Adopting the principles of collagen biomineralization for intrafibrillar infiltration of yttria-stabilized zirconia into three-dimensional collagen scaffolds

Advances in zirconia-based dental materials: Properties, classification, applications, and future prospects

OBJECTIVES

Zirconia (ZrO2) ceramics are widely used in dental restorations due to their superior mechanical properties, durability, and ever-improving translucency. This review aims to explore the properties, classification, applications, and recent advancements of zirconia-based dental materials, highlighting their potential to revolutionize dental restoration techniques.

STUDY SELECTION, DATA AND SOURCES

The most recent literature available in scientific databases (PubMed and Web of Science) reporting advances of zirconia-based materials within the dental field is thoroughly examined and summarized, covering the major keywords "dental zirconia, classification, aesthetic, LTD, applications, manufacturing, surface treatments".

CONCLUSIONS

An exhaustive overview of the properties, classifications, and applications of dental zirconia was presented, alongside an exploration of future prospects and potential advances. This review highlighted the importance of addressing challenges such as low-temperature degradation resistance and optimizing the balance between mechanical strength and translucency. Also, innovative approaches to improve the performances of zirconia as dental material was discussed.

CLINICAL SIGNIFICANCE

This review provides a better understanding of zirconia-based dental biomaterials for dentists, helping them to make better choice when choosing a specific material to fabricate the restorations or to place the implant. Moreover, new generations of zirconia are still expected to make progress on key issues such as the long-term applications in dental materials while maintaining both damage resistance and aesthetic appeal, defining the directions for future research.

Zirconium ion mediated collagen nanofibrous hydrogels with high mechanical strength

Low mechanical strength is still the key question for collagen hydrogel consisting of nanofibrils as hard tissue repair scaffolds with no loss of biological function. In this work, novel collagen nanofibrous hydrogels with high mechanical strength were fabricated based on the pre-protection of trisodium citrate masked Zr(SO4)2 solution for collagen self-assembling nanofibrils and then further coordination with Zr(SO4)2 solution. The mature collagen nanofibrils with d-period were observed in Zr(IV) mediated collagen hydrogels by AFM when the Zr(IV) concentration was ≥ 10 mmol/L, and the distribution of zirconium element was uniform. Due to the coordination of Zr(IV) with ─COOH, ─NH2 and ─OH within collagen and the tighter entanglement of collagen nanofibrils, the elastic modulus and compressive strength of Zr(IV) mediated collagen nanofibrous hydrogel were 208.3 and 1103.0 kPa, which were approximate 77 and 12 times larger than those of pure collagen hydrogel, respectively. Moreover, the environmental stability such as thermostability, swelling ability and biodegradability got outstanding improvements and could be regulated by Zr(IV) concentration. Most importantly, the resultant hydrogel showed excellent biocompatibility and even accelerated cell proliferation.

Janus Membrane with Intrafibrillarly Strontium-Apatite-Mineralized Collagen for Guided Bone Regeneration

Commercial collagen membranes face difficulty in guided bone regeneration (GBR) due to the absence of hierarchical structural design, effective interface management, and diverse bioactivity. Herein, a Janus membrane called SrJM is developed that consists of a porous collagen face to enhance osteogenic function and a dense face to maintain barrier function. Specifically, biomimetic intrafibrillar mineralization of collagen with strontium apatite is realized by liquid precursors of amorphous strontium phosphate. Polycaprolactone methacryloyl is further integrated on one side of the collagen as a dense face, which endows SrJM with mechanical support and a prolonged lifespan. In vitro experiments demonstrate that the dense face of SrJM acts as a strong barrier against fibroblasts, while the porous face significantly promotes cell adhesion and osteogenic differentiation through activation of calcium-sensitive receptor/integrin/Wnt signaling pathways. Meanwhile, SrJM effectively enhances osteogenesis and angiogenesis by recruiting stem cells and modulating osteoimmune response, thus creating an ideal microenvironment for bone regeneration. In vivo studies verify that the bone defect region guided by SrJM is completely repaired by newly formed vascularized bone. Overall, the outstanding performance of SrJM supports its ongoing development as a multifunctional GBR membrane, and this study provides a versatile strategy of fabricating collagen-based biomaterials for hard tissue regeneration.

Coordination with zirconium: A facile approach to improve the mechanical properties and thermostability of gelatin hydrogel

The poor mechanical property and thermostability restricted applications of gelatin hydrogel. Herein, a facile and inexpensive approach of immerging cooling induced gelatin hydrogels into Zr(SO₄)₂ dilute solution was applied to overcome these shortages. After this treatment, the micropores in hydrogel decreased to tens of microns while the water content slightly decreased. XPS results revealed that the coordination bonds formed between amino or carboxyl groups of gelatins and Zr⁴⁺. After immerging in 0.06 M Zr⁴⁺ solution, mechanical tests showed that the elastic modulus, compressive modulus and compressive strength of hydrogel were about 400, 1192 and 476 kPa, respectively, which were approximate 100, 11 and 5 times larger than those of pure gelatin. The DSC data indicated that the thermoreversible temperature of triple helix structure in gelatin was improved from about 30 °C to 55 °C. More importantly, the rheological temperature sweep test revealed that hydrogels with 0.06 M Zr⁴⁺ treatment can maintain the hydrogel state without melting even at 80 °C. CCK-8 tests and Calcein-AM/PI double-stain experiments demonstrated Zr⁴⁺ coordination was non-cytotoxic. These promising data indicated this nontoxic method was efficient and had potential to fabricate gelatin related materials for further application.

Collagen mineralization with lepidocrocite via Fe(OH)2 addition

The mineralization of collagen in vitro has been extensively investigated for hydroxyapatite, silica, calcium carbonate and lepidocrocite (γ-FeOOH). Henceforth, it is interesting to investigate whether collagen also could serve as a generic mineralization template for other minerals, like magnetite. To this end, and inspired by the partial oxidation approach, first a ferrous hydroxide (Fe(OH)₂) intermediate is synthesized via the titration of base to a solution of Fe²⁺. Subsequently, the Fe(OH)₂ is mixed with collagen fibrils and poly(aspartic acid) is added to promote the formation of intrafibrillar crystals. Platelet-shaped lepidocrocite crystals being present throughout the entire thickness of the collagen fibrils can be realized, as was confirmed with electron tomography. The formation of lepidocrocite, which is an Fe³⁺ compound, is hypothesized to be induced via oxidation of the Fe²⁺ species and, therefore, the oxygen concentration during titration, TEM sample preparation and drying of TEM samples are investigated. Although the reaction is sensitive to small changes in experimental conditions, highly mineralized collagen fibers can be realized.

Intrafibrillar lepidocrocite platelets are shown to be present throughout the entire thickness of collagen fibrils using electron tomography.

Advances in biomineralization-inspired materials for hard tissue repair

Biomineralization is the process by which organisms form mineralized tissues with hierarchical structures and excellent properties, including the bones and teeth in vertebrates. The underlying mechanisms and pathways of biomineralization provide inspiration for designing and constructing materials to repair hard tissues. In particular, the formation processes of minerals can be partly replicated by utilizing bioinspired artificial materials to mimic the functions of biomolecules or stabilize intermediate mineral phases involved in biomineralization. Here, we review recent advances in biomineralization-inspired materials developed for hard tissue repair. Biomineralization-inspired materials are categorized into different types based on their specific applications, which include bone repair, dentin remineralization, and enamel remineralization. Finally, the advantages and limitations of these materials are summarized, and several perspectives on future directions are discussed.

The effects of washing a collagen sample prior to TEM examination

Transmission electron microscopy (TEM) is an important analysis technique to visualize (bio)macromolecules and their assemblies, including collagen fibers. Many protocols for TEM sample preparation of collagen involve one or more washing steps to remove excess salts from the dispersion that could hamper analysis when dried on a TEM grid. Such protocols are not standardized and washing times as well as washing solvents vary from procedure to procedure, with each research group typically having their own protocol. Here, we investigate the influence of washing with water, ethanol, but also methanol and 2‐propanol, for both mineralized and unmineralized collagen samples via a protocol based on centrifugation. Washing with water maintains the hydrated collagen structure and the characteristic banding pattern can be clearly observed. Conversely, washing with ethanol results in dehydration of the fibrils, often leading to aggregation of the fibers and a less obvious banding pattern, already within 1 min of ethanol exposure. As we show, this process is fully reversible. Similar observations were made for methanol and propanol. Based on these results, a standardized washing protocol for collagenous samples is proposed.

Time-Resolved Cryo-TEM Study on the Formation of Iron Hydroxides in a Collagen Matrix

The mineralization of collagen via synthetic procedures has been extensively investigated for hydroxyapatite as well as for silica and calcium carbonate. From a fundamental point of view, it is interesting to investigate whether collagen could serve as a generic mineralization template for other minerals, like iron oxides. Here, bio-inspired coprecipitation reaction, generally leading to the formation of magnetite, is used to mineralize collagen with iron hydroxides. Platelet-shaped green rust crystals form outside the collagen matrix, while inside the collagen, nanoparticles with a size of 2.6 nm are formed, which are hypothesized to be iron (III) hydroxide. Mineralization with nanoparticles inside the collagen solely occurs in the presence of poly(aspartic acid) (pAsp). In the absence of pAsp, magnetite particles are formed around the collagen. Time-resolved cryo-TEM shows that during the coprecipitation reaction, initially a beam-sensitive phase is formed, possibly an Fe³⁺–pAsp complex. This beam-sensitive phase transforms into nanoparticles. In a later stage, sheet-like crystals are also found. After 48 h of mineralization, ordering of the nanoparticles around one of the collagen sub-bands (the a-band) is observed. This is very similar to the collagen–hydroxyapatite system, indicating that mineralization with iron hydroxides inside collagen is possible and proceeds via a similar mechanism as hydroxyapatite mineralization.

Rapid collagen-directed mineralization of calcium fluoride nanocrystals with periodically patterned nanostructures

Collagen fibrils present periodic structures, which provide space for intrafibrillar growth of oriented hydroxyapatite nanocrystals in bone and contribute to the good mechanical properties of bone. However, there are not many reports focused on bioprocess-inspired synthesis of non-native inorganic materials inside collagen fibrils and detailed forming processes of crystals inside collagen fibrils remain poorly understood. Herein, the rapid intrafibrillar mineralization of calcium fluoride nanocrystals with a periodically patterned nanostructure is demonstrated. The negatively charged calcium fluoride precursor phase infiltrates collagen fibrils through the gap zones creating an intricate periodic mineralization pattern. Later, the nanocrystals initially filling the gap zones only expand gradually into the remaining space within the collagen fibrils. Mineralized tendons with organized calcium fluoride nanocrystals acquire mechanical properties (indentation elastic modulus ∼25.1 GPa and hardness ∼1.5 GPa) comparable or even superior to those of native human dentin and lamellar bone. Understanding the mineral growth processes in collagen may facilitate the development of tissue engineering and repairing.

Matrix stiffening by self-mineralizable guided bone regeneration

Collagen membranes produced in vitro with different degrees of intrafibrillar mineralization are potentially useful for guided bone regeneration (GBR). However, highly-mineralized collagen membranes are brittle and difficult for clinical manipulation. The present study aimed at developing an intrafibrillar self-mineralization strategy for GBR membrane by covalently conjugating high-molecular weight polyacrylic acid (HPAA) on Bio-Gide® membranes (BG). The properties of the self-mineralizable membranes (HBG) and their potential to induce bone regeneration were investigated. The HBG underwent the progressive intrafibrillar mineralization as well as the increase in stiffness after immersed in supersaturated calcium phosphate solution, osteogenic medium, or after being implanted into a murine calvarial bone defect. The HBG promoted in-situ bone regeneration via stimulating osteogenic differentiation of mesenchymal stromal cells (MSCs). Hippo signaling was inhibited when MSCs were cultured on the self-mineralized HBG, and in HBG-promoted MSC osteogenesis during in-situ bone regeneration. This resulted in translocation of the transcription co-activators Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) into the nucleus to induce transcription of genes promoting osteogenic differentiation of MSCs. Taken together, these findings indicated that HBG possessed the ability to self-mineralize in situ via intrafibrillar mineralization. The increase in stiffness of the extracellular matrix expedited in-situ bone regeneration by inactivating the Hippo-YAP/TAZ signaling cascade. STATEMENT OF SIGNIFICANCE: Guided bone regeneration (GBR) membranes made of naturally derived collagen have been widely used in the bone defect restoration. However, application of collagen GBR membranes run into the bottleneck with the challenges like insufficient stress strength, relatively poor dimensional stability and unsatisfactory osteoinductivity. This study develops a modified GBR membrane that can undergo progressive self-mineralization and matrix stiffening in situ. Increase in extracellular matrix stiffness provides the mechanical cues required for MSCs differentiation and expedites in-situ bone regeneration by inactivating the Hippo-YAP/TAZ signaling cascade.

In Vitro Mineralization of Collagen

Collagen mineralization is a biological process in many skeletal elements in the animal kingdom. Examples of these collagen-based skeletons are the siliceous spicules of glass sponges or the intrafibrillar hydroxyapatite platelets in vertebrates. The mineralization of collagen in vitro has gained interest for two reasons: understanding the processes behind bone formation and the synthesis of scaffolds for tissue engineering. In this paper, the efforts toward collagen mineralization in vitro are reviewed. First, general introduction toward collagen type I, the main component of the extracellular matrix in animals, is provided, followed by a brief overview of collagenous skeletons. Then, the in vitro mineralization of collagen is critically reviewed. Due to their biological abundance, hydroxyapatite and silica are the focus of this review. To a much lesser extent, also some efforts with other minerals are outlined. Combining all minerals and the suggested mechanisms for each mineral, a general mechanism for the intrafibrillar mineralization of collagen is proposed. This review concludes with an outlook for further improvement of collagen-based tissue engineering scaffolds.

Confinement controlled mineralization of calcium carbonate within collagen fibrils

The amorphous calcium carbonate infiltrates into collagen fibrils and transforms into a co-oriented crystalline phase under the function of confinement.