanced Piezocatalysis by Calcium Phosphate Nanowires via Gold Nanoparticle Conjugation

Piezocatalytic materials have considerable application potential in wireless therapy. Most of these applications require biocompatible nanomaterials for in vivo targeting and control of intracellular processes. However, the piezocatalytic performance of a material decreases at a nanometer size regime, and most of the biocompatible materials have poor piezocatalytic efficiency. In particular, hydroxyapatite or calcium phosphate-based nanomaterials have weak piezocatalytic properties that limit the biomedical application potential. Here, we show that anisotropic shape and Au nanoparticle conjugation can enhance the piezocatalytic property of a calcium phosphate nanomaterial by 10 times and the performance approaches that of the bulk/nanoparticle form of well-known BaTiO3. The colloidal form of calcium phosphate nanowires/nanorods/nanospheres (2-5 nm diameter and 30-1000 nm length) and their Au nanoparticle (5-8 nm) composites are prepared, and their piezoelectric properties have been investigated with piezoresponse force microscopy. It has been observed that the anisotropic nanowire structure of calcium phosphate can enhance the piezoelectric property by 2 times and Au nanoparticle conjugation can enhance it up to 10 times with a piezoelectric constant value of 72 pm/V, which is close to the value of the bulk/nanoparticle form of BaTiO3. This enhanced piezoelectric property is shown to enhance the piezocatalytic reactions by 10 times. The approach has been used to design colloidal nano-bioconjugate for selective labeling of cancer cells, followed by wireless cell therapy via medical-grade ultrasound-based intracellular reactive oxygen species generation. The developed approach and material can be extended for wireless therapeutic applications and for controlling intracellular processes.

Role of nanostructured materials in hard tissue engineering

The rise in the use of biomaterials in bone regeneration in the last decade has exponentially multiplied the number of publications, methods, and approaches to improve and optimize their functionalities and applications. In particular, biomimetic strategies based on the self-assembly of molecules to design, create and characterize nanostructured materials have played a very relevant role. We address this idea on four different but related points: self-setting bone cements based on calcium phosphate, as stable tissue support and regeneration induction; metallic prosthesis coatings for cell adhesion optimization and prevention of inflammatory response exacerbation; bio-adhesive hybrid materials as multiple drug delivery localized platforms and finally bio-inks. The effect of the physical, chemical, and biological properties of the newest biomedical devices on their bone tissue regenerative capacity are summarized, described, and analyzed in detail. The roles of experimental conditions, characterization methods and synthesis routes are emphasized. Finally, the future opportunities and challenges of nanostructured biomaterials with their advantages and shortcomings are proposed in order to forecast the future directions of this field of research.

Ceramic Nanofiber Materials for Wound Healing and Bone Regeneration: A Brief Review

Ceramic nanofibers have been shown to be a new horizon of research in the biomedical area, due to their differentiated morphology, nanoroughness, nanotopography, wettability, bioactivity, and chemical functionalization properties. Therefore, considering the impact caused by the use of these nanofibers, and the fact that there are still limited data available in the literature addressing the ceramic nanofiber application in regenerative medicine, this review article aims to gather the state-of-the-art research concerning these materials, for potential use as a biomaterial for wound healing and bone regeneration, and to analyze their characteristics when considering their application.

Dual-Scale Porosity Alumina Structures Using Ceramic/Camphene Suspensions Containing Polymer Microspheres

This study demonstrates the utility of thermo-regulated phase separable alumina/camphene suspensions containing poly(methyl methacrylate) (PMMA) microspheres as porogens for the production of multi-scale porosity structures. The homogeneous suspension prepared at 60 °C could undergo phase separation during freezing at room temperature. This process resulted in the 3D networks of camphene crystals and alumina walls containing PMMA microspheres. As a consequence, relatively large dendritic pores with several tens of microns size could be created as the replica of frozen camphene crystals. In addition, after the removal of PMMA microspheres via heat-treatment, micron-sized small spherical pores could be generated in alumina walls. As the PMMA content with respect to the alumina content increased from 0 vol% to 40 vol%, while the camphene content in the suspensions was kept constant (70 vol%), the overall porosity increased from 45.7 ± 0.5 vol% to 71.4 ± 0.5 vol%. This increase in porosity is attributed to an increase in the fraction of spherical pores in the alumina walls. Thus, compressive strength decreased from 153 ± 18.3 MPa to 33 ± 7.2 MPa. In addition, multi-scale porosity alumina objects with a honeycomb structure comprising periodic hexagonal macrochannels surrounded by dual-scale porosity walls were constructed using a 3D plotting technique.