Biodegradable polymer/hydroxyapatite composites: surface analysis and initial attachment of human osteoblasts

Calcium Orthophosphate (CaPO4) Containing Composites for Biomedical Applications: Formulations, Properties, and Applications

The goal of this review is to present a wide range of hybrid formulations and composites containing calcium orthophosphates (abbreviated as CaPO4) that are suitable for use in biomedical applications and currently on the market. The bioactive, biocompatible, and osteoconductive properties of various CaPO4-based formulations make them valuable in the rapidly developing field of biomedical research, both in vitro and in vivo. Due to the brittleness of CaPO4, it is essential to combine the desired osteologic properties of ceramic CaPO4 with those of other compounds to create novel, multifunctional bone graft biomaterials. Consequently, this analysis offers a thorough overview of the hybrid formulations and CaPO4-based composites that are currently known. To do this, a comprehensive search of the literature on the subject was carried out in all significant databases to extract pertinent papers. There have been many formulations found with different material compositions, production methods, structural and bioactive features, and in vitro and in vivo properties. When these formulations contain additional biofunctional ingredients, such as drugs, proteins, enzymes, or antibacterial agents, they offer improved biomedical applications. Moreover, a lot of these formulations allow cell loading and promote the development of smart formulations based on CaPO4. This evaluation also discusses basic problems and scientific difficulties that call for more investigation and advancements. It also indicates perspectives for the future.

Bone Tissue Engineering and Nanotechnology: A Promising Combination for Bone Regeneration

Large bone defects are the leading contributor to disability worldwide, affecting approximately 1.71 billion people. Conventional bone graft treatments show several disadvantages that negatively impact their therapeutic outcomes and limit their clinical practice. Therefore, much effort has been made to devise new and more effective approaches. In this context, bone tissue engineering (BTE), involving the use of biomaterials which are able to mimic the natural architecture of bone, has emerged as a key strategy for the regeneration of large defects. However, although different types of biomaterials for bone regeneration have been developed and investigated, to date, none of them has been able to completely fulfill the requirements of an ideal implantable material. In this context, in recent years, the field of nanotechnology and the application of nanomaterials to regenerative medicine have gained significant attention from researchers. Nanotechnology has revolutionized the BTE field due to the possibility of generating nanoengineered particles that are able to overcome the current limitations in regenerative strategies, including reduced cell proliferation and differentiation, the inadequate mechanical strength of biomaterials, and poor production of extrinsic factors which are necessary for efficient osteogenesis. In this review, we report on the latest in vitro and in vivo studies on the impact of nanotechnology in the field of BTE, focusing on the effects of nanoparticles on the properties of cells and the use of biomaterials for bone regeneration.

A biphasic calcium phosphate/acylated methacrylate gelatin composite hydrogel promotes osteogenesis and bone repair

PURPOSE/AIM

Bone defects caused by trauma, tumors, congenital malformation, or inflammation are very common in orthopedics. In recent years, mimicking the composition and structure of natural bone tissue has become a hot topic in biomaterial research, with the aim of developing an ideal biomaterial for bone defect transplantation. Here, the feasibility of a biphasic calcium phosphate (BCP)/acylated methacrylate gelatin (GelMA) composite hydrogel to repair bone defects was evaluated in vitro and in rats.

MATERIALS AND METHODS

The biocompatibility of a biphasic calcium phosphate (BCP)/acylated methacrylate gelatin (GelMA) composite hydrogel was evaluated by cytoskeleton staining, live/dead cell staining and cell proliferation assays. The in vitro osteogenic activities of the composite hydrogel were evaluated by alkaline phosphatase and alizarin red staining, as well as osteogenic gene expression analysis at both transcript and protein levels. The in vivo bone repair activities were evaluated using the rat skull defect model.

RESULTS

The BCP/GelMA composite hydrogel displayed excellent biocompatibility and promoted osteogenesis of bone marrow mesenchymal stem cells in vitro. In addition, the BCP/GelMA composite hydrogel markedly promoted new bone formation in the rat skull-defect model.

CONCLUSIONS

BCP/GelMA composite hydrogel may be an effective artificial material for bone tissue engineering.

Silica Aerogel-Polycaprolactone Scaffolds for Bone Tissue Engineering

Silica aerogel is a material composed of SiO₂ that has exceptional physical properties when utilized for tissue engineering applications. Poly-ε-caprolactone (PCL) is a biodegradable polyester that has been widely used for biomedical applications, namely as sutures, drug carriers, and implantable scaffolds. Herein, a hybrid composite of silica aerogel, prepared with two different silica precursors, tetraethoxysilane (TEOS) or methyltrimethoxysilane (MTMS), and PCL was synthesized to fulfil bone regeneration requirements. The developed porous hybrid biocomposite scaffolds were extensively characterized, regarding their physical, morphological, and mechanical features. The results showed that their properties were relevant, leading to composites with different properties. The water absorption capacity and mass loss were evaluated as well as the influence of the different hybrid scaffolds on osteoblasts' viability and morphology. Both hybrid scaffolds showed a hydrophobic character (with water contact angles higher than 90°), low swelling (maximum of 14%), and low mass loss (1-7%). hOB cells exposed to the different silica aerogel-PCL scaffolds remained highly viable, even for long periods of incubation (7 days). Considering the obtained results, the produced hybrid scaffolds may be good candidates for future application in bone tissue engineering.

Bioinspired Collagen/Gelatin Nanopillared Films as a Potential Implant Coating Material

Collagen-based Sharpey's fibers are naturally located between alveolar bone and tooth, and they have critical roles in a well-functioning tooth such as mechanical stability, facile differentiation, and disease protection. The success of Sharpey's fibers in these important roles is due to their unique location, vertical alignment with respect to tooth surface, as well as their micronanofiber architecture. Inspired by these structures, herein, we introduce the use of nanoporous anodic aluminum oxide molds in a drop-casting setup to fabricate biopolymeric films possessing arrays of uniform Collagen:Gelatin (Col:Gel) nanopillars. Obtained structures have diameters of ∼90 nm and heights of ∼300 nm, yielding significantly higher surface roughness values compared to their flat counterparts. More importantly, the nanostructures were parallel to each other but perpendicular to the underlying film surface imitating the natural collagenous structures of Sharpey's fibers regarding nanoscale morphology, geometrical orientation, as well as biochemical content. Viability testing showed that the nanopillared Col:Gel films have high cell viabilities (over 90%), and they display significantly improved attachment (ca. ∼ 2 times) and mineralization for Saos-2 cells when compared to flat Col:Gel films and Tissue Culture Polystyrene (TCPS) controls, plausibly due to their largely increased surface roughness and area. Hence, such Sharpey's fiber-inspired bioactive nanopillared Col:Gel films can be used as a dental implant coating material or tissue engineering platform with enhanced cellular and osteogenic properties.

A Beginner’s Guide to the Characterization of Hydrogel Microarchitecture for Cellular Applications

The extracellular matrix (ECM) is a three-dimensional, acellular scaffold of living tissues. Incorporating the ECM into cell culture models is a goal of cell biology studies and requires biocompatible materials that can mimic the ECM. Among such materials are hydrogels: polymeric networks that derive most of their mass from water. With the tuning of their properties, these polymer networks can resemble living tissues. The microarchitectural properties of hydrogels, such as porosity, pore size, fiber length, and surface topology can determine cell plasticity. The adequate characterization of these parameters requires reliable and reproducible methods. However, most methods were historically standardized using other biological specimens, such as 2D cell cultures, biopsies, or even animal models. Therefore, their translation comes with technical limitations when applied to hydrogel-based cell culture systems. In our current work, we have reviewed the most common techniques employed in the characterization of hydrogel microarchitectures. Our review provides a concise description of the underlying principles of each method and summarizes the collective data obtained from cell-free and cell-loaded hydrogels. The advantages and limitations of each technique are discussed, and comparisons are made. The information presented in our current work will be of interest to researchers who employ hydrogels as platforms for cell culture, 3D bioprinting, and other fields within hydrogel-based research.

Synthesis and Properties of Magnetic Fe3O4/PCL Porous Biocomposite Scaffolds with Different Sizes and Quantities of Fe3O4 Particles

In clinical practice, to treat diseases such as osteosarcoma or chondrosarcoma with broad surgical ostectomy, it would be ideal to have scaffolds that not only fill up the bone void but also possess the ability to regulate the subsequent regimes for targeted chemotherapy and/or bone regeneration. Magnetic targeting of therapeutic agents to specific sites in the body provides certain advantages such as minimal side-effects of anti-cancer drugs. The objective of this study was to characterize novel magnetic scaffolds that can be used as a central station to regulate the drug delivery of a magnetic nanoparticle system. Different sizes and quantities of Fe3O4 particles were mixed with poly-ε-caprolactone (PCL) to construct the magnetic scaffolds, and their mechanical properties, degradation performance, and cell biocompatibility were evaluated. It appeared that the presence of Fe3O4 particles influenced the magnetic, mechanical, and biological performances of the scaffolds. The prepared bio-nanocomposite scaffolds provided predominantly magnetic/superparamagnetic properties. Scaffolds with a micron-sized Fe3O4 to PCL weight (wt) ratio of 0.1:0.9 exhibited higher mechanical performances among samples, with Young’s modulus reaching 1 MPa and stiffness, 13 N/mm. Although an increased Fe3O4 particle proportion mildly influenced cell growth during the biocompatibility test, none of the Fe3O4/PCL scaffolds showed a cytotoxic effect.

Growth and Regeneration of Osteochondral Cells in Bioactive Niche: A Promising Approach for Osteochondral Tissue Repair

Functional repair of osteochondral defects caused due to osteoarthritis still remains the greatest challenge in orthopedic therapy. A prospective clinical strategy would be exploring osteochondral tissue engineering possibilities that promote simultaneous regeneration of the articular cartilage layer as well as the underlying subchondral bone. Incorporating the appropriate cues onto the scaffolds for the regeneration of the two contrasting tissues is therefore a demanding function. In the present study, a polymer-ceramic composite scaffolding material consisting of ternary bioactive glass (67.12 SiO₂/28.5 CaO/4.38 P₂O₅ mol %) incorporated into a semi interpenetrating polymer network of hydrophilic-hydrophobic polymer (poly(vinyl alcohol)-polycaprolactone) matrix is prepared and physicochemically characterized. In vitro bioactivity, bone-bonding ability, and biocompatibility evaluation were performed in comparison with the pristine scaffold. The degree of chondrogenic and osteogenic potential of mesenchymal stem cells in both the scaffolds was evaluated by gene expression studies. Although both the scaffolds favored the differentiation to both cell lineages in their respective medium, a higher expression of bone specific genes found with the composite scaffold suggested that this composite scaffold would serve better for osteal layer and henceforth to promote the integration of the osteochondral construct at the defect site.

In vitro biocompatiability and mechanical properties of bone adhesive tape composite based on poly(butyl fumarate)/poly(propylene fumarate)-diacrylate networks

Polyfumarate has been considered as injectable and biodegradable bone cement. However, its mechanical and degradation properties are particularly important. Therefore, the current study aimed to develop the properties by compositing poly (butyl fumarate)-based networks with hydroxyapatite nano-powders. In this regard, the poly (butyl fumarate) (PBF) matrix composite was compared with different components by evaluating their composition, mechanical properties, hydrophilicity, and biodegradability. Furthermore, their bioactivity in the phosphate-buffered saline (PBS) and, via applying mouse embryo osteoblast precursor cells (MC3T3-E1), their cell interaction, including adhesion, proliferation, and in vitro cytotoxicity assay, were assessed. The addition of hydroxyapatite improved the mechanical strength and modulus of PBF matrix composite. The composite reinforced with 3 wt% hydroxyapatite showed a higher lap-shear strength (1.68 MPa) and bonding strength (4.30 MPa), a maximum compression strength at fracture (95.18 MPa), modulus (925.29 MPa), and compression strength at yield (31.43 MPa), respectively. Also, hydrophilicity and in vitro degradation of the composite were enhanced in the presence of hydroxyapatite. In this condition, after a period of immersion (52 weeks) in PBS, the weight loss rate, and degradation rate of the composite increased. The composite proliferation, adhesion, and toxicity of MC3T3-E1 cells improved in comparison to the PBF matrix composite. Accordingly, controllable strength and degradation of the composite, along with its proven biocompatibility, make the composite a candidate for the treatment of comminuted fractures.

In vitro characterization of hierarchical 3D scaffolds produced by combining additive manufacturing and thermally induced phase separation

This paper reports on the hybrid process we have used for producing hierarchical scaffolds made of poly(lactic-co-glycolic) acid (PLGA) and nanohydroxyapatite (nHA), analyzes their internal structures via scanning electron microscopy, and presents the results of our in vitro proliferation of MC3T3-E1 cells and alkaline phosphatase activity (ALP) for 0 and 21 days. These scaffolds were produced by combining additive manufacturing (AM) and thermally induced phase separation (TIPS) techniques. Slow cooling at a rate of 1.5 °C/min during the TIPS process was used to enable a uniform temperature throughout the scaffolds, and therefore, a relatively uniform pore size range. We produced ten different scaffold compositions and topologies in this study. These scaffolds had macrochannels with diameters of ∼300 µm, ∼380 µm, and ∼460 µm, generated by the extraction of embedded porous 3D-plotted polyethylene glycol (PEG) matrices. The other experimental factors included different TIPS temperatures (-20 °C, -10 °C, and 0 °C), as well as varying PLGA concentrations (8%, 10%, and 12% w/v) and nHA content (0%, 10%, and 20% w/w). Our results indicated that almost all these macro/microporous scaffolds supported cell growth over the period of 21 days. Nevertheless, significant differences were observed among some scaffolds in terms of their support of cell proliferation and differentiation. This paper presents the results of our in vitro cell culture for 0 and 21 days. Our optimal scaffold with a porosity of ∼90%, a modulus of ∼5.2 MPa, and a nHA content of 20% showed a cell adhesion of ∼29% on day 0 and maintained cell proliferation and ALP activity over the 21-day in vitro culture. Hence, the use of additive manufacturing and designed experiments to optimize the scaffold fabrication parameters resulted in superior mechanical properties that most other studies using TIPS.

Strategies for Bone Regeneration: From Graft to Tissue Engineering

Bone is a regenerative organ characterized by self-renewal ability. Indeed, it is a very dynamic tissue subjected to continuous remodeling in order to preserve its structure and function. However, in clinical practice, impaired bone healing can be observed in patients and medical intervention is needed to regenerate the tissue via the use of natural bone grafts or synthetic bone grafts. The main elements required for tissue engineering include cells, growth factors and a scaffold material to support them. Three different materials (metals, ceramics, and polymers) can be used to create a scaffold suitable for bone regeneration. Several cell types have been investigated in combination with biomaterials. In this review, we describe the options available for bone regeneration, focusing on tissue engineering strategies based on the use of different biomaterials combined with cells and growth factors.

Effect of Different Polishing Systems on the Surface Roughness and Gloss of Novel Nanohybrid Resin Composites

Objectives  To evaluate the surface roughness and gloss of three nanohybrid resin composites after polishing with three different polishing systems.

Materials and Methods  A total number of 112 disc specimens (10 × 3 mm) were prepared from nanohybrid—Empress Direct (ID), Grandio (GR), Filtek Z350 (Z350) and a microhybrid resin composite restorative materials—Filtek Z250 (Z250). Following 24-hour storage in 37°C distilled water, each composite group ( n = 28) was assigned into four groups ( n = 7) according to finishing/polishing (F/P) system: Mylar strip, Optrapol, Politip, and Sof-Lex (SL). The surface roughness (Ra, mm) was measured by a novel three-dimensional method using an image analysis software attached to an environmental scanning electron microscope. A glossometer was used to measure the surface gloss.

Results Statistical analysis used was ANOVA test. Two-way Anova test revealed that the “type of composite” and “F/P techniques” had a significant effect on both surface roughness and gloss of the tested resin composite materials ( p < 0.05). Tukey’s post hoc test showed that ID, GR, and Z350 revealed lower surface roughness and higher surface gloss than Z250 within the same polishing system ( p < 0.05). Sof-Lex polishing discs produced the lowest surface roughness and highest surface gloss values compared with Optrapol and Politip ( p < 0.05).

Conclusion  The tested F/P systems provided comparable surface roughness and gloss for nanohybrid composites. The Sof-Lex system provided the best surface roughness and gloss for nanohybrid composites.

Alkali treatment facilitates functional nano-hydroxyapatite coating of 3D printed polylactic acid scaffolds

Autografting is currently the gold standard for treatment of bone defects, but has shown disadvantages in the limited volume of and donor site morbidity associated with harvested bone. Customized bone scaffolds that mimic the mechanical and biological properties of native bone are needed to augment the currently limited bone regeneration strategies. To achieve this goal, a repeated cross-hatch structure with uniform cubic pores was designed and 3D printed using polylactic acid (PLA) via fused deposition modeling (FDM). PLA surfaces were modified by wet chemical (alkali) treatment for either 1 h (1hAT) or 6 h (6hAT), followed by coating with nano-hydroxyapatite (nHA). Our hypotheses were that: (i) 6-hour (but not 1-hour) alkali treatment would enhance nHA coating, (ii) the nHA coating on the 6-hour alkali-treated surface would increase hydrophilicity and cell attachment/proliferation, and (iii) stiffness, but not effective Young's modulus, would be reduced by 6-hour alkali treatment. The effects of AT and nHA coating on scaffold morphology was observed by scanning electron microscopy and quantified using a custom MATLAB script. Chemical composition and hydrophilicity were evaluated via energy dispersive X-ray spectroscopy and Fourier transform infrared spectroscopy, and water contact angle analyses, respectively. Mechanical testing and in vitro cell culture were further employed to analyze compressive properties, and cell attachment and proliferation, respectively. As expected, 6hAT led to reduced strut width and stiffness, while improving the nHA coating and hydrophilicity. Interestingly, PLA/6hAT but not PLA/6hAT/nHA demonstrated a reduction in effective modulus compared to PLA and PLA/nHA scaffolds. From in vitro experiments, the combined PLA/6hAT/nHA modification resulted in the greatest extent of cell attachment but not proliferation. These results collectively demonstrate that the PLA/6hAT/nHA scaffold exhibits properties that may prove beneficial for cancellous bone regeneration.

Enhanced Bioactivity of Micropatterned Hydroxyapatite Embedded Poly(L-lactic) Acid for a Load-Bearing Implant

Poly(L-lactic) acid (PLLA) is among the most promising polymers for bone fixation, repair, and tissue engineering due to its biodegradability and relatively good mechanical strength. Despite these beneficial characteristics, its poor bioactivity often requires incorporation of bioactive ceramic materials. A bioresorbable composite made of PLLA and hydroxyapatite (HA) may improve biocompatibility but typically causes deterioration in mechanical properties, and bioactive coatings inevitably carry a risk of coating delamination. Therefore, in this study, we embedded micropatterned HA on the surface of PLLA to improve bioactivity while eliminating the risk of HA delamination. An HA pattern was successfully embedded in a PLLA matrix without degeneration of the matrix’s mechanical properties, thanks to a transfer technique involving conversion of Mg to HA. Furthermore, patterned HA/PLLA’s biological response outperformed that of pure PLLA. These results confirm patterned HA/PLLA as a candidate for wide acceptance in biodegradable load-bearing implant applications.

Induced Hydrophilicity and In Vitro Preliminary Osteoblast Response of Polyvinylidene Fluoride (PVDF) Coatings Obtained via MAPLE Deposition and Subsequent Thermal Treatment

Recent advancements in biomedicine have focused on designing novel and stable interfaces that can drive a specific cellular response toward the requirements of medical devices or implants. Among these, in recent years, electroactive polymers (i.e., polyvinylidene fluoride or PVDF) have caught the attention within the biomedical applications sector, due to their insolubility, stability in biological media, in vitro and in vivo non-toxicity, or even piezoelectric properties. However, the main disadvantage of PVDF-based bio-interfaces is related to the absence of the functional groups on the fluoropolymer and their hydrophobic character leading to a deficiency of cell adhesion and proliferation. This work was aimed at obtaining hydrophilic functional PVDF polymer coatings by using, for the first time, the one-step, matrix-assisted pulsed evaporation (MAPLE) method, testing the need of a post-deposition thermal treatment and analyzing their preliminary capacity to support MC3T3-E1 pre-osteoblast cell survival. As osteoblast cells are known to prefer rough surfaces, MAPLE deposition parameters were studied for obtaining coatings with roughness of tens to hundreds of nm, while maintaining the chemical properties similar to those of the pristine material. The in vitro studies indicated that all surfaces supported the survival of viable osteoblasts with active metabolisms, similar to the “control” sample, with no major differences regarding the thermally treated materials; this eliminates the need to use a secondary step for obtaining hydrophilic PVDF coatings. The physical-chemical characteristics of the thin films, along with the in vitro analyses, suggest that MAPLE is an adequate technique for fabricating PVDF thin films for further bio-applications.

Current and Future Concepts for the Treatment of Impaired Fracture Healing

Bone regeneration represents a complex process, of which basic biologic principles have been evolutionarily conserved over a broad range of different species. Bone represents one of few tissues that can heal without forming a fibrous scar and, as such, resembles a unique form of tissue regeneration. Despite a tremendous improvement in surgical techniques in the past decades, impaired bone regeneration including non-unions still affect a significant number of patients with fractures. As impaired bone regeneration is associated with high socio-economic implications, it is an essential clinical need to gain a full understanding of the pathophysiology and identify novel treatment approaches. This review focuses on the clinical implications of impaired bone regeneration, including currently available treatment options. Moreover, recent advances in the understanding of fracture healing are discussed, which have resulted in the identification and development of novel therapeutic approaches for affected patients.

Preparation and performance evaluation of electrospun poly(3-hydroxybutyrate) composite scaffolds as a potential hard tissue engineering application

In the present study, poly(3-hydroxybutyrate)-based composite scaffolds were prepared with multi-walled carbon nanotubes and hydroxyapatite nanoparticles for hard tissue engineering applications by electrospinning. All the prepared scaffolds showed connective porous structure, which were suitable for cell proliferation and migration. The mechanical properties of the poly(3-hydroxybutyrate) scaffold were improved by 0.5% of carbon nanotube addition, whereas the addition of hydroxyapatite nanoparticles up to 10% had an insignificant effect in tensile strength. However, scanning electron microscopy and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay results suggested that the mesenchymal stem cells attachment and their metabolic activities on the surface of the poly(3-hydroxybutyrate) scaffolds with hydroxyapatite were enhanced compared to poly(3-hydroxybutyrate) scaffolds. In addition, after 6 weeks of in vivo biocompatibility results in a model of rat indicated better tissue reactions for the scaffolds that contained hydroxyapatite. Overall, poly(3-hydroxybutyrate) composite scaffolds with 10% hydroxyapatite and 0.5% carbon nanotube showed optimal performances for the potential scaffold for hard tissue engineering application.

Spatially-offset Raman spectroscopy for monitoring mineralization of bone tissue engineering scaffolds: feasibility study based on phantom samples

Using phantom samples, we investigated the feasibility of spatially-offset Raman spectroscopy (SORS) as a tool for monitoring non-invasively the mineralization of bone tissue engineering scaffold in-vivo. The phantom samples consisted of 3D-printed scaffolds of poly-caprolactone (PCL) and hydroxyapatite (HA) blends, with varying concentrations of HA, to mimic the mineralisation process. The scaffolds were covered by a 4 mm layer of skin to simulate the real in-vivo measurement conditions. At a concentration of HA approximately 1/3 that of bone (~0.6 g/cm³), the characteristic Raman band of HA (960 cm^-1) was detectable when the PCL:HA layer was located at 4 mm depth within the scaffold (i.e. 8 mm below the skin surface). For the layers of the PCL:HA immediately under the skin (i.e. top of the scaffold), the detection limit of HA was 0.18 g/cm³, which is approximately one order of magnitude lower than that of bone. Similar results were also found for the phantoms simulating uniform and inward gradual mineralisation of the scaffold, indicating the suitability of SORS to detect early stages of mineralisation. Nevertheless, the results also show that the contribution of the materials surrounding the scaffold can be significant and methods for subtraction need to be investigated in the future. In conclusion, these results indicate that spatially-offset Raman spectroscopy is a promising technique for in-vivo longitudinal monitoring scaffold mineralization and bone re-growth.

Fabrication and Characterization of Scaffolds of Poly(ε-caprolactone)/Biosilicate® Biocomposites Prepared by Generative Manufacturing Process

Scaffolds of poly(ε-caprolactone) (PCL) and their biocomposites with 0, 1, 3, and 5 wt.% Biosilicate® were fabricated by the generative manufacturing process coupled with a vertical miniscrew extrusion head to application for restoration of bone tissue. Their morphological characterization indicated the designed 0°/90° architecture range of pore sizes and their interconnectivity is feasible for tissue engineering applications. Mechanical compression tests revealed an up to 57% increase in the stiffness of the scaffold structures with the addition of 1 to 5 wt.% Biosilicate® to the biocomposite. No toxicity was detected in the scaffolds tested by in vitro cell viability with MC3T3-E1 preosteoblast cell line. The results highlighted the potential application of scaffolds fabricated with poly(ε-caprolactone)/Biosilicate® to tissue engineering.

Guar-Based Injectable Thermoresponsive Hydrogel as a Scaffold for Bone Cell Growth and Controlled Drug Delivery

In this study, an injectable thermoresponsive hydroxypropyl guar-graft-poly(N-vinylcaprolactam) (HPG-g-PNVCL) copolymer was synthesized by graft polymerization. The reaction parameters such as temperature, time, monomer, and initiator concentrations were varied. In addition, the HPG-g-PNVCL copolymer was modified with nano-hydroxyapatite (n-HA) by in situ covalent cross-linking using divinyl sulfone (DVS) cross-linker to obtain HPG-g-PNVCL/n-HA/DVS composite material. Grafted copolymer and composite materials were characterized using Fourier transform infrared spectroscopy, thermogravimetric analysis, proton nuclear magnetic resonance spectroscopy (1H NMR), and differential scanning calorimetry. The morphology of the grafted copolymer (HPG-g-PNVCL) and the composite (HPG-g-PNVCL/n-HA/DVS) was examined using scanning electron microscopy (SEM), which showed interconnected porous honeycomb-like structures. Using Ultraviolet-visible spectroscopy, low critical solution temperature for HPG-g-PNVCL was observed at 34 °C, which is close to the rheology gel point at 33.5 °C. The thermoreversibility of HPG-g-PNVCL was proved by rheological analysis. The HPG-g-PNVCL hydrogel was employed for slow release of the drug molecule. Ciprofloxacin, a commonly known antibiotic, was used for sustainable release from the HPG-g-PNVCL hydrogel as a function of time at 37 °C because of viscous nature and thermogelation of the copolymer. In vitro cytotoxicity study reveals that the HPG-g-PNVCL thermogelling polymer works as a biocompatible scaffold for osteoblastic cell growth. Additionally, in vitro biomineralization study of HPG-g-PNVCL/n-HA/DVS was conducted using a simulated body fluid, and apatite-like structure formation was observed by SEM.

In Vitro Bone Cell Response to Tensile Mechanical Solicitations: Is There an Optimal Protocol?

Bone remodeling is strongly linked to external mechanical signals. Such stimuli are widely used in vitro for bone tissue engineering by applying mechanical solicitations to cell cultures so as to trigger specific cell responses. However, the literature highlights considerable variability in devices and protocols. Here the major biological, mechanical, and technical parameters implemented for in vitro tensile loading applications are reviewed. The objective is to identify which values are used most, and whether there is an optimal protocol to obtain a functional tissue-engineering construct. First, a shift that occurred from fundamental comprehension of bone formation, to its application in rebuilt tissues and clinical fields is shown. Despite the lack of standardized protocols, consensual conditions relevant for in vitro bone development, in particular cell differentiation, could be highlighted. Culture processes are guided by physiological considerations, although out-of-range conditions are sometimes used without implying negative results for the development of rebuilt tissue. Consensus can be found on several parameters, such as strain frequency (1 Hz) or the use of rest periods, but other points have not yet been fully established, especially synergies with other solicitations. It is believed that the present work will be useful to develop new tissue-engineering processes based on stretching.

Bone Regeneration Using Adipose-Derived Stem Cells in Injectable Thermo-Gelling Hydrogel Scaffold Containing Platelet-Rich Plasma and Biphasic Calcium Phosphate

For bone regeneration, a biocompatible thermo-gelling hydrogel, hyaluronic acid-g-chitosan-g-poly(N-isopropylacrylamide) (HA-CPN) was used as a three-dimensional organic gel matrix for entrapping rabbit adipose-derived stem cells (rASCs). Biphasic calcium phosphate (BCP) ceramic microparticles were embedded within the gel matrix as a mineralized bone matrix, which was further fortified with platelet-rich plasma (PRP) with osteo-inductive properties. In vitro culture of rASCs in HA-CPN and HA-CPN/PRP/BCP was compared for cell proliferation and osteogenic differentiation. Overall, HA-CPN/PRP/BCP was a better injectable cell carrier for osteogenesis of rASCs with increased cell proliferation rate and alkaline phosphatase activity, enhanced calcium deposition and mineralization of extracellular matrix, and up-regulated expression of genetic markers of osteogenesis. By implanting HA-CPN/PRP/BCP/rASCs constructs in rabbit critical size calvarial bone defects, new bone formation at the defect site was successfully demonstrated from computed tomography, and histological and immunohistochemical analysis. Taken together, by combining PRP and BCP as the osteo-inductive and osteo-conductive factor with HA-CPN, we successfully demonstrated the thermo-gelling composite hydrogel scaffold could promote the osteogenesis of rASCs for bone tissue engineering applications.

Engineering Citric Acid-Based Porous Scaffolds for Bone Regeneration

Tissue engineering aims to develop scaffolds that are biocompatible and mimic the mechanical and biological properties of the target tissue as closely as possible. Here, we describe the fabrication and characterization of a biodegradable, elastomeric porous scaffold: poly(1,8-octanediol-co-citric acid) (POC) incorporated with nanoscale hydroxyapatite (HA). While this chapter focuses on the scaffold's potential for bone regeneration, POC can also be used in other tissue engineering applications requiring an elastomeric implant. Because of the relative ease with which POC can be synthesized, its mechanical properties can be tailored to mimic the structure and function of the target elastomeric tissue for enhanced tissue regeneration.

Polymer-mineral scaffold augments in vivo equine multipotent stromal cell osteogenesis

Background

Use of bioscaffolds to direct osteogenic differentiation of adult multipotent stromal cells (MSCs) without exogenous proteins is a contemporary approach to bone regeneration. Identification of in vivo osteogenic contributions of exogenous MSCs on bioscaffolds after long-term implantation is vital to understanding cell persistence and effect duration.

Methods

This study was designed to quantify in vivo equine MSC osteogenesis on synthetic polymer scaffolds with distinct mineral combinations 9 weeks after implantation in a murine model. Cryopreserved, passage (P)1, equine bone marrow-derived MSCs (BMSC) and adipose tissue-derived MSCs (ASC) were culture expanded to P3 and immunophenotyped with flow cytometry. They were then loaded by spinner flask on to scaffolds composed of tricalcium phosphate (TCP)/hydroxyapatite (HA) (40:60; HT), polyethylene glycol (PEG)/poly-l-lactic acid (PLLA) (60:40; GA), or PEG/PLLA/TCP/HA (36:24:24:16; GT). Scaffolds with and without cells were maintained in static culture for up to 21 days or implanted subcutaneously in athymic mice that were radiographed every 3 weeks up to 9 weeks. In vitro cell viability and proliferation were determined. Explant composition (double-stranded (ds)DNA, collagen, sulfated glycosaminoglycan (sGAG), protein), equine and murine osteogenic target gene expression, microcomputed tomography (μCT) mineralization, and light microscopic structure were assessed.

Results

The ASC and BMSC number increased significantly in HT constructs between 7 and 21 days of culture, and BMSCs increased similarly in GT constructs. Radiographic opacity increased with time in GT-BMSC constructs. Extracellular matrix (ECM) components and dsDNA increased significantly in GT compared to HT constructs. Equine and murine osteogenic gene expression was highest in BMSC constructs with mineral-containing scaffolds. The HT constructs with either cell type had the highest mineral deposition based on μCT. Regardless of composition, scaffolds with cells had more ECM than those without, and osteoid was apparent in all BMSC constructs.

Conclusions

In this study, both exogenous and host MSCs appear to contribute to in vivo osteogenesis. Addition of mineral to polymer scaffolds enhances equine MSC osteogenesis over polymer alone, but pure mineral scaffold provides superior osteogenic support. These results emphasize the need for bioscaffolds that provide customized osteogenic direction of both exo- and endogenous MSCs for the best regenerative potential.

3D printing of hydroxyapatite polymer-based composites for bone tissue engineering

Skeletal defects reconstruction, using custom-made substitutes, represents a valid solution to replacing lost and damaged anatomical bone structures, renew their original function, and at the same time, restore the original aesthetic aspect. Rapid prototyping (RP) techniques allow the construction of complex physical models based on 3D clinical images. However, RP machines usually work with synthetic polymers; therefore, producing custom-made scaffolds using a biocompatible material directly by RP is an exciting challenge. The aim of the present work is to investigate the potentiality of 3D printing as a manufacturing method to produce an osteogenic hydroxyapatite-polylactic acid bone graft substitute.

Bone regeneration in minipigs by intrafibrillarly-mineralized collagen loaded with autologous periodontal ligament stem cells

Biomimetic intrafibrillarly-mineralized collagen (IMC) is a promising scaffold for bone regeneration because of its structural and functional similarity to natural bone. The objective of this study was to evaluate the bone regeneration potential of IMC loaded with autologous periodontal ligament stem cells (PDLSCs) in large bone defects in minipigs. A macroporous IMC with a bone-like subfibrillar nanostructure was fabricated using a biomimetic bottom-up approach. Non-healing full thickness defects were established on the cranial bone in minipigs, and IMC and hydroxyapatite (HA) scaffolds seeded with autologous PDLSCs were implanted into these defects. Computed tomographic imaging, histology staining, and atomic force microscopy were applied to evaluate to the quantity, micro/nano structures, and mechanical performance of the neo-bone after 12 weeks of implantation. Compared with HA, IMC showed superior regeneration properties characterized by the profuse deposition of new bony structures with a normal architecture and vascularization. Immunohistochemistry showed that the runt-related transcription factor 2 and transcription factor Osterix were highly expressed in the neo-bone formed by IMC. Furthermore, the nanostructure and nanomechanics of the neo-bone formed by IMC were similar to that of natural bone. This study provides strong evidence for the future clinical applications of the IMC-based bone grafts.

Bone healing capabilities of recombinant human bone morphogenetic protein-9 (rhBMP-9) with a chitosan or collagen carrier in rat calvarial defects

The aim of this study was to examine the effects of recombinant human BMP-9 (rhBMP-9) with chitosan sponge (ChiS) or absorbable collagen sponge (ACS) on bone formation in rat calvarial defects. The defects were treated by one of the following implantations: ChiS, rhBMP-9/ChiS, ACS, rhBMP-9/ACS and no implantation. The animals were euthanized at 8 weeks for histological evaluation. The percentage of defect closure (DC) in the rhBMP-9/ACS group was significantly greater than that in the ACS group. The rhBMP-9/ACS group demonstrated the highest level of DC among all the groups. The newly formed bone area (NBA) and NBA/total area in the ChiS-implanted groups and in the rhBMP-9/ACS group were significantly greater compared with those in the ACS group. It can be concluded that rhBMP-9/ACS has a potential to induce bone formation in rat calvarial defects. Further studies are required to elucidate the mechanism of bone formation induced by rhBMP-9.

Quantitative Kinetics Evaluation of Blocks Versus Granules of Biphasic Calcium Phosphate Scaffolds (HA/β-TCP 30/70) by Synchrotron Radiation X-ray Microtomography: A Human Study

INTRODUCTION

Successful bone regeneration using both granules and blocks of biphasic calcium phosphate materials has been reported in the recent literature, in some clinical applications for maxillary sinus elevation, but the long-term kinetics of bone regeneration has still not been fully investigated.

MATERIALS AND METHODS

Twenty-four bilateral sinus augmentation procedures were performed and grafted with hydroxyapatite/β-tricalcium phosphate 30/70, 12 with granules and 12 with blocks. The samples were retrieved at different time points and were evaluated for bone regeneration, graft resorption, neovascularization, and morphometric parameters by computed microtomography and histology.

RESULTS

A large amount of newly formed bone was detected in the retrieved specimens, together with a good rate of biomaterial resorption and the formation of a homogeneous and rich net of new vessels. The morphometric values were comparable at 5/6 months from grafting but, 9 months after grafting, revealed that the block-based specimens mimicked slightly better than granule-based samples the healthy native bone of the maxillary site.

CONCLUSION

The scaffold morphology was confirmed to influence the long-term kinetics of bone regeneration.

Competent processing techniques for scaffolds in tissue engineering

Engineering a functional tissue ex vivo requires a synchronized effort towards developing technologies for ECM mimicking scaffold and cultivating tissue-specific cells in an integrated and controlled manner. Cell-interactive scaffolds in three dimensions (3D), designed and processed appropriately with an apt biomaterial to yield optimal porosity and mechanical strength is the key in tissue engineering (TE). In order to accomplish these facets in a 3D scaffold, multiple techniques and processes have been explored by researchers all over the world. New techniques offering reasonable flexibility to use blends of different materials for integrated tissue-specific mechanical strength and biocompatibility have an edge over conventional methods. They may allow a combinatorial approach with a mix of materials while incorporating multiple processing techniques for successful creation of tissue-specific ECM mimics. In this review, we analyze the material requirement from different TE perspectives, while discussing pros and cons of advanced fabrication techniques for scale-up manufacturing.

Effect of hypoxia on the proliferation of porcine bone marrow-derived mesenchymal stem cells and adipose-derived mesenchymal stem cells in 2- and 3-dimensional culture

OBJECTIVE

Bone marrow-derived mesenchymal stem cells (MSCs) and adipose-derived mesenchymal stem cells (ASCs) currently represent a promising tool for the regeneration of large bony defects. Therefore, it is pivotal to find the best cell source within the body and the best conditions for in vitro cellular expansion. This study compared cellular response of MSCs and ASCs from a porcine animal in normoxic (21% O2) and hypoxic (2% O2) cell culture conditions via 2D and 3D experimental settings.

MATERIALS AND METHODS

The effect of constant exposure to hypoxia on primary pig stem cells was evaluated by two methods. First, a cumulative population doublings (cumPD) over a period of 40 days, a metabolic activity assay in both 2D and 3D beta-TCP-PHB scaffolds, followed by analysis of osteogenic differentiation potential in cell monolayers.

RESULTS

Our results displayed enhanced cell culture proliferation in 2% O2 for both MSCs and ASCs, with impaired osteogenic differentiation of MSCs. The impact of constant hypoxia on porcine MSCs and ASCs exhibited a statistically significant decrease in osteogenic differentiation under hypoxic conditions with the MSCs.

CONCLUSIONS

Our data suggest that MSCs and ASCs expanded in hypoxic culture conditions, might be more suitable for use in the clinical setting where large cell numbers are required. When differentiated in normoxic conditions, MSCs showed the highest osteogenic differentiation potential and might be the best choice of cells with consideration to bone repair.

Effect of enzymatic degradation of chitosan in polyhydroxybutyrate/chitosan/calcium phosphate composites on in vitro osteoblast response

Polyhydroxybutyrate/chitosan/calcium phosphate composites are interesting biomaterials for utilization in regenerative medicine and they may by applied in reconstruction of deeper subchondral defects. Insufficient informations were found in recent papers about the influence of lysozyme degradation of chitosan in calcium phosphate/chitosan based composites on in vitro cytotoxicity and proliferation activity of osteoblasts. The effect of enzymatic chitosan degradation on osteoblasts proliferation was studied on composite films in which the porosity of origin 3D scaffolds was eliminated and the surface texture was modified. The significantly enhanced proliferation activity with faster population growth of osteoblasts were found on enzymatically degraded biopolymer composite films with α-tricalcium phosphate and nanohydroxyapatite. No cytotoxicity of composite films prepared from lysozyme degraded scaffolds containing a large fraction of low molecular weight chitosans (LMWC), was revealed after 10 days of cultivation. Contrary to above in the higher cytotoxicity origin untreated nanohydroxyapatite films and porous composite scaffolds. The results showed that the synergistic effect of surface distribution, morphology of nanohydroxyapatite particles, microtopography and the presence of LMWC due to chitosan degradation in composite films were responsible for compensation of the cytotoxicity of nanohydroxyapatite composite films or porous composite scaffolds.

A porous medium-chain-length poly(3-hydroxyalkanoates)/hydroxyapatite composite as scaffold for bone tissue engineering

Polyhydroxyalkanoates (PHA) are hydrophobic biopolymers with huge potential for biomedical applications due to their biocompatibility, excellent mechanical properties and biodegradability. A porous composite scaffold made of medium-chain-length poly(3-hydroxyalkanoates) (mcl-PHA) and hydroxyapatite (HA) was fabricated using particulate leaching technique and NaCl as a porogen. Different percentages of HA loading was investigated that would support the growth of osteoblast cells. Ultrasonic irradiation was applied to facilitate the dispersion of HA particles into the mcl-PHA matrix. The different P(3HO-co-3HHX)/HA composites were investigated using field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and energy dispersive X-ray analysis (EDXA). The scaffolds were found to be highly porous with interconnecting pore structures and the HA particles were homogeneously dispersed in the polymer matrix. The scaffolds biocompatibility and osteoconductivity were also assessed following the proliferation and differentiation of osteoblast cells on the scaffolds. From the results, it is clear that scaffolds made from P(3HO-co-3HHX)/HA composites are viable candidate materials for bone tissue engineering applications.

Rheological evaluations and in vitro studies of injectable bioactive glass-polycaprolactone-sodium alginate composites

Composite pastes composed of various amounts of melt-derived bioactive glass 52S4 (MG5) and polycaprolactone (PCL) microspheres in sodium alginate solution were prepared. Rheological properties in both rotatory and oscillatory modes were evaluated. Injectability was measured as injection force versus piston displacement. In vitro calcium phosphate precipitation was also studied in simulated body fluid (SBF) and tracked using scanning electron microscopy, X-ray diffraction and FTIR analyses. All composite pastes were thixotropic in nature and exhibited shear thinning behavior. The magnitude of thixotropy decreased by adding 10-30 wt% PCL, while further amounts of PCL increased it again. Moreover, the composites were viscoelastic materials in which the elastic modulus was higher than viscous term. The pastes which were just made of MG5 or PCL had poor injectability, whereas the composites containing both of these constituents exhibited reasonable injectability. All pastes revealed adequate structural stability in contact with SBF solution. In vitro calcium phosphate precipitation was well observed on the paste made of MG5 and somewhat on the pastes with 10-40 wt% PCL, however the precipitated layer was amorphous in nature. Overall, the produced composites may be appropriate as injectable biomaterials for non-invasive surgeries but more biological evaluations are essential.

The fabrication of well-interconnected polycaprolactone/hydroxyapatite composite scaffolds, enhancing the exposure of hydroxyapatite using the wire-network molding technique

In this study, the fabrication method was proposed for the well-interconnected polycaprolactone/hydroxyapatite composite scaffold with exposed hydroxyapatite using modified WNM technique. To characterize well-interconnected scaffolds in terms of hydroxyapatite exposure, several assessments were performed as follows: morphology, mechanical property, wettability, calcium ion release, and cell response assessments. The results of these assessments were compared with those of control scaffolds which were fabricated by precision extruding deposition (PED) apparatus. The control PED scaffolds have interconnected pores with nonexposed hydroxyapatite. Consequently, cell attachment of proposed WNM scaffold was improved by increased hydrophilicity and surface roughness of scaffold surface resulting from the exposure of hydroxyapatite particles and fabrication process using powders. Moreover, cell proliferation and differentiation of WNM scaffold were increased, because the exposure of hydroxyapatite particles may enhance cell adhesion and calcium ion release. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2315-2325, 2017.

In vitro investigation of nanohydroxyapatite/poly(L-lactic acid) spindle composites used for bone tissue engineering

Calcium phosphate ceramics such as synthetic hydroxyapatite and tricalcium phosphate are widely used in the clinic, but they stimulate less bone regeneration. In this paper, nano-hydroxyapatite/poly(L-lactic acid) (nano-HA/PLLA) spindle composites with good mechanical performance were fabricated by a modified in situ precipitation method. The HA part of composite, distributing homogenously in PLLA matrix, is spindle shape with size of 10-30 nm in diameter and 60-100 nm in length. The molar ratio of Ca/P in the synthesized nano-HA spindles was deduced as 1.52 from the EDS spectra, which is close to the stoichiometric composition of HA (Ca/P & 1.67). The compress strength is up to 150 MPa when the HA content increase to 20 %. The in vitro tests indicate that HA/PLLA bio-composites have good biodegradability and bioactivity when immersed in simulated body fluid solutions. All the results suggested that HA/PLLA nano-biocomposites are appropriate to be applied as bone substitute in bone tissue engineering.

Uniformly-dispersed nanohydroxapatite-reinforced poly(ε-caprolactone) composite films for tendon tissue engineering application

Regeneration of injuries at tendon-to-bone interface (TBI) remains a challenging issue due to the complex tissue composition involving both soft tendon tissues and relatively hard bone tissues. Tissue engineering using polymeric/ceramic composites has been of great interest to generate scaffolds for tissue's healing at TBI. Herein, we presented a novel method to blend polymers and bioceramics for tendon tissue engineering application. A homogeneous composite comprising of nanohydroxyapatite (nHA) particles in poly(ε-caprolactone) (PCL) matrix was obtained using a combination of solvent and mechanical blending process. X-ray diffraction analysis showed that the as-fabricated PCL/nHA composite film retained phase-pure apatite and semi-crystalline properties of PCL. Infrared spectroscopy spectra confirmed that the PCL/nHA composite film exhibited the characteristics functional groups of PCL and nHA, without alteration to the chemical properties of the composite. The incorporation of nHA resulted in PCL/nHA composite film with improved mechanical properties such as Young's Modulus and ultimate tensile stress, which were comparable to that of the native human rotator tendon. Seeding with human tenocytes, cells attached on the PCL/nHA composite film, and after 14days of culturing, these cells could acquire elongated morphology without induced cytotoxicity. PCL/nHA composite film could also result in increased cell metabolism with prolonged culturing, which was comparable to that of the PCL group and higher than that of the nHA group. All these results demonstrated that the developed technique of combining solvent and mechanical blending could be applied to fabricate composite films with potential for tendon tissue engineering applications.