The effect of calcium phosphate ceramic composition and structure on in vitro behavior. II. Precipitation

Tricalcium phosphate-loaded injectable hydrogel as a promising osteogenic and bactericidal teicoplanin-delivery system for osteomyelitis treatment: An in vitro and in vivo investigation

Osteomyelitis is an inflammation of bone tissue usually caused by pyogenic bacteria. The most recurrent clinical approach consists of bone debridement followed by parenteral administration of antibiotics. However, systemic antibiotic treatment has limitations regarding absorption rate and bioavailability over time. The main challenge of osteomyelitis treatment consists of coupling the persistent infection treatment with the regeneration of the bone debrided. In this work, we developed an injectable drug delivery system based on poloxamer 407 hydrogel containing undoped Mg, Zn-doped tricalcium phosphate (β-TCP), and teicoplanin, a broad-spectrum antibiotic. We evaluated how the addition of teicoplanin and β-TCP affected the micellization, gelation, particle size, and surface charge of the hydrogel. Later, we studied the hydrogel degradation and drug delivery kinetics. Finally, the bactericidal, biocompatibility, and osteogenic properties were evaluated through in vitro studies and confirmed by in vivo Wistar rat models. Teicoplanin was found to be encapsulated in the corona portions of the hydrogel micelles, yielding a bigger hydrodynamics radius. The encapsulated teicoplanin showed a sustained release over the evaluated period, enough to trigger antibacterial properties against Gram-positive bacteria. Besides, the formulations were biocompatible and showed bone healing ability and osteogenic properties. Finally, in vivo studies confirmed that the proposed locally injected formulations yielded osteomyelitis treatment with superior outcomes than parenteral administration while promoting bone regeneration. In conclusion, the presented formulations are promising drug delivery systems for osteomyelitis treatment and deserve further technological improvements.

Mineral matrix deposition of MC3T3-E1 pre-osteoblastic cells exposed to silicocarnotite and nagelschmidtite bioceramics: In vitro comparison to hydroxyapatite

This work presents the effect of the silicocarnotite (SC) and nagelschmidtite (Nagel) phases on in vitro osteogenesis. The known hydroxyapatite of biological origin (BHAp) was used as a standard of osteoconductive characteristics. The evaluation was carried out in conventional and osteogenic media for comparative purposes to assess the osteogenic ability of the bioceramics. First, the effect of the material on cell viability at 24 h, 7 and 14 days of incubation was evaluated. In addition, cell morphology and attachment on dense bioceramic surfaces were observed by fluorescence microscopy. Specifically, alkaline phosphatase (ALP) activity was evaluated as an osteogenic marker of the early stages of bone cell differentiation. Mineralized extracellular matrix was observed by calcium phosphate deposits and extracellular vesicle formation. Furthermore, cell phenotype determination was confirmed by scanning electron microscope. The results provided relevant information on the cell attachment, proliferation, and osteogenic differentiation processes after 7 and 14 days of incubation. Finally, it was demonstrated that SC and Nagel phases promote cell proliferation and differentiation, while the Nagel phase exhibited a superior osteoconductive behavior and could promote MC3T3-E1 cell differentiation to a higher extent than SC and BHAp, which was reflected in a higher number of deposits in a shorter period for both conventional and osteogenic media.

High Boron Content Enhances Bioactive Glass Biodegradation

Derived Hench bioactive glass (BaG) containing boron (B) is explored in this work as it plays an important role in bone development and regeneration. B was also found to enhance BaG dissociation. However, it is only possible to incorporate a limited amount of B. To increase the amount of B in BaG, bioactive borosilicate glasses (BaG-B_x) were fabricated based on the use of the solution-gelation process (sol-gel). In this work, a high B content (20 wt.%) in BaG, respecting the conditions of bioactivity and biodegradability required by Hench, was achieved for the first time. The capability of BaG-B_x to form an apatite phase was assessed in vitro by immersion in simulated body fluid (SBF). Then, the chemical structure and the morphological changes in the fabricated BaG-B_x (x = 0, 5, 10 and 20) were studied. The formation of hydroxyapatite (HAp) layer was observed with X-ray diffraction (XRD) and infrared (IR) spectroscopy. The presence of HAp layer was confirmed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Enhanced bioactivity and chemical stability of BaG-B_x were evaluated with an ion exchange study based on Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) and energy dispersive spectroscopy (EDS). Results indicate that by increasing the concentration of B in BaG-Bx, the crystallization rate and the quality of the newly formed HAp layer on BaG-B_x surfaces can be improved. The presence of B also leads to enhanced degradation of BaGs in SBF. Accordingly, BAG-B_x can be used for bone regeneration, especially in children, because of its faster degradation as compared to B-free glass.

Properties of Coatings Based on Calcium Phosphate and Their Effect on Cytocompatibility and Bioactivity of Titanium Nickelide

Coatings based on calcium phosphate with thicknesses of 0.5 and 2 μm were obtained by high-frequency magnetron sputtering on NiTi substrates in an argon atmosphere. The coating was characterized using X-ray diffraction, scanning electron microscopy, atomic force microscopy, and in vitro cytocompatibility and bioactivity studies. A biphasic coating of tricalcium phosphate (Ca₃(PO₄)₂) and hydroxyapatite (Ca₁₀(PO₄)₆(OH)₂) with a 100% degree of crystallinity was formed on the surface. The layer enriched in calcium, phosphorus, and oxygen was observed using scanning electron microscopy and energy-dispersive X-ray spectroscopy. Scanning electron microscopy showed that the surface structure is homogeneous without visible defects. The 2 µm thick coating obtained by sputtering with a deposition time of 4 h and a deposition rate of 0.43 µm/h is uniform, contains the highest amount of the calcium phosphate phase, and is most suitable for the faster growth of cells and accelerated formation of apatite layers. Samples with calcium phosphate coatings do not cause hemolysis and have a low cytotoxicity index. The results of immersion in a solution simulating body fluid show that NiTi with the biphasic coating promotes apatite growth, which is beneficial for biological activity.

The Impact of Hydroxyapatite Sintering Temperature on Its Microstructural, Mechanical, and Biological Properties

Hydroxyapatite (HA), the principal mineral of bone tissue, can be fabricated as an artificial calcium phosphate (CaP) ceramic and potentially used as bioceramic material for bone defect treatment. Nevertheless, the production method (including the applied sintering temperature) of synthetic hydroxyapatite directly affects its basic properties, such as its microstructure, mechanical parameters, bioabsorbability, and osteoconductivity, and in turn influences its biomedical potential as an implantable biomaterial. The wide application of HA in regenerative medicine makes it necessary to explain the validity of the selection of the sintering temperature. The main emphasis of this article is on the description and summarization of the key features of HA depending on the applied sintering temperature during the synthesis process. The review is mainly focused on the dependence between the HA sintering temperature and its microstructural features, mechanical properties, biodegradability/bioabsorbability, bioactivity, and biocompatibility.

Evolution of dynamics of physico-chemical and mechanical properties of hydroxyapatite with fluorine addition and degradation stability of new matrices

This multidisciplinary study examined sensitively the change in the dynamics of main mechanical performance, stability of crystal structure, crystallinity quality, strength, corrosion resistance, biocompatibility, resistance to structural degradation/separations and mechanical durability features of hydroxyapatite (HAp) biomedical materials based on the fluorine addition and degradation process to guide future medical and dental treatment studies. In the study, the fluorine ions were used to be the dental coating, filling and supporting material for biologically or synthetically produced bone minerals. The general characteristic properties were investigated by means of standard spectroscopic, structural and mechanical analysis methods including RAMAN, SEM-EDS, TEM, Vickers micro-indentation hardness and density measurements. A time dependent release test was performed to evaluate possible fluorine ion release after the degradation process. It was found that the fundamental characteristic properties of HAp biomedical materials are noted to improve with the increase in the fluoride level up to 2% due much more stabilization of HAp crystal system. The combination of RAMAN spectra and powder XRD analyzes indicates that 2% addition level affects positively the formation velocity of characteristic HAP phase. Besides, fluorine doped HAp materials all exhibited the main characteristic peaks after degradation process. This is attributed to the fact that the fluorine ions enabled the hydroxyapatite to enhance the structural quality and stability towards the corrosion environment. However, in case of excess dopant level of 3% the degradation rates were obtained to increase due to higher contribution rate and especially electrostatic interactions. As for the surface morphology examinations, 2% fluorine added HAp with the highest density of 3.0879 g/cm³ was determined to present the superior crystallinity quality (smallest grain size, best smooth surface, honeycomb pattern, regular shaped particles and densest particle distributions through the specimen surface). Conversely, the excess fluorine triggered to increase seriously degree of micro/macro porosity in the surface morphology and microscopic structural problems in the crystal system. Thus, the HAp doped with 3% was the most affected material from the degradation process. Additionally, the fluorine ion values read after the release process were quite far from the value that could cause toxic effects. Lastly, the optimum fluorine addition provides the positive effects on the highest durability, stiffness and mechanical fracture strength properties as a consequence of differentiation in the surface residual compressive stress regions (lattice strain fields), amplification sites and active operable slip systems in the matrix. Hence, the crack propagations prefer to proceed in the transcrystalline regions rather than the intergranular parts. Similarly, it was found that Vickers micro-indentation hardness tests showed that the microhardness parameters increased after the degradation process. All in all, the fluorine addition level of 2% was noted to be good choice to improve the fundamental characteristic properties of hydroxyapatite biomedical materials for heavy-duty musculoskeletal, orthopedic implant, biological and therapeutic applications in medicine and dentistry application fields.

Formulation and Characterization of a New Injectable Bone Substitute Composed PVA/Borax/CaCO3 and Demineralized Bone Matrix

The occurrence of bone-related disorders and diseases has dramatically increased in recent years around the world. Demineralized bone matrix (DBM) has been widely used as a bone implant due to its osteoinduction and bioactivity. However, the use of DBM is limited because it is a particulate material, which makes it difficult to manipulate and implant with precision. In addition, these particles are susceptible to migration to other sites. To address this situation, DBM is commonly incorporated into a variety of carriers. An injectable scaffold has advantages over bone grafts or preformed scaffolds, such as the ability to flow and fill a bone defect. The aim of this research was to develop a DBM carrier with such viscoelastic properties in order to obtain an injectable bone substitute (IBS). The developed DBM carrier consisted of a PVA/glycerol network cross-linked with borax and reinforced with CaCO3 as a pH neutralizer, porosity generator, and source of Ca. The physicochemical properties were determined by an injectability test, FTIR, SEM, and TGA. Porosity, degradation, bioactivity, possible cytotoxic effect, and proliferation in osteoblasts were also determined. The results showed that the developed material has great potential to be used in bone tissue regeneration.

eIF2α-ATF4 Pathway Activated by a Change in the Calcium Environment Participates in BCP-Mediated Bone Regeneration

Biphasic calcium phosphate (BCP) ceramic is a classic bone void filler and a common basis of new materials for bone defect repair. However, the specific mechanism of BCP in osteogenesis has not been fully elucidated. Endoplasmic reticulum stress (ERs) and the subsequent PERK-eIF2α-ATF4 pathway can be activated by various factors, including trauma and intracellular calcium changes, and therefore worth exploring as a potential mechanism in BCP-mediated bone repair. Herein, a rat lateral femoral epicondyle defect model in vivo and a simulated BCP-mediated calcium environment in vitro were constructed for the analysis of BCP-related osteogenesis and the activation of ERs and the eIF2α-ATF4 pathway. An inhibitor of eIF2α dephosphorylation (salubrinal) was also used to explore the effect of the eIF2α-ATF4 pathway on BCP-mediated bone regeneration. The results showed that the ERs and eIF2α-ATF4 pathway activation were observed during 4 weeks of bone repair, with a rapid but brief increase immediately after artificial defect surgery and a re-increase after 4 weeks with the resorption of BCP materials. Mild ERs and the activated eIF2α induced by the calcium changes mediated by BCP regulated the expression of osteogenic-related proteins and had an important role during the defect repair. In conclusion, the eIF2α-ATF4 pathway activated by a change in the calcium environment participates in BCP-mediated bone regeneration. eIF2α-ATF4 and ERs could provide new directions for further studies on new materials in bone tissue engineering.

Self-healing capacity of fiber-reinforced calcium phosphate cements

A major problem concerning the mechanical properties of calcium phosphate cements (CPC) is related to their inherent brittleness, which limits their applicability to non-load bearing bone defects. In this work the preparation of a damage tolerant CPC is presented, where the incorporation of functionalized carbon fibers facilitates steady state flat crack propagation with crack openings below 10 µm. A subsequent self-healing process in simulated body fluid, that mimics the in vivo mineralization of bioactive surfaces, closes the cracks and completely restores the mechanical properties. Hereby, two pathways of self-healing are presented: i) intrinsic healing that bases on the inherent bioactive properties of the cement matrix and chemically treated fibers, and ii) capsule based extrinsic healing, where H₂PO₄^- is released as an initiator for the apatite formation. Such damage tolerant CPCs with self-healing capacity are of particular interest to increase the lifetime of implants as well as in the field of load-bearing bioceramics.

A study on biosafety of HAP ceramic prepared by SLA-3D printing technology directly

Hydroxyapatite powder was mixed into photosensitive resin to form complex shape scaffold using SLA-3D printing technology, and then the final entity was obtained successively by debinding and sintering. It is crucial to confirm whether the prepared hydroxyapatite scaffold have the toxic effects after our designed printing, debinding, and sintering processes because the photosensitive resin in the starting printing paste is poisonous to cells. To investigate these issues in details, thermogravimetric analysis (TG), differential scanning calorimetry (DSC), in vitro cytotoxicity test, and implantation pre-experiment in the rabbit parietal were performed, aiming to develop the SLA-3D prepared hydroxyapatite scaffold. Through thermal analysis, it was proved that photosensitive resin would be completely pyrolyzed at temperature ranging from 350 °C to 580 °C, corresponding to a secondary chemical reaction mechanism. Combined with cytotoxicity test results, it is unquestionable that the toxic substances would be totally decomposed after debinding process and a good biocompatible HAP samples could be obtained. The finally prepared HAP samples with micro-holes showed good biosafety in pre-experiment of the rabbit parietal implantation.

Tissue engineered bone mimetics to study bone disorders ex vivo: Role of bioinspired materials

Recent advances in materials development and tissue engineering has resulted in a substantial number of bioinspired materials that recapitulate cardinal features of bone extracellular matrix (ECM) such as dynamic inorganic and organic environment(s), hierarchical organization, and topographical features. Bone mimicking materials, as defined by its self-explanatory term, are developed based on the current understandings of the natural bone ECM during development, remodeling, and fracture repair. Compared to conventional plastic cultures, biomaterials that resemble some aspects of the native environment could elicit a more natural molecular and cellular response relevant to the bone tissue. Although current bioinspired materials are mainly developed to assist tissue repair or engineer bone tissues, such materials could nevertheless be applied to model various skeletal diseases in vitro. This review summarizes the use of bioinspired materials for bone tissue engineering, and their potential to model diseases of bone development and remodeling ex vivo. We largely focus on biomaterials, designed to re-create different aspects of the chemical and physical cues of native bone ECM. Employing these bone-inspired materials and tissue engineered bone surrogates to study bone diseases has tremendous potential and will provide a closer portrayal of disease progression and maintenance, both at the cellular and tissue level. We also briefly touch upon the application of patient-derived stem cells and introduce emerging technologies such as organ-on-chip in disease modeling. Faithful recapitulation of disease pathologies will not only offer novel insights into diseases, but also lead to enabling technologies for drug discovery and new approaches for cell-based therapies.

The 3D Printing of Calcium Phosphate with K-Carrageenan under Conditions Permitting the Incorporation of Biological Components-A Method

Critical-size bone defects are a common clinical problem. The golden standard to treat these defects is autologous bone grafting. Besides the limitations of availability and co-morbidity, autografts have to be manually adapted to fit in the defect, which might result in a sub-optimal fit and impaired healing. Scaffolds with precise dimensions can be created using 3-dimensional (3D) printing, enabling the production of patient-specific, 'tailor-made' bone substitutes with an exact fit. Calcium phosphate (CaP) is a popular material for bone tissue engineering due to its biocompatibility, osteoconductivity, and biodegradable properties. To enhance bone formation, a bioactive 3D-printed CaP scaffold can be created by combining the printed CaP scaffold with biological components such as growth factors and cytokines, e.g., vascular endothelial growth factor (VEGF), bone morphogenetic protein-2 (BMP-2), and interleukin-6 (IL-6). However, the 3D-printing of CaP with a biological component is challenging since production techniques often use high temperatures or aggressive chemicals, which hinders/inactivates the bioactivity of the incorporated biological components. Therefore, in our laboratory, we routinely perform extrusion-based 3D-printing with a biological binder at room temperature to create porous scaffolds for bone healing. In this method paper, we describe in detail a 3D-printing procedure for CaP paste with K-carrageenan as a biological binder.

Cleaning effect of osteoconductive powder abrasive treatment on explanted human implants and biofilm-coated titanium discs

The aim of this study is to test the cleaning effect and surface modification of a new implant surface treatment on explanted dental implants and titanium discs. It is a modified air powder abrasive (APA) treatment applied using osteoconductive powders. Twenty-eight in vitro Ca-precipitated organic film-coated titanium discs and 13 explanted dental implants were treated. In a 2-step approach, 3 powders were used: hydroxylapatite (HA) and biomimetic calcium phosphate (BioCaP), which are osteoconductive, and erythritol, which is not. APA treatment was applied. (Air pressure: 2.4 bar; water flow for cleaning: 41.5 ml/min, for Coating 1: 2.1 ml/min, and for Coating 2: 15.2 ml/min.) The test groups were as follows: Group 1: HA cleaning + BioCaP Coating 1; Group 2: HA cleaning + BioCaP Coating 2; Group 3: erythritol cleaning + BioCaP Coating 1; Group 4: erythritol cleaning + BioCaP Coating 2; Group 5: HA cleaning; Group 6: erythritol cleaning; and control: no powder. Cleaned areas were calculated by point counting method. Surface changes and chemical content were evaluated using light microscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Cleaning effect between groups was compared by a pairwise Student's t test. The significance level was fixed at p < .05. Cleaning effect on the discs was 100% in all test groups and 5% in the control. Powder particles in varying size and shape were embedded on the surface. All HA- or CaP-treated surfaces showed Ca and P content but no surface damage. Calcified biofilm remnants were removed from the implant surface by the test groups, whereas in control groups, they remained. APA treatment with CaP and HA powders under clinically applicable pressure settings gives positive results in vitro; therefore, they could be promising when used in vivo.

Recent Trends in Hydroxyapatite (HA) Synthesis and the Synthesis Report of Nanostructure HA by Hydrothermal Reaction

This research summary the trend in synthesis of Hydroxyapatite (HA) using different route such as dry method and wet method (co-precipitation method; emulsion method, hydrolysis method, sol-gel method, hydrothermal method). In addition, the research group also report the technique to synthesis nano-structure HA by hydrothermal reaction using Ca(OH)₂ and H₃PO₄ with the Ca/P molar ratio of 1.67. The mixture after homogenized for 2 h, follow by hydrothermal reaction at different hydrothermal temperature time (100 °C, 150 °C, and 180 °C) and different hydrothermal reaction time (0 h, 12 h and 24 h). The 180 °C-hydrothermal treated-HA has needle-like shape with the diameter of 10 ~ 20 nm and length of below 100 nm, which is similar with human bone. For the hydrothermal reaction, temperature is the key to form nanostructure HA.

Stabilization of Ca-deficient hydroxyapatite in biphasic calcium phosphate ceramics by adding alginate to enhance their biological performances

It is of significance to further improve the bioactivity of existing calcium phosphate (Ca–P) biomaterials to satisfy the needs of regenerative medicine.

"Fabrication of arbitrarily shaped carbonate apatite foam based on the interlocking process of dicalcium hydrogen phosphate dihydrate"

Carbonate apatite (CO₃Ap) foam with an interconnected porous structure is highly attractive as a scaffold for bone replacement. In this study, arbitrarily shaped CO₃Ap foam was formed from α-tricalcium phosphate (α-TCP) foam granules via a two-step process involving treatment with acidic calcium phosphate solution followed by hydrothermal treatment with NaHCO₃. The treatment with acidic calcium phosphate solution, which is key to fabricating arbitrarily shaped CO₃Ap foam, enables dicalcium hydrogen phosphate dihydrate (DCPD) crystals to form on the α-TCP foam granules. The generated DCPD crystals cause the α-TCP granules to interlock with each other, inducing an α-TCP/DCPD foam. The interlocking structure containing DCPD crystals can survive hydrothermal treatment with NaHCO₃. The arbitrarily shaped CO₃Ap foam was fabricated from the α-TCP/DCPD foam via hydrothermal treatment at 200 °C for 24 h in the presence of a large amount of NaHCO₃.

Spatial charge manipulated set-selective apatite deposition on micropatterned piezoceramic

Apatite was selectively deposited with the manipulation of spatial charge on the micropatterned piezoelectric K_0.5Na_0.5NbO₃.

Hydrogen-substituted β-tricalcium phosphate synthesized in organic media

β-Tricalcium phosphate (β-TCP) platelets synthesized in ethylene glycol offer interesting geometries for nano-structured composite bone substitutes but were never crystallographically analyzed. In this study, powder X-ray diffraction and Rietveld refinement revealed a discrepancy between the platelet structure and the known β-TCP crystal model. In contrast, a model featuring partial H for Ca substitution and the inversion of P1O₄ tetrahedra, adopted from the whitlockite structure, allowed for a refinement with minimal misfits and was corroborated by HPO₄^2- absorptions in Fourier-transform IR spectra. The Ca/P ratio converged to 1.443 ± 0.003 (n = 36), independently of synthesis conditions. As a quantitative verification, the platelets were thermally decomposed into hydrogen-free β-TCP and β-calcium pyrophosphate which resulted in a global Ca/P ratio in close agreement with the initial β-TCP Ca/P ratio (ΔCa/P = 0.003) and with the chemical composition measured by inductively coupled plasma (ΔCa/P = 0.003). These findings thus describe for the first time a hydrogen-substituted β-TCP structure, i.e. a Mg-free whitlockite, represented by the formula Ca_21 - x(HPO₄)_2x(PO₄)_14 - 2x, where x = 0.80 ± 0.04, and may have implications for resorption properties of bone regenerative materials.

Electric field-assisted formation of organically modified hydroxyapatite (ormoHAP) spheres in carboxymethylated gelatin gels

A biomimetic strategy was developed in order to prepare organically modified hydroxyapatite (ormoHAP) with spherical shape. The technical approach is based on electric field-assisted migration of calcium ions and phosphate ions into a hydrogel composed of carboxymethylated gelatin. The electric field as well as the carboxymethylation using glucuronic acid (GlcA) significantly accelerates the mineralization process, which makes the process feasible for lab scale production of ormoHAP spheres and probably beyond. A further process was developed for gentle separation of the ormoHAP spheres from the gelatin gel without compromising the morphology of the mineral. The term ormoHAP was chosen since morphological analyses using electron microscopy (SEM, TEM) and element analysis (EDX, FT-IR, XRD) confirmed that carboxymethylated gelatin molecules use to act as organic templates for the formation of nanocrystalline HAP. The hydroxyapatite (HAP) crystals self-organize to form hollow spheres with diameters ranging from 100 to 500nm. The combination of the biocompatible chemical composition and the unique structure of the nanocomposites is considered to be a useful basis for future applications in functionalized degradable biomaterials.

STATEMENT OF SIGNIFICANCE

A novel bioinspired mineralization process was developed based on electric field-assisted migration of calcium and phosphate ions into biochemically carboxymethylated gelatin acting as organic template. Advantages over conventional hydroxyapatite include particle size distribution and homogeneity as well as achievable mechanical properties of relevant composites. Moreover, specifically developed calcium ion or phosphate ion release during degradation can be useful to adjust the fate of bone cells in order to manipulate remodeling processes. The hollow structure of the spheres can be useful for embedding drugs in the core, encapsulated by the highly mineralized outer shell. In this way, controlled drug release could be achieved, which enables advanced strategies for threating bone-related diseases, e.g. osteoporosis and multiple myeloma.

Regulating the antibiotic drug release from β-tricalcium phosphate ceramics by atmospheric plasma surface engineering

Atmospheric plasma jet is a new promising tool that leads to the design of controlled drug release from bioceramic matrices.

In Vitro and in Vivo Studies of Novel Poly(D,L-lactic acid), Superhydrophilic Carbon Nanotubes, and Nanohydroxyapatite Scaffolds for Bone Regeneration

Poly(D,L-lactide acid, PDLLA) has been researched for scaffolds in bone regeneration. However, its hydrophobocity and smooth surface impedes its interaction with biological fluid and cell adhesion. To alter the surface characteristics, different surface modification techniques have been developed to facilitate biological application. The present study compared two different routes to produce PDLLA/superhydrophilic vertically aligned carbon nanotubes:nanohydroxyapatite (PDLLA/VACNT-O:nHAp) scaffolds. For this, we used electrodeposition and immersion in simulated body fluid (SBF). Characterization by goniometry, scanning electron microscopy, X-ray diffraction, and infrared spectroscopy confirmed the polymer modifications, the in vitro bioactivity, and biomineralization. Differential scanning calorimetry and thermal gravimetric analyses showed that the inclusion of VACNT-O:nHA probably acts as a nucleating agent increasing the crystallization rate in the neat PDLLA without structural alteration. Our results showed the formation of a dense nHAp layer on all scaffolds after 14 days of immersion in SBF solution; the most intense carbonated nHAp peaks observed in the PDLLA/VACNT-O:nHAp samples suggest higher calcium precipitation compared to the PDLLA control. Both cell viability and alkaline phosphatase assays showed favorable results, because no cytotoxic effects were present and all produced scaffolds were able to induce detectable mineralization. Bone defects were used to evaluate the bone regeneration; the confocal Raman and histological results confirmed high potential for bone applications. In vivo study showed that the PDLLA/VACNT-O:nHAp scaffolds mimicked the immature bone and induced bone remodeling. These findings indicate surface improvement and the applicability of this new nanobiomaterial for bone regenerative medicine.

Biomineralized matrices dominate soluble cues to direct osteogenic differentiation of human mesenchymal stem cells through adenosine signaling

Stem cell differentiation is determined by a repertoire of signals from its microenvironment, which includes the extracellular matrix (ECM) and soluble cues. The ability of mesenchymal stem cells (MSCs), a common precursor for the skeletal system, to differentiate into osteoblasts and adipocytes in response to their local cues plays an important role in skeletal tissue regeneration and homeostasis. In this study, we investigated whether a bone-specific calcium phosphate (CaP) mineral environment could induce osteogenic differentiation of human MSCs, while inhibiting their adipogenic differentiation, in the presence of adipogenic-inducing medium. We also examined the mechanism through which the mineralized matrix suppresses adipogenesis of hMSCs to promote their osteogenic differentiation. Our results show that hMSCs cultured on mineralized matrices underwent osteogenic differentiation despite being cultured in the presence of adipogenic medium, which indicates the dominance of matrix-based cues of the mineralized matrix in directing osteogenic commitment of stem cells. Furthermore, the mineralized matrix-driven attenuation of adipogenesis was reversed with the inhibition of A2b adenosine receptor (A2bR), implicating a role of adenosine signaling in mineralized environment-mediated inhibition of adipogenesis. Such synthetic matrices with an intrinsic ability to direct differentiation of multipotent adult stem cells toward a targeted phenotype while inhibiting their differentiation into other lineages not only will be a powerful tool in delineating the role of complex microenvironmental cues on stem cell commitment but also will contribute to functional tissue engineering and their translational applications.

A New Bioactive Polylactide-based Composite with High Mechanical Strength

A new bioresorbable polylactide/calcium phosphate composite with improved mechanical strengths and a more basic filler, tetracalcium phosphate (TTCP), was prepared by melt compounding. N-(2-aminoethyl)-3-aminoproplytrimethoxysilane (AEAPS) and pyromellitic dianhydride (PMDA) were used to improve the interfacial adhesion between TTCP and polylactide (PLA). While AEAPS improved the dispersion of TTCP in the matrix, PMDA might react with the terminal hydroxyl group of PLA and the amino group on the surface of AEAPS modified TTCP, which could further enhance the interfacial strength. The tensile strength was improved to 68.4 MPa for the PLA/TTCP-AEAPS composite from 51.5 MPa for the PLA/TTCP composite (20 wt% of TTCP). Dynamic mechanical analysis suggested that there was a 51 % improvement in storage modulus compared to that of PLA alone, when PMDA (0.2 wt% of PMDA) was incorporated into the PLA/TTCP-AEAPS composite (5 wt% of TTCP). Using this new bioresorbable PLA composite incorporated with a more basic filler for biomedical application, the inflammation and allergic effect resulted from the degraded acidic product are expected to be reduced.

Biomineralized matrix-assisted osteogenic differentiation of human embryonic stem cells

The physical and chemical properties of a matrix play an important role in determining various cellular behaviors, including lineage specificity. We demonstrate that the differentiation commitment of human embryonic stem cells (hESCs), both in vitro and in vivo, can be solely achieved through synthetic biomaterials. hESCs were cultured using mineralized synthetic matrices mimicking a calcium phosphate (CaP)-rich bone environment differentiated into osteoblasts in the absence of any osteogenic inducing supplements. When implanted in vivo, these hESC-laden mineralized matrices contributed to ectopic bone tissue formation. In contrast, cells within the corresponding non-mineralized matrices underwent either osteogenic or adipogenic fate depending upon the local cues present in the microenvironment. To our knowledge, this is the first demonstration where synthetic matrices are shown to induce terminal cell fate specification of hESCs exclusively by biomaterial-based cues both in vitro and in vivo. Technologies that utilize tissue specific cell-matrix interactions to control stem cell fate could be a powerful tool in regenerative medicine. Such approaches can be used as a tool to advance our basic understanding and assess the translational potential of stem cells.

The use of physiological solutions or media in calcium phosphate synthesis and processing

This review examined the literature to spot uses, if any, of physiological solutions/media for the in situ synthesis of calcium phosphates (CaP) under processing conditions (i.e. temperature, pH, concentration of inorganic ions present in media) mimicking those prevalent in the human hard tissue environments. There happens to be a variety of aqueous solutions or media developed for different purposes; sometimes they have been named as physiological saline, isotonic solution, cell culture solution, metastable CaP solution, supersaturated calcification solution, simulated body fluid or even dialysate solution (for dialysis patients). Most of the time such solutions were not used as the aqueous medium to perform the biomimetic synthesis of calcium phosphates, and their use was usually limited to the in vitro testing of synthetic biomaterials. This review illustrates that only a limited number of research studies used physiological solutions or media such as Earle's balanced salt solution, Bachra et al. solutions or Tris-buffered simulated body fluid solution containing 27mM HCO3(-) for synthesizing CaP, and these studies have consistently reported the formation of X-ray-amorphous CaP nanopowders instead of Ap-CaP or stoichiometric hydroxyapatite (HA, Ca10(PO4)6(OH)2) at 37°C and pH 7.4. By relying on the published articles, this review highlights the significance of the use of aqueous solutions containing 0.8-1.5 mMMg(2+), 22-27mM HCO3(-), 142-145mM Na(+), 5-5.8mM K(+), 103-133mM Cl(-), 1.8-3.75mM Ca(2+), and 0.8-1.67mM HPO4(2-), which essentially mimic the composition and the overall ionic strength of the human extracellular fluid (ECF), in forming the nanospheres of X-ray-amorphous CaP.

Bioeutectic® Ceramics for Biomedical Application Obtained by Laser Floating Zone Method. In vivo Evaluation

In this study, the Bioeutectic^® blocks were inserted into the critical size defects of eight rabbits, using both tibiae, and the physical and chemical nature of the remodeled interface between the Bioeutectic^® implants and the surrounding bone were performed at four and 15 months. The results showed a new fully mineralized bone growing in direct contact with the implants. The ionic exchange, taking place at the implant interface with the body fluids was essential in the process of the implant integration through a dissolution-precipitation-transformation mechanism. The study found the interface biologically and chemically active over the 15 months implantation period. The osteoblastic cells migrated towards the interface and colonized the surface at the contact areas with the bone. The new developed apatite structure of porous morphology mimics natural bone.

Biodegradation process of α-tricalcium phosphate and α-tricalcium phosphate solid solution bioceramics in vivo: a comparative study

This article reports the structure and morphology of the in vivo interface between implants composed of either a tricalcium phosphate (αTCP) or αTCP doped with 3.0 wt% dicalcium silicate (αTCP(ss)) ceramic, and natural bone of rabbit tibias. Both interfaces developed a new bone layer in direct contact with the implants after 4 and 8 weeks of implantation. The specimens were examined using analytical scanning and transmission electron microscopy, up to the lattice plane resolution level. Degradation processes of the implants developed at the interfaces encouraged osseous tissue ingrowth into the periphery of the material, changing the microstructure of the implants. The ionic exchange initiated at the implant interface with the environment was essential in the integration process of the implant, through a dissolution–precipitation–transformation mechanism. The interfaces developed normal biological and chemical activities and remained reactive over the 8-week period. Organized collagen fibrils were found at the αTCP(ss)/bone interface after 4 weeks, whereas a collagen-free layer was present around the Si-free αTCP implants. These findings suggest that the incorporation of silicate ions into αTCP ceramic promotes processes of the bone remodeling at the bone/αTCP(ss) interface, hence the solubility rate of the aTCP(ss) material decreased.

Tricalcium phosphate and tricalcium phosphate/polycaprolactone particulate composite for controlled release of protein

β-Tricalcium phosphate (β-TCP) with three different particle size ranges was used to study the effects of particle size and surface area on protein adsorption and release. Polycaprolactone (PCL) coating was applied on the particle systems to investigate its effect on particulate system properties from both structural and application aspects. The maximum loading of 27 mg/g was achieved for 100 nm particles. Bovine serum albumin (BSA) loading amount was controlled by varying the BSA loading solution concentration, as well as the sample powder's surface area. Increasing the surface area of the delivery powder significantly increased loading and release yield. Unlike the samples with low surface area, the lowest particle size samples showed sigmoidal release profile. This indicated that release was governed by different mechanisms for particles with different sizes. While the majority of samples showed no more than 50% release, the 550 nm particles demonstrated 100% release. PCL coating showed no significant ability to attenuate burst release in PBS. However, it led to a steadier release profile as compared to the bare TCP particles. FTIR analysis also proved that the secondary structure of BSA did not change significantly during the adsorption; however, minor denaturation was found during the release. The same results were found when PCL coating was applied on the TCP particles. We envision potential use of TCP and TCP+PCL systems in bone growth factor or orthopedic drug delivery applications in future bone tissue engineering application.

Silicon-stabilized α-tricalcium phosphate and its use in a calcium phosphate cement: characterization and cell response

α-Tricalcium phosphate (α-TCP) is widely used as a reactant in calcium phosphate cements. This work aims at doping α-TCP with silicon with a twofold objective. On the one hand, to study the effect of Si addition on the stability and reactivity of this polymorph. On the other, to develop Si-doped cements and to evaluate the effect of Si on their in vitro cell response. For this purpose a calcium-deficient hydroxyapatite was sintered at 1250°C with different amounts of silicon oxide. The high temperature polymorph α-TCP was stabilized by the presence of silicon, which inhibited reversion of the β→α transformation, whereas in the Si-free sample α-TCP completely reverted to the β-polymorph. However, the β-α transformation temperature was not affected by the presence of Si. Si-α-TCP and its Si-free counterpart were used as reactants for a calcium phosphate cement. While Si-α-TCP showed faster hydrolysis to calcium-deficient hydroxyapatite, upon complete reaction the crystalline phases, morphology and mechanical properties of both cements were similar. An in vitro cell culture study, in which osteoblast-like cells were exposed to the ions released by both materials, showed a delay in cell proliferation in both cases and stimulation of cell differentiation, more marked for the Si-containing cement. These results can be attributed to strong modification of the ionic concentrations in the culture medium by both materials. Ca-depletion from the medium was observed for both cements, whereas continuous Si release was detected for the Si-containing cement.

Gradual pore formation in natural origin scaffolds throughout subcutaneous implantation

This study used a rat subcutaneous implantation model to investigate gradual in situ pore formation in a self-regulating degradable chitosan-based material, which comprises lysozyme incorporated into biomimetic calcium phosphate (CaP) coatings at the surface to control the scaffold degradation and subsequent pore formation. Specifically, the in vivo degradation of the scaffolds, the in situ pore formation, and the tissue response were investigated. Chitosan or chitosan/starch scaffolds were studied with and without a CaP coating in the presence or absence of lysozyme for a total of six experimental groups. Twenty-four scaffolds per group were implanted, and eight scaffolds were retrieved at each of three time points (3, 6, and 12 weeks). Harvested samples were analyzed for weight loss, microcomputed tomography, and histological analysis. All scaffolds showed pronounced weight loss and pore formation as a function of time. The highest weight loss was 29.8% ± 1.5%, obtained at week 12 for CaP chitosan/starch scaffolds with lysozyme incorporated. Moreover, all experimental groups showed a significant increase in porosity after 12 weeks. At all time points no adverse tissue reaction was observed, and as degradation increased, histological analysis showed cellular ingrowth throughout the implants. Using this innovative methodology, the ability to gradually generate pores in situ was clearly demonstrated in vivo.

Mg- and Zn-modified calcium phosphates prepared by biomimetic precipitation and subsequent treatment at high temperature

Powders of magnesium-modified as well as zinc-modified calcium phosphates (Me-β-TCP and HA) with a (Ca(2+)+Mg(2+)+Zn(2+)+Na(+)+K(+))/P ratio of 1.3-1.4 and various Me(2+)/(Me(2+)+Ca(2+)) ratios (from 0.005 to 0.16) were prepared in biomimetic electrolyte systems at pH 8, mother liquid maturation and further syntering at 600-1000°C. Some differences in zinc and magnesium modifications have been prognosed on the basis of thermodynamic modeling of the studied systems and explained by the Mg(2+) and Zn(2+) ion chemical behaviour. The temperature as well as the degree of Zn(2+) and Mg(2+) ions substitutions were found to stabilize the β-TCP structure and this effect was more prononced for zinc. Thus, zinc-modified β-TCP powders consisting of idiomorphic crystals were obtained through sintering of Zn(2+) ion substituted calcium phosphates precursors at 800-1000°C. The Mg(2+) ion substitution leads to obtaining magnesium-modified β-TCP with spherical grains.

Poly (L-lactic acid)/calcium-deficient nanohydroxyapatite electrospun mats for bone marrow stem cell cultures

Electrospinning of bioresorbable polymers is a promising and valuable scaffolding technique. To improve its potential applications, the addition of specific fillers has been considered. This paper reports the fabrication of electrospun poly(L-lactic acid)/Ca-deficient-hydroxyapatite (PLLA/dHAp) mats, the content of nanosized d-HAp ranged between 1 and 8 wt%. All samples consisted of micrometric and submicrometric fibers, comprising 2D voids of 8 and 13 µm for PLLA and PLLA/d-HAp mats, respectively. The surface of the electrospun fibers was characterized by an uniform distribution of nanopores. Hybrid mats loaded with 1 wt% d-HAp showed the most homogeneous microstructure, differently from the mats loaded with 4 and 8 wt% d-HAp due to the presence of microagglomerates. The viscoelastic properties of PLLA/d-HAp hybrids were characterized by a decreasing trend of the storage modulus with increases in the nanofiller content. The microstructure, viscoelastic behavior, and cytocompatibility were investigated using murine bone marrow mesenchymal stem cells. On the basis of the biological data, the electrospun PLLA and PLLA/d-HAp mats can be regarded as potential scaffolds for bone marrow mesenchymal stem cells culture.